At the recommended doses (short treatments) Prolifen side effects are not severe and do not interfere with treatment. The incidence of side effects is however directly proportional to the doses and the duration of treatment. The most common side effects of Prolifen include:
Vasomotor Symptoms – Prolifen Side Effects
Consisting of hot flushes, at times accompanied by hyperhidrosis (excessive sweating). These events, probably linked to neurovegetative modifications, may be partially determined by hypophyseal secretions and partially by the anti-estrogen effects of the drug. These disorders are encountered quite frequently but they do not generally cause discomfort and disappear as soon as treatment is suspended.
These are caused by abdominal tension, sense of swelling, pain and tender gonads. These occur quite frequently and may also be intense. Gonad pain is often related to ovulation or with ovarian swelling. The patients suffering from pelvic pain must be examined carefully to detect any enlargement of the ovaries.
Enlargement of the Ovaries and Ovarian Cysts
This complication, certainly undesirable, is reported by almost all authors: however at the recommended doses of Prolifen, abnormal ovarian enlargement occurs in a limited number of cases and does not generally cause any discomfort to the patient. It can be detected by and abnormally high increase in temperature or with the normal gynecological examinations and in general disappear with the suspension of treatment.
There are only two cases mentioned in literature which required surgery. If enlargement of the ovaries occurs, it is necessary to suspend Prolifen (clomiphene citrate) treatment until the ovaries return to normal dimensions, and a reduced dose and/or duration must be used for the successive treatments. The treatment of every cystic enlargement should always be conservative, unless surgery is indicated.
Visual Disturbances as Prolifen Side Effects
These disturbances, consisting of clouding, spots or flashing that appear with or are accentuated by exposure to intense light. They are probably linked to the mydriatic effect of the drug and disappear when treatment is suspended. Only one case of severe reduction in visual acuity has been described, that was reversed when treatment was suspended. Treatment with Prolifen must be suspended at the onset of visual disturbances and an ophthalmologic examination should be performed.
Other Disturbances With Prolifen Treatment
Other less frequently reported disturbances that generally occur for prolonged cycles include: nausea, vomiting, heartburn, nervousness, tiredness, vertigo or sensation of light-headedness, insomnia, headache, painful breasts, abundant menses, urticaria or allergic dermatitis, increase in weight, polyuria or pollakiuria, slight loss of hair that is reversible. A large number of patients treated with Prolifen reveal sulfobromophthalein sodium retention caused by intrahepatic cholestasis generally without symptoms. There has been just one case reported of jaundice.