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Binds with estrogen receptors in cytoplasm, increasing secretion of folliclestimulating hormone, luteinizing hormone, and gonadotropin in hypothalamus and pituitary gland. • As appropriate, review all other significant and life-threatening adverse reactions. • Inform patient that drug increases risk of multiple births, which heightens maternal risk. for 5 days starting any time in patients with no recent uterine bleeding; or 50 mg/day P. CNS: nervousness, insomnia, dizziness, light-headedness CV: vasomotor flushing EENT: visual disturbances GI: nausea; vomiting; abdominal discomfort, distention, and bloating GU: breast tenderness, ovarian enlargement, multiple pregnancies, birth defects in resulting pregnancies, ovarian hyperstimulation syndrome, uterine bleeding Instruct patient to immediately report signs and symptoms of ovarian hyperstimulation syndrome, including nausea, vomiting, diarrhea, abdominal or pelvic pain, and swelling in hands or legs. • Advise patient not to take drug if she is or may become pregnant. If ovulation doesn't occur, increase to 100 mg/day P. If patient doesn't respond after three courses, no further doses are recommended. Start next course of therapy as early as 30 days after previous course. 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It means that it will in some tissues act as an estrogen and in others block estrogen. However, the bottom line is that in males it generally works its hormonal magic by blocking or inhibiting estrogen at the hypothalamus which, in turn, stimulates Gn RH and, further downstream, LH (leutinizing hormone) in the pituitary. Males can see their low testosterone levels double or more, especially in the case of secondary hypogonadism. Some decent research and years of clinical practice have born this out. For example, one study put 36 men with average total testosterone of 248 ng/dl on 25 mg/day of Clomid and after 4-6 weeks the men's average testosterone was a much improved 610 ng/dl. Clomid (clomiphene) or Nolvadex (tamoxifen), which is better? In this article we will try to resolve doubts about the choice between the two drugs, as well as find the differences: Clomid and Nolvadex. Clomiphene citrate (available in pharmacies under the brand names Clomid, Clomid) and tamoxifen (brand name Nolvadex) is antiestrogen belonging to the same group trifeniletilenov. They are structurally similar and are classified as selective modulators of estrogen receptors with mixed agonistic and antagonistic properties. This means that in certain tissue, they block the action of estrogen by binding to a receptor, while in other tissues could act as a real estrogen receptors activating. In men, both drugs act as anti-estrogens in their ability to interfere with estrogen negative feedback on the hypothalamus and stimulate the increased production of Gn RH (gonadotropin-releasing hormone). This will result in increased production of luteinizing hormone by the pituitary gland, which in turn can increase the production of testosterone by the testes. 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