Clofert Max

Clofert Max Uses, Dosage, Side Effects, Food Interaction and all others data.

A triphenyl ethylene stilbene derivative which is an estrogen agonist or antagonist depending on the target tissue.

Clomifene (previously clomiphene) is an orally administered, non steroidal, ovulatory stimulant that acts as a selective estrogen receptor modulator (SERM). Clomifene can lead to multiple ovulation, and hence increase the risk of conceiving twins. In comparison to purified FSH, the rate of ovarian hyperstimulation syndrome is low. There may be an increased risk of ovarian cancer and weight gain. Clomifene is capable of interacting with estrogen-receptor-containing tissues, including the hypothalamus, pituitary, ovary, endometrium, vagina, and cervix. It may compete with estrogen for estrogen-receptor-binding sites and may delay replenishment of intracellular estrogen receptors. Clomifene initiates a series of endocrine events culminating in a preovulatory gonadotropin surge and subsequent follicular rupture. The first endocrine event, in response to a course of clomifene therapy, is an increase in the release of pituitary gonadotropins. This initiates steroidogenesis and folliculogenesis resulting in growth of the ovarian follicle and an increase in the circulating level of estradiol. Following ovulation, plasma progesterone and estradiol rise and fall as they would in a normal ovulatory cycle.

Coenzyme Q10 is an essential cofactor in the mitochondrial electron transport chain, where it accepts electrons from complex I and II, an activity that is vital for the production of ATP.

Ubidecarenon has roles in many prysiological process including sulfide oxidation, regulation of mitochondrial permeability transition pore and translocation of protons and calcium ions accross biological membranes. Studies have shown its benefitial effect in treating cancer, statin myopathy, congestive heart failure and hypertension.

Clofert Max
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Clofert Max
Generic	Clomifene + Ubidecarenone
Weight	25mg
Type	Tablet
Therapeutic Class
Manufacturer	Maneesh Pharmaceuticals Ltd
Available Country	India
Last Updated:	September 19, 2023 at 7:00 am

Uses

Clomifene is a medication used to induce ovulation.

Used mainly in female infertility due to anovulation (e.g. due to polycystic ovary syndrome) to induce ovulation.

HMG CoA reductase inhibitors mediated decreased level of Coenzyme Q10 in blood, Drug induced Myopathy, Protects body against free radical damage with its antioxidant property, Adjuvant therapy in cardiovascular disease especially in angina and congestive heart failure, Immune system depression, Cognitive decline, Useful in the management of Periodontal Disease

Clofert Max is also used to associated treatment for these conditions: Ovulatory DysfunctionMigraine

How Clofert Max works

Clomifene has both estrogenic and anti-estrogenic properties, but its precise mechanism of action has not been determined. Clomifene appears to stumulate the release of gonadotropins, follicle-stimulating hormone (FSH), and leuteinizing hormone (LH), which leads to the development and maturation of ovarian follicle, ovulation, and subsequent development and function of the coprus luteum, thus resulting in pregnancy. Gonadotropin release may result from direct stimulation of the hypothalamic-pituitary axis or from a decreased inhibitory influence of estrogens on the hypothalamic-pituitary axis by competing with the endogenous estrogens of the uterus, pituitary, or hypothalamus. Clomifene has no apparent progestational, androgenic, or antrandrogenic effects and does not appear to interfere with pituitary-adrenal or pituitary-thyroid function.

Ubidecarenone is an essential cofactor in the mitochondrial electron transport chain. Its functions are the acceptance of electrons from the complex I and II and this activity is vital for the production of ATP. It acts as a mobile redox agent shuttling electrons and protons in the electron transport chain. Ubidecarenone also presents antioxidant activity in mitochondria and cellular membranes, protecting against peroxidation of lipid membranes as well as inhibiting oxidation of LDL-cholesterol.

Dosage

Clofert Max dosage

The recommended dose of Co-enzyme Q10 is:

For Co-enzyme Q10 deficiency:150 mg daily.

For mitochondrial disorders:150-160 mg, or 2 mg/kg/day.

For heart failure in adults:100 mg per day divided into 2 or 3 doses.

For recent myocardial infarction:120 mg daily in 2 divided doses.

For high blood pressure:120-200 mg per day divided into 2 doses.

For isolated systolic hypertension:60 mg twice daily.

For preventing migraine headache:100 mg three times daily.

For Parkinsons disease:300 mg, 600 mg, 1200 mg and 2400 mg per day in 3-4 divided doses.

For infertility in men:200-300 mg per day.

For muscular dystrophy:100 mg per day.

Dividing the total daily dose by taking smaller amounts two or three times a day instead of a large amount all at once can help to reduce side effects.

Side Effects

Coenzyme Q10 is well tolerated and having no significant side effects. Mild gastrointestinal symptoms such as nausea, diarrhea and epigastric distress have been reported.

Toxicity

The acute oral LD₅₀ of clomifene is 1700 mg/kg in mice and 5750 mg/kg in rats. The toxic dose in humans is not known. Toxic effects accompanying acute overdosage of clomifene have not been reported. Signs and symptoms of overdosage as a result of the use of more than the recommended dose during clomifene therapy include nausea, vomiting, vasomotor flushes, visual blurring, spots or flashes, scotomata, ovarian enlargement with pelvic or abdominal pain.

There have not been reports of adverse events of diet supplementation with ubidecarenone. The normal side effects reported in humans are related to the gastrointestinal tract.

Precaution

Supplemental Coenzyme Q10 may improve beta-cell function and glycemic control in type II diabetics. Therefore, those diabetic patients who do use supplemental Coenzyme Q10 should determine by appropriate monitoring if they need to make any adjustments in their diabetic medications.

Interaction

Warfarin: Supplemental Coenzyme Q10 may decrease the effectiveness of Warfarin.

Statins: The statin drugs are known to decrease Coenzyme Q10 levels in humans.

Doxorubicin: Coenzyme Q10 may increase the cardiotoxicity of doxorubicin.

Antidiabetic medications: Coenzyme Q10 may improve glycemic control in some type II diabetics. If this were to occur, antidiabetic medications might need appropriate adjusting

Volume of Distribution

Ubidecarenone is distributed to the various tissues of the body and it is able to enter the brain. In preclinical studies with intravenous administration of ubidecarenone, it is reported a volume of distribution of 20.4 L/kg which reflects its ability to penetrate extensively into organs and tissues. AS a general rule, tissues with high-energy requirements or metabolic activity tend to presents higher amounts of ubidecarenone, these organs can be heart, kidney, liver and muscle.

Elimination Route

Based on early studies with 14 C-labeled clomifene, the drug was shown to be readily absorbed orally in humans.

Ubidecarenone is absorbed from the small intestine into the lymphatics and then it can enter the blood. The hydrophobicity and large molecular weight limit its absorption making it very poor and variable depending on the food intake and the number of lipids presented in the food. The absorption is lower in the presence of an empty stomach and greater in presence of high lipid food diet. The daily dosage of ubidecarenone presents the reach of maximal serum concentration by reaching a plateau after three weeks. The pharmacokinetic properties may vary between different brands but studies have reported an AUC of 11.51 mcg h/ml and a Cmax of 0.32 mcg/ml at a time of 7.9 h.

Half Life

5-7 days

The pharmacokinetic properties may vary between different brands but studies have reported a half-life of ubidecarenone of 21.7 h.

Clearance

In preclinical studies with intravenous administration of ubidecarenone, it is reported a total clearance of 1.18 ml h/kg which was indicative of a prolonged elimination.

Elimination Route

Based on early studies with 14C-labeled clomiphene citrate, the drug was shown to be readily absorbed orally in humans and excreted principally in the feces. Mean urinary excretion was approximately 8% with fecal excretion of about 42%.

The main elimination route of ubidecarenone is through the bile. After its oral administration, over 60% of the dose is excreted in the feces in the form of unchanged ubidecarenone and a small fraction of the metabolites. In the urine, ubidecarenone is bound to saposin B protein and represents only 8.3% of the total administered dose.