Clomid/Nolva&Eye Related Problems

[thegodfather]

safety

[BajanBastard]

I know for a fact that clomid fvcks with your vision, nolva insert also says nolva can cause vision problems. What doses of clomid/nolva do you usually run?

[cheezy12]

I didn't kow that. Hmm I'm gonna have to look that up.

[Stackertoo]

That crap gave me bacne from hell, LSD vision and depression.
Sounds like tons of fun.

[thegodfather]

I know for a fact that clomid fvcks with your vision, nolva insert also says nolva can cause vision problems. What doses of clomid/nolva do you usually run?

Nolva at 40mg/ED and as much trib as I can get my hands on...I bounce back ok from that...but I have thus far avoided running nolva all the way through a cycle. One theory I had as to why some people experience bad sides on Clomid/Nolva is overdosing, 300/100/50 is not the way Clomid is prescribed and is a massive dose, even medically. Although, the eye problems I've seen in some reports were on dosages as little as 20mg and for only 5 days in some cases. The problem is, this holds me back from running a long cycle or very suppressive compounds as I'm reluctant to take my chances running high doses of both compounds.

[Reprisal 6]

I'm interested as well. I have seen many people having problems that sometimes don't subside for weeks or even months. Including myself.

[thegodfather]

I'm interested as well. I have seen many people having problems that sometimes don't subside for weeks or even months. Including myself.

JAMA, The Journal of the American Medical Association, Dec 20, 1995 v274 n23 p1820F(1)
Visual disturbance secondary to clomiphene citrate. (Arch Ophthalmol 1995;113:482-484)(Abstract) Valerie A. Purvin.

Full Text: COPYRIGHT 1995 American Medical Association

Objective: To identify a distinctive constellation of persistent visual abnormalities secondary to treatment with clomiphene citrate.

Design: Description of the clinical findings in three patients with visual disturbance secondary to clomiphene treatment.

Setting. A neuro-ophthalmology referral center.

Patients: Three women aged 32 to 36 years treated for infertility with clomiphene for 4 to 15 months.

Results: All three patients experienced prolonged afterimages (palinopsia), shimmering of the peripheral field, and photophobia while undergoing treatment with clomiphene. The results of the neuro-ophthalmologic examination and electrophysiologic studies were normal in all three patients. Unlike previously reported cases, visual symptoms did not resolve on cessation of treatment. Patients remain symptomatic from 2 to 7 years after discontinuing treatment with the medication.

Conclusions: Treatment with clomiphene can cause prolonged visual disturbance. Patients who develop such symptoms should be advised that continued administration may cause irreversible changes. Women with characteristic visual symptoms should be questioned about past use of clomiphene.

(1995;113-482-484) Valerie A. Purvin, Midwest Eye Institute, 1800 N Capitol Ave, Indianapolis, IN 46202.

__________________________________________________ _______________
Optic neuropathy associated with clomiphene citrate therapy.

Lawton AW.

Department of Ophthalmology, Louisiana State University School of Medicine, New Orleans.

A 31-year-old woman developed acute visual loss in her right eye immediately after a 5-day course of CC for primary infertility. Although she gradually recovered vision, she did not return to 20/20 acuity in that eye. As CC may cause vascular sludging, it is hypothesized that increased blood viscosity resulted in sufficiently reduced flow in a posterior ciliary artery to produce an anterior ischemic optic neuropathy. Patients experiencing visual symptoms while taking clomiphene should have their eyes examined promptly for evidence of visual changes or optic nerve injury.

PMID: 8299802 [PubMed - indexed for MEDLINE]






Tamoxifen is actually associated with ocular toxicity as well. As with clomid, the changes are generally reversible. It also seems to take longer for symptoms to appear in tamoxifen users, but there are case reports like the brief abstract below where onset of symptoms is rapid.

Cancer. 1988 Jan 1;61(1):33-5.

Reversible ocular toxicity related to tamoxifen therapy.

Ashford AR, Donev I, Tiwari RP, Garrett TJ.

Department of Medicine, Harlem Hospital Center, New York, NY 10037.

A 42-year-old woman with metastatic breast cancer developed bilateral optic disc swelling, retinal hemorrhages, and visual impairment three weeks after starting treatment with low doses of tamoxifen. Neurologic evaluation failed to provide an explanation for the ocular findings which resolved completely after cessation of tamoxifen therapy. This case suggests that tamoxifen has the potential for causing serious ophthalmologic toxicity which may be reversible if recognized early.

Long term studies in breast cancer patients using tamoxifen have shown an incidence of ocular toxicity of about 6%, with retinal opacity being the irreversible side effect. Other optic problems seem to resolve when the drug is withdrawn.

[thegodfather]

I've posted that case study before on here...Symptoms lasting 2-7 years is all I needed to see to keep me away from Clomid...With my existing eye conditions I dont think I can risk using Clomid at all in my PCT...Nolvadex seems to be the lesser of two evils when comparing the two, however it too caused significant damage to the eye...As you can see, this is a perplexing situation I'm in with wanting to continue cycling, Im just not willing to risk further complications to my vision over it...

[BajanBastard]

40mg in IMO too high a dose and overkill, 10-20mg should be enough.

[Timm1704]

surely there is other ways of regaining your natural testosterone production without the (simple and effective) use of clomid or nolvadex . i hope there is after reading this thread

[thegodfather]

Possible food and drug interactions when taking Nolvadex
If Nolvadex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Nolvadex with the following:

Aminoglutethimide (Cytadren )
Blood-thinning drugs such as Coumadin
Bromocriptine (Parlodel)
Cancer drugs such as Cytoxan
Letrozole (Femara)
Phenobarbital
Rifampin (Rifadin)
__________________________________________________ _______________

Effects on the Eye: Ocular disturbances, including corneal changes, decrement in color vision perception, retinal vein thrombosis, and retinopathy have been reported in patients receiving NOLVADEX. An increased incidence of cataracts and the need for cataract surgery have been reported in patients receiving NOLVADEX.

In the NSABP P-1 trial, an increased risk of borderline significance of developing cataracts among those women without cataracts at baseline (540-NOLVADEX; 483-placebo; RR=1.13, 95% CI: 1.00-1.28) was observed. Among these same women, NOLVADEX was associated with an increased risk of having cataract surgery (101-NOLVADEX; 63-placebo; RR=1.62, 95% CI: 1.17-2.25) (See Table 3 in CLINICAL PHARMACOLOGY ). Among all women on the trial (with or without cataracts at baseline), NOLVADEX was associated with an increased risk of having cataract surgery (201-NOLVADEX; 129-placebo; RR=1.51, 95% CI: 1.21-1.89). Eye examinations were not required during the study. No other conclusions regarding non-cataract ophthalmic events can be made.

http://www.drugs.com/Tamoxifen_Citrate/index.html

__________________________________________________ _______________
PURPOSE: To estimate the prevalence of abnormalities in visual function and ocular structures associated with the long-term use of tamoxifen citrate. METHODS: A single-masked, cross-sectional study involving multiple community and institutional ophthalmologic departments was conducted with a volunteer sample of 303 women with breast cancer currently taking part in a randomized clinical trial to determine the efficacy of tamoxifen (20 mg/day) in preventing recurrences. Participants included women who had never been on drug (n=85); women who had taken tamoxifen for an average of 4.8 years, then been off the drug for an average of 2.7 years (n=140); and women who had been on tamoxifen continuously for an average of 7.8 years (n=78). Women were evaluated by questionnaire, psychophysical testing, and clinical examination to determine any abnormalities in visual function and the comparative prevalences of corneal, lens, retinal, and optic nerve pathology. RESULTS: There were no cases of vision-threatening ocular toxicity among the tamoxifen-treated participants. Compared with nontreated participants, the tamoxifen-treated women had no differences in the activities of daily vision, visual acuity measurements, or other tests of visual function except for color screening. Intraretinal crystals (odds ratio [OR]=3.58, P=.178) and posterior subcapsular opacities (OR=4.03, P=.034) were more frequent in the tamoxifen-treated group. CONCLUSIONS: Women should have a thorough baseline ophthalmic evaluation within the first year of initiating tamoxifen therapy and receive appropriate follow-up evaluations.

http://0-www.ncbi.nlm.nih.gov.csulib...&dopt=Abstract
__________________________________________________ _______________

[thegodfather]

TAMOXIFEN (NOLVADEX ®)
Primary Use: Used in the treatment of metastatic breast cancer.
Guidelines for Management (modified after Gorin, et al): Because so many oncologists are requesting visual exams on their breast cancer patients who are taking tamoxifen, we are including here our recommended guidelines in following these patients.
15
1. Baseline ophthalmic examination within the first year of starting tamoxifen. This should include slit lamp biomicroscopy of the anterior and posterior segments in combination with a handheld indirect or contact lens. Baseline color vision testing is important.
2. In keeping with the American Academy of Ophthalmology’s current recommendations, in normal adults, do a complete eye examination at least every 2 years.More frequent examinations if ocular symptoms occur.
3. The discovery of a limited number of intraretinal crystals in the absence of macular edema or visual impairment does not seem to warrant discontinuation of the drug.
4. Consultation with the oncologist is essential if significant ocular findings occur.
5. Presence of age-related maculopathy is not a contraindication to the use of tamoxifen. However, informed consent may be advisable in our litigious society.
6. Presence of posterior subcapsular cataracts is not an indication to stop the drug since the condition usually progresses even if the drug is discontinued.
7. Significant color loss may be a valid reason to consider discontinuing the drug. Gorin, et al. recommend considering stopping the drug for 3 months (in patients on prophylactic therapy), and retesting. If the color vision returns to normal, restart the drug and retest in 3 months. If, at any time, there is no rebound from stopping the drug, or continued progression, then one may need to consult the oncologist and re-evaluate the risk/benefit.
Note: Gorin et al confirm the risk of tamoxifen in the causation of posterior subcapsular cataracts, but found minimal effects of this drug on retinal small vessel occlusive disease. No more a risk factor than hypertension or glaucoma.

http://piodr.sterling.net/staticCont...bus%202005.pdf