Cyclofenil
Template:Short description Script error: No such module "Distinguish". Template:Drugbox Cyclofenil, sold under the brand name Sexovid among others, is a selective estrogen receptor modulator (SERM) medication which is used as a gonadotropin stimulant or ovulation inducer and in menopausal hormone therapy in women.[1][2][3][4] It is mostly no longer available.[4] The medication is taken by mouth.[5][6][7]
Side effects of cyclofenil include liver toxicity among others.[8] It is a selective estrogen receptor modulator (SERM) and hence is a mixed agonist–antagonist of the estrogen receptor (ER), the biological target of estrogens like estradiol.[6] It has antiestrogenic effects on the hypothalamic–pituitary–gonadal axis and hence can increase sex hormone production and stimulate ovulation.[6][9]
Cyclofenil was introduced for medical use in 1970.[10] It has been mostly discontinued, but remains available in a few countries, including Brazil, Italy, and Japan.[4][11][1] It has been used as a doping agent by male athletes.[6]
Medical use
Cyclofenil is used to treat menstrual disturbances and anovulatory infertility caused by insufficiency of the hypothalamic–pituitary–gonadal axis in women.[1] It has also been used to treat menopausal symptoms.[1] The medication is generally used at a dosage of 400 to 600 mg per day.[1][6][7]
Available forms
Cyclofenil has been available in the form of 100, 200, and 400 mg oral tablets.[6]
Non-medical use
Cyclofenil has been used by male athletes to increase testosterone levels.[6] It is not effective for this purpose in women.[6]
Contraindications
Cyclofenil is contraindicated during pregnancy and in those with severe liver disease and unexplained uterine bleeding.[12]
Side effects
Cyclofenil is associated with a relatively high incidence of hepatotoxicity.[8] Biochemical signs of undesirable liver changes have been observed in 35% or more of individuals and 1% of individuals experience overt hepatitis.[8]
Pharmacology
Pharmacodynamics
Cyclofenil is a SERM, or a mixed agonist and antagonist of the estrogen receptors (ERs).[6] It is described as a relatively weak/mild SERM.[6] The medication is generally less effective than other SERMs.[13] The medication is an "impeded estrogen" and is thought to work as a progonadotropin by blocking the actions of estrogens in the pituitary gland and hypothalamus, thereby disinhibiting release of the gonadotropins luteinizing hormone and follicle-stimulating hormone.[9] In men, cyclofenil can increase testosterone levels due its progonadotropic effects.[6]
Pharmacokinetics
In terms of distribution, cyclofenil acts both centrally and peripherally.[13] The elimination half-life of cyclofenil after a single 200 mg dose is 18 to 29 hours.[14][15]
Chemistry
Cyclofenil is a nonsteroidal SERM and is closely related structurally to triphenylethylene SERMs like clomifene and tamoxifen.[7] It has been referred to as a diphenylethylene derivative, differing from triphenylethylenes only by the replacement of one of the phenyl rings with a cyclohexane ring.[16][9]
History
Cyclofenil was first introduced for medical use in 1970 under the brand name Ondogyne in France.[10] Subsequently, it was introduced throughout the world under a variety of other brand names, including its most well-known brand name Sexovid.[10]
Society and culture
Generic names
Cyclofenil is the English generic name of the drug and its INN, USAN, and BAN.[2][3][4]
Brand names
Cyclofenil has been marketed under a variety of brand names including Ciclifen, Fertodur, Gyneuro, Klofenil, Menoferil, Menopax, Neoclym, Oginex, Ondonid, Ondogyne, Rehibin, Sexadieno, Sexovar, and Sexovid.[17][10][11]
Availability
Cyclofenil remains available today only in Brazil, Italy, and Japan.[4][11][1] In the past, it has also been available in France, Germany, Mexico, Sweden, Switzerland, Turkey, and the United Kingdom.[3][10][11][1]
Regulation
Cyclofenil is included on the World Anti-Doping Agency list of illegal doping agents in sport.[18][19]
Research
Cyclofenil was investigated as a possible treatment for scleroderma in the 1980s, but was found to be ineffective.[20] Later study of its efficacy in treating Raynaud's phenomenon in people with scleroderma also found no significant benefit.[21]
References
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