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These disturbances may be irreversible, especially with increased dosage or duration of therapy. Patients should be warned that these visual symptoms render such activities as driving a car or operating machinery more hazardous than usual, particularly under conditions of variable lighting. These visual symptoms appear to be due to intensification and prolongation of after-images. Symptoms often first appear or are accentuated with exposure to a brightly lit environment. While measured visual acuity usually has not been affected, a study patient taking 200 mg clomiphene citrate daily developed visual blurring on the day 7 of treatment, which progressed to severe diminution of visual acuity by the day 10. No other abnormality was found, and the visual acuity returned to normal on the day 3 after treatment was stopped. Ophthalmologically definable scotomata and retinal cell function (electroretinographic) changes have also been reported. A patient treated during clinical studies developed phosphenes and scotomata during prolonged clomiphene citrate administration, which disappeared by the day 32 after stopping therapy. Post-marketing surveillance of adverse events has also revealed other visual signs and symptoms during clomiphene citrate therapy. The significance of these visual symptoms is not understood. While the aetiology of these visual symptoms is not yet understood, patients with any visual symptoms should discontinue treatment and have a complete ophthalmological evaluation carried out promptly. The ovarian hyperstimulation syndrome (OHSS) has been reported to occur in patients receiving clomiphene citrate for ovulation induction. It may progress rapidly (within 24 hours to several days) to become a serious medical event, anabolic steroids legal uk. In some cases, OHSS occurred following cyclic use of clomiphene citrate or when clomiphene citrate was used in combination with gonadotropins. Transient liver function test abnormalities suggestive of hepatic dysfunction, which may be accompanied by morphologic changes on liver biopsy, have been reported in association with OHSS. OHSS is a medical event distinct from uncomplicated ovarian enlargement. The clinical signs of this syndrome in severe cases can include gross ovarian enlargement, gastrointestinal symptoms, ascites, dyspnoea, oliguria, and pleural effusion. In addition, the following symptoms have been reported in association with this syndrome: pericardial effusion, anasarca, hydrothorax, acute abdomen, hypotension, renal failure, pulmonary oedema, intraperitoneal and ovarian haemorrhage, deep venous thrombosis, torsion of the ovary, and acute respiratory distress. The early warning signs of OHSS are abdominal pain and distention, nausea, vomiting, diarrhoea, and weight gain. Elevated urinary steroid levels, varying degrees of electrolyte imbalance, hypovolaemia, haemoconcentration, and hypoproteinaemia may occur. Death due to hypovolaemic shock, haemoconcentration, or thromboembolism has occurred. The patient who complains of abdominal or pelvic pain, discomfort, or distension after taking clomiphene citrate should be examined because of the possible presence of an ovarian cyst or other cause. Due to fragility of enlarged ovaries in severe cases, abdominal and pelvic examination should be performed very cautiously. If conception results, rapid progression to the severe form of the syndrome may occur. To minimize the hazard associated with occasional abnormal ovarian enlargement associated with clomiphene citrate, the lowest dose consistent with expected clinical results should be used. undefined Click here >>> prescription stool bulking agents for diarrhea, bulking and shredding cycle – buy legal anabolic steroids. Prescription stool bulking agents. 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