Enclomifene

rdf:langString Enclomifene

rdf:langString D10876

rdf:langString CCNCCOC1=CC=C/C/C3=CC=CC=C3

rdf:langString GKIRPKYJQBWNGO-OCEACIFDSA-N

rdf:langString Enclomiphene; -Clomifene; RMI-16289; Enclomid; Enclomifene citrate; Enclomiphene citrate

rdf:langString Androxal

rdf:langString R6D2UI4FLS

rdf:langString Enclomifene (INN), or enclomiphene (USAN), a nonsteroidal selective estrogen receptor modulator of the triphenylethylene group acts by antagonizing the estrogen receptor (ER) in the pituitary gland, which reduces negative feedback by estrogen on the hypothalamic-pituitary-gonadal axis, thereby increasing gonadotropin secretion and hence gonadal production of testosterone. It is one of the two stereoisomers of clomifene, which itself is a mixture of 38% zuclomifene and 62% enclomifene. Enclomifene is the (E)-stereoisomer of clomifene, while zuclomifene is the (Z)-stereoisomer. Whereas zuclomifene is more estrogenic, enclomifene is more antiestrogenic. In accordance, unlike enclomifene, zuclomifene is antigonadotropic due to activation of the ER and reduces testosterone levels in men. As such, isomerically pure enclomifene is more favorable than clomifene as a progonadotropin for the treatment of male hypogonadism. Enclomifene or Enclomiphene (former tentative brand names Androxal and EnCyzix), was under development for the treatment of male hypogonadism and type 2 diabetes. By December 2016, it was in preregistration and was under review by the Food and Drug Administration in the United States and the European Medicines Agency in the European Union. In January 2018, the Committee for Medicinal Products for Human Use of the European Medicines Agency recommended refusal of marketing authorization for enclomifene for the treatment of secondary hypogonadism. In April 2021, development of enclomifene was discontinued for all indications. Clomiphene citrate, of which enclomiphene citrate is derived from, is a drug approved by the Food and Drug Association (FDA) for indications of anovulatory or oligo-ovulatory infertility and male infertility (spermatogenesis induction). A media release by the FDA for the pharmacy compounding advisory committee compared the efficacy of testosterone replacement therapy against enclomiphene. They wrote that while testosterone replacement therapy often resulted in side effects such as transference risk, supranormal testosterone levels, suppressed spermatogenesis, suppressed testicular function, and testicular atrophy, none of these risks are present in enclomiphene. In 2009, a study discovered that “short-term clinical safety data for enclomiphene have been satisfactory and equivalent to safety data for testosterone gels and placebo.” In 2016, a study on enclomiphene citrate reported that “the ability [of enclomiphene citrate] to treat testosterone deficiency in men while maintaining fertility supports a role for enclomiphene citrate in the treatment of men in whom testosterone therapy is not a suitable option.” In 2019, a study was published that found that “enclomiphene has been shown to increase testosterone levels while stimulating [follicular-stimulating hormone] and [luteinizing hormone] production.” The key difference between enclomiphene citrate and traditional testosterone replacement therapy is that enclomiphene citrate stimulates the body to produce its own testosterone, while traditional testosterone replacement therapy replaces low testosterone levels in men with exogenous, synthetic testosterone. A study conducted in 2013 offered this assessment of the potential of enclomiphene citrate to increase sexual function in men: “If enclomiphene citrate can correct the central defect in men that blocks their ability to produce [lutenizing hormone] and [follicular-stimulating hormone] and thus to produce both testosterone and sperm in the testes, this drug may prove itself superior to other treatments.”

rdf:langString Androxal