Enclomiphene vs Clomiphene: 7 Questions Answered for Each

Enclomiphene and clomiphene have similar names because they are chemically related, and they are often discussed together in connection with low testosterone in men. They are not interchangeable, and their standing with the FDA is very different. This guide asks the same seven questions about each one. It is educational and does not replace medical advice.

1. What is it?

• Clomiphene. A medication made of two closely related molecules, called isomers: enclomiphene and zuclomiphene.
• Enclomiphene. One of those two isomers, prepared without the other.

2. Is it FDA-approved?

• Clomiphene. Yes, for treating certain ovulation problems in women. It is not FDA-approved for any use in men.
• Enclomiphene. No. It is not FDA-approved for any use. An application for approval was submitted in the past and was not approved.

3. How is it used for men?

• Clomiphene. Some clinicians prescribe it to men off-label, which means for a purpose the FDA has not reviewed or approved.
• Enclomiphene. It is available only as a compounded medication prescribed by a licensed provider.

Neither one is an FDA-approved treatment for low testosterone.

4. How does it act?

• Both. They belong to a class called selective estrogen receptor modulators. They block estrogen receptors in the brain, which leads the brain to send stronger signals to the testicles.
• The difference. Clomiphene's second isomer, zuclomiphene, stays in the body considerably longer and has some estrogen-like activity. Enclomiphene does not include it.

How a medication acts does not establish how well it works or how safe it is for a particular person.

5. How much is known about side effects?

• Clomiphene. It has FDA-approved labeling, based on its approved use in women. That labeling lists visual symptoms, hot flashes, mood changes, headache, and abdominal discomfort, among others.
• Enclomiphene. It has no FDA-approved labeling. Information comes from limited studies and from what is known about related medications.

Claims that one causes fewer side effects than the other are not supported by an approved label. With either, any change in vision should be reported before the next dose.

6. How is it obtained?

• Clomiphene. As an FDA-approved generic tablet from a pharmacy, with a prescription.
• Enclomiphene. As a compounded medication from a state-licensed pharmacy, with a prescription. Compounded medications are not reviewed by the FDA for safety, effectiveness, or quality.

7. What should I tell a provider before either one?

• Any eye condition or previous visual problems
• A personal or family history of blood clots
• Liver disease
• A history of hormone-sensitive cancer
• All medications and supplements
• Plans to have children
• Whether you compete in a sport with drug testing, since both are prohibited under anti-doping rules

What the two have in common

• Both require a prescription and a confirmed diagnosis
• Both call for blood tests before and during treatment
• Neither is intended for men with normal testosterone levels
• Neither replaces attention to sleep, weight, alcohol, and other medications
• Responses vary from person to person

Questions to ask your provider

• Do my symptoms and blood tests confirm low testosterone?
• Which option are you recommending, and why?
• Is it FDA-approved, off-label, or compounded?
• How will I be monitored?
• Which symptoms should I report right away?

A note about Nu Image

Nu Image does not prescribe clomiphene. Nu Image offers online evaluations with licensed providers for men's hormone concerns, and one option a provider may consider is compounded enclomiphene in a rapid-dissolve tablet. It is not FDA-approved, and a prescription is not guaranteed.

This content is for educational purposes only and is not medical advice, diagnosis, or treatment. Enclomiphene is not approved by the FDA. Compounded medications are prepared by state-licensed compounding pharmacies and are not reviewed or approved by the FDA for safety, efficacy, or quality. Prescription products require an online consultation with a licensed healthcare provider, who will determine whether a prescription is appropriate.