Fast Facts
Active ingredient: Enclomiphene
Therapeutic area: Men's health - management of functional/secondary hypogonadism (low testosterone due to inadequate hypothalamic-pituitary signaling)
Strengths available: 50 mg tablets (formulations and availability vary by source)
Androxal is an oral, non-steroidal selective estrogen receptor modulator (SERM) investigated for the treatment of secondary hypogonadism in adult men. It is intended to help restore the body's own testosterone production rather than replace testosterone directly.
Jump to dosage instructions in the Dosage and Directions section or see its legal status in the United States under Legal Status and US Regulations.
How It Works
Enclomiphene selectively blocks estrogen feedback at the hypothalamus and pituitary. This can increase LH and FSH secretion, which may stimulate the testes to produce more endogenous testosterone and preserve fertility compared with exogenous testosterone therapy.
If you are comparing options, visit Similar or Alternative Medicines for a side-by-side understanding.
Dosage and Directions
Use exactly as prescribed by your clinician. Do not change your dose without medical advice.
- Swallow tablets whole with water. Do not crush, chew, or split unless your pharmacist says it is safe.
- Androxal may be taken with or without food, but try to take it at the same time each day for consistency.
- If your provider orders lab monitoring (testosterone, LH/FSH, hematocrit, liver enzymes), complete tests as scheduled to guide dose adjustments.
Important: Dosage regimens can differ based on clinical goals and response. Follow your personal plan rather than any general schedule you find online.
Precautions
Before starting Androxal, tell your healthcare provider about all medical conditions and medicines you use. Stop driving or using machinery if you develop vision changes.
- Visual symptoms (blurred vision, floaters, photophobia) can occur; seek medical advice if these appear.
- Liver conditions: use caution and monitor liver enzymes if you have a history of hepatic disease.
- Risk of venous thromboembolism with SERMs is low but possible; discuss your cardiovascular risk factors.
- Mood changes or headaches may occur; report persistent or severe symptoms.
Note: Some legacy warnings for clomiphene relate to female fertility treatment and do not apply to men (for example, ovarian cysts or abnormal uterine bleeding).
Who Should Not Use It
Do not take Androxal (enclomiphene) if you have:
- Known hypersensitivity to enclomiphene, clomiphene, or any tablet component
- Active or severe liver disease
- Unexplained visual disturbances
- Current or prior estrogen-dependent malignancy (discuss risks with your specialist)
Always have a clinician confirm that your low testosterone is due to secondary hypogonadism and not primary testicular failure or another condition requiring different management.
Possible Side Effects
Most effects are mild to moderate and may lessen with time. Contact a clinician if symptoms are severe or persistent.
- Visual disturbances (blurred vision, spots/floaters, sensitivity to light)
- Hot flashes or flushing
- Nausea or vomiting
- Headache
- Breast discomfort or tenderness
Rare but serious: signs of blood clots (leg swelling/pain, chest pain, shortness of breath), severe mood changes, jaundice or dark urine.
Drug Interactions
Tell your prescriber about all prescription, OTC, and supplement products you use. The following may interact or complicate monitoring:
- Thyroid hormone replacement (levothyroxine) - may alter symptom interpretation and lab assessments
- Immunosuppressants such as cyclosporine - monitor closely for adverse effects
- Estrogens or estrogen-containing therapies - may reduce the intended effect of enclomiphene
- Lipid-lowering agents (statins) - not a direct interaction, but report muscle/liver symptoms promptly
- Oral contraceptives/ethinyl estradiol (if applicable in household exposure or for partners) - theoretical counteraction of mechanism
Alcohol and grapefruit have no well-documented, consistent effect with enclomiphene, but moderation and consistent habits aid interpretation of lab trends.
Missed Dose
If you miss a dose, take it as soon as you remember unless it is close to your next dose. If it is almost time for the next dose, skip the missed tablet and resume the regular schedule. Do not double up.
Overdose
Seek medical help if you take more than prescribed. Symptoms may include nausea, vomiting, marked flushing, headache, or visual disturbances. Bring the medication pack or a list of medicines to the healthcare facility.
Storage
- Store at room temperature away from moisture, heat, and direct light.
- Keep out of reach of children and pets.
- Do not use after the expiration date; ask your pharmacist about safe disposal.
Similar or Alternative Medicines
Options depend on the cause of low testosterone, fertility goals, and risk profile. Discuss these with your clinician:
- Clomiphene citrate (brand: Clomid; generic widely available) - a racemic mixture SERM used off-label in men; increases LH/FSH similar to enclomiphene.
- Tamoxifen (Nolvadex) - SERM sometimes used off-label to stimulate gonadotropins; less commonly chosen than clomiphene.
- Aromatase inhibitors (e.g., anastrozole) - reduce estradiol and may modestly raise testosterone; helpful if estradiol is elevated.
- Human chorionic gonadotropin (hCG) - mimics LH to directly stimulate testicular testosterone; often used when fertility preservation is a priority.
- Testosterone replacement therapy (TRT: gels, injections, patches) - replaces testosterone directly; may suppress fertility without adjuncts.
See cost comparisons in Typical Prices in the USA.
Typical Prices in the USA (cash estimates)
Prices vary by pharmacy, region, insurance, and formulation. Approximate monthly ranges in USD:
- Enclomiphene (Androxal/compounded): about $50-$200 per month where legally compounded and prescribed.
- Clomiphene citrate (generic): roughly $10-$60 per month depending on dose and pharmacy discount programs.
- Tamoxifen (generic): often $9-$40 per month.
- Anastrozole (generic): typically $5-$40 per month.
- hCG (prescription): prices vary widely; ballpark $60-$180 for a multi-week supply depending on vial size and brand.
- TRT (testosterone cypionate injections, generic): about $25-$80 per month for medication alone; gels/patches can range $100-$400+ monthly.
These figures are illustrative and not offers. Use price comparison tools or talk to your pharmacist for real-time quotes.
Legal Status and US Regulations
Regulatory note: As of the most recent public information, Androxal (enclomiphene) is not FDA-approved for any indication in the United States. That means:
- Commercial marketing of Androxal as an FDA-approved drug is not permitted.
- Enclomiphene may sometimes be discussed for compounding. Compounding is tightly regulated under federal (Sections 503A/503B of the FD&C Act) and state laws. Availability depends on whether the bulk substance and formulation meet FDA and state board requirements; pharmacies may not legally compound if it violates those rules.
- Importation for personal use is generally prohibited; the FDA may exercise limited enforcement discretion in rare circumstances, but this is not guaranteed and does not apply to products that pose safety risks or are otherwise restricted.
- Enclomiphene is not a controlled substance; however, it remains prescription-only where legally obtainable.
- Clomiphene citrate, an FDA-approved drug for female infertility, can be prescribed off-label to men for secondary hypogonadism. Off-label prescribing is legal in the US when supported by a clinician's judgment.
Telehealth: Non-controlled prescription rules vary by state. The federal Ryan Haight Act primarily covers controlled substances; enclomiphene/clomiphene are not controlled, but state telemedicine standards and in-person exam requirements may apply.
Bottom line: To obtain therapy lawfully in the US, work with a licensed clinician and a licensed US pharmacy. Be cautious with overseas or unverified online sources.
For clinical use guidance, return to Dosage and Directions and Precautions.
