This is a novel, non-standard combination product primarily used in the Indian context for the management of male infertility, specifically oligospermia and asthenospermia, with adjunctive antioxidant support. Acetylcysteine provides mucolytic and antioxidant effects, Astaxanthin is a potent carotenoid antioxidant, and Clomiphene citrate is a selective estrogen receptor modulator (SERM) used to stimulate gonadotropin secretion. This combination is not a first-line therapy per international guidelines but is prescribed based on empirical evidence and clinical experience in India for improving semen parameters.
Adult: One tablet daily, preferably after a meal (to enhance Astaxanthin absorption). Duration: Typically prescribed for 3-6 months, reassessed based on semen analysis.
Note: Swallow whole with a full glass of water. Take with food, preferably a meal containing fats (e.g., milk, nuts) to improve Astaxanthin absorption. Avoid taking with antacids within 2 hours as they may interfere with absorption. Do not crush or chew.
The combination works synergistically: Clomiphene blocks estrogen receptors at the hypothalamus and pituitary, reducing negative feedback and increasing secretion of GnRH, FSH, and LH. Elevated FSH stimulates spermatogenesis in Sertoli cells, while LH stimulates Leydig cells to produce testosterone. Acetylcysteine, a precursor to glutathione, acts as a direct and indirect antioxidant, reducing oxidative stress in seminal plasma which is detrimental to sperm motility and DNA integrity. Astaxanthin, a powerful lipid-soluble antioxidant, protects sperm cell membranes from lipid peroxidation, improving sperm motility and morphology.
Pregnancy: CONTRANDICATED. Clomiphene is a Pregnancy Category X drug. It is teratogenic and can cause fetal abnormalities. Women of childbearing potential should use effective contraception during and for weeks after treatment if a male partner is taking this (though risk is indirect).
Driving: Caution advised. May cause dizziness, visual disturbances (blurred vision, photophobia), and fatigue, which can impair the ability to drive or operate machinery.
| Warfarin and other anticoagulants | Clomiphene may alter protein binding and increase bleeding risk. Acetylcysteine may have mild anticoagulant effect. | Major |
| Thyroid hormones | Clomiphene may increase serum thyroxine-binding globulin, altering thyroid function tests and potentially dose requirements. | Moderate |
| CYP2C9/2C19/3A4 inducers (e.g., Rifampicin, Carbamazepine, Phenytoin) | May decrease plasma levels of Clomiphene, reducing efficacy. | Moderate |
| CYP2C9/2C19/3A4 inhibitors (e.g., Fluconazole, Ketoconazole, Clarithromycin) | May increase plasma levels of Clomiphene, increasing toxicity risk. | Moderate |
| Nitroglycerin and other vasodilators | Concurrent use with Acetylcysteine may cause additive hypotensive effects. | Moderate |
| Activated Charcoal | May reduce absorption of Acetylcysteine and Astaxanthin if taken simultaneously. | Minor |
Same composition (Acetylcysteine (600mg) + Astaxanthin (4mg) + Clomiphene (100mg)), different brands: