Enclomiphene and clomiphene are not two names for the same thing, but they are closely related. Clomiphene citrate is a racemic mixture of two isomers, enclomiphene (the trans-isomer) and zuclomiphene (the cis-isomer), while enclomiphene is the trans-isomer on its own. That is a difference in what the product contains, not a statement about how either one performs in any patient.
The regulatory picture differs too. Clomiphene citrate is an FDA-approved product, sold under the brand name Clomid, approved for ovulation induction in women; prescribing it to men for low testosterone is off-label. There is no FDA-approved enclomiphene product at all, so Enclomiphene for Low Testosterone is compounded as an oral capsule to a prescriber's order, is used off-label, and is not a controlled substance.
What is the difference between enclomiphene and clomiphene?
Start with chemistry, because that is where the two part ways. Clomiphene citrate is a mixture of two mirror-image forms of the same molecule. One of them is enclomiphene. The other is zuclomiphene, described as the more estrogenic of the two and as having a long half-life. Enclomiphene is the isomer without the zuclomiphene component, which is how Bayview's formulation page states it: unlike racemic clomiphene, enclomiphene lacks the long-half-life estrogenic zuclomiphene isomer.
Read that as composition, not as a ranking. Saying one preparation contains a second isomer and the other does not is a factual description of contents. It is not a claim that either is better tolerated, stronger, or more likely to work for you. Evidence in men is still developing for both, and neither has an FDA approval for low testosterone.
The second real difference is form and source. Clomiphene citrate reaches patients as a manufactured tablet. Enclomiphene reaches patients as a compounded capsule prepared by a pharmacy on an individual prescription, because no manufacturer holds an approved enclomiphene product.
How is enclomiphene understood to work?
Enclomiphene citrate is a selective estrogen receptor modulator, or SERM. It is understood to block estrogen's signal at the pituitary gland and the hypothalamus, which increases release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH prompts the testes to produce more testosterone, and FSH supports sperm production. Because this route acts through the body's own hormone axis rather than adding testosterone from outside, sperm production is generally maintained.
That mechanism is the reason the molecule comes up in conversations about fertility. It is a description of a pathway, not a promise about an outcome, and your prescriber is the one who decides whether any of it applies to your situation.
How do enclomiphene, clomiphene, and testosterone compare?
A few points sit under that table. Clomiphene citrate has an FDA approval, but it is an approval for ovulation induction in women, so every use in men is off-label. Enclomiphene has no approved product of any kind and is prescribed off-label. Testosterone is different in kind: FDA-approved testosterone products exist, it is a Schedule III controlled substance, and compounded testosterone for men is dispensed only on a prescription written for a named patient. Controlled substances are not shipped to New York addresses.
Why is enclomiphene compounded and clomiphene is not?
Because of who makes it. Clomiphene citrate has been a manufactured, FDA-approved drug for decades, so a pharmacist can fill a clomiphene prescription from commercial stock. No company holds an FDA approval for an enclomiphene product, so there is no commercial bottle to dispense. A patient whose prescriber writes for enclomiphene needs a compounding pharmacy to prepare it.
That is what a 503A pharmacy does. Bayview prepares each order in small batches under USP 795 non-sterile compounding standards, using the strength the prescriber specifies. The pharmacy does not provide consultations and does not decide whether a preparation is appropriate for you. A valid prescription from your own clinician comes first. You can see the rest of what is prepared this way in the compounded medications catalog.
Is enclomiphene FDA-approved?
No. There is no FDA-approved enclomiphene product, and compounded enclomiphene is not FDA-approved. It is prescribed off-label for men with low testosterone caused by secondary hypogonadism, meaning the signal from the pituitary and hypothalamus rather than the testes themselves.
Compounded preparations in general are not reviewed by the FDA for safety or effectiveness the way manufactured drugs are. What exists in the published literature on this molecule includes a systematic review and meta-analysis of clomiphene or enclomiphene citrate in male hypogonadism, plus reference sources such as StatPearls and MedlinePlus. Evidence is still developing, and results vary. If you want a number, a percentage, or a timeline, that conversation belongs with your prescriber, not with a pharmacy page.
How does enclomiphene compare to testosterone therapy?
The two approaches raise testosterone by different routes. Testosterone therapy supplies testosterone from outside the body, and exogenous testosterone suppresses the hypothalamic-pituitary-gonadal axis and can suppress the body's own sperm production. Enclomiphene acts on that axis instead, and because it does, sperm production is generally maintained.
Practical differences follow from that. Enclomiphene is an oral capsule and is not a controlled substance, so a prescription can be sent by e-prescribe, fax, or phone. Compounded testosterone for men comes as a topical cream, an anhydrous topical gel, a troche, or a rapid-dissolve tablet, is a Schedule III controlled substance, and must be e-prescribed. Topical testosterone also carries a transfer risk to women and children who touch the application site.
This comparison is educational. It is not a claim of effectiveness for any particular patient, and not a claim of superiority over any alternative. Which route fits a given man, if either does, is a clinical decision.
What strengths does compounded enclomiphene come in?
Typical off-label dosing is oral once daily, individualized and titrated to response and tolerability. Prescribers typically start low and adjust at follow-up. Dose and appropriateness are your prescriber's decisions, not the pharmacy's, and nothing here is a dose recommendation.
Monitoring is also the prescriber's call. Published guidance and the formulation page describe checking total testosterone and, where fertility is a goal, semen parameters, along with symptom review at follow-up. A provider may also monitor LH and FSH.
What side effects are reported?
MedlinePlus lists the following for clomiphene: headache, hot flashes or flushing, nausea or other stomach upset, mood changes, and breast tenderness or enlargement. SERMs in this class can also cause visual symptoms such as blurred vision, spots, or flashes of light. Those are uncommon and usually go away, but stop the medication and contact your provider if they happen, and your provider may arrange an eye evaluation.
Seek care for chest pain, shortness of breath, or signs of a serious allergic reaction such as rash, swelling, or trouble breathing. Enclomiphene should be avoided by anyone with a known sensitivity to clomiphene, enclomiphene, or a capsule ingredient, and used with caution in people with liver problems. This is men's therapy: it is not for use by women, especially those who are pregnant or may become pregnant, or by children.
Store capsules at room temperature per the label, away from excess heat, light, and moisture, out of reach of children, and do not use past the beyond-use date.
What does compounded enclomiphene cost?
Enclomiphene capsules start at $160 for 90 capsules at Bayview. Your actual price depends on the strength and quantity your prescriber writes, so the number on your prescription may differ from the starting price.
Compounded preparations are generally not billed through insurance, and Bayview fills them as cash prescriptions. If you want the reasoning behind that, we wrote it up in do compounding pharmacies take insurance. Some people submit a receipt to an HSA or FSA, which is a question for your plan administrator.
What does Bayview compound for this?
On a prescriber's order, Bayview prepares compounded enclomiphene capsules in 6.25 mg, 12.5 mg, 25 mg, and 50 mg strengths, in small batches under USP 795 non-sterile compounding standards. Capsules are dispensed only against a valid prescription naming you. For men prescribed testosterone instead, the pharmacy prepares topical cream, anhydrous topical gel, troche, and rapid-dissolve tablet forms, with a starting cash price of $90 for 45 g, on a controlled-substance prescription written for a named patient.
How do I get a prescription?
Ask your own prescriber. Bring the question plainly: you have read about enclomiphene and clomiphene, you want to know whether either is reasonable for you, and you want to know what labs would be checked first. If your clinician decides to write for compounded enclomiphene, they can e-prescribe to Bayview Pharmacy, 3844 Post Rd, Warwick, RI 02886. Because enclomiphene is not a controlled substance, fax and phone orders are also accepted, and no EPCS workflow is required.
If the electronic health record does not list the compound, the prescriber can enter it as a compound or free-text prescription naming the active ingredient and strength, with directions, quantity, and refills. We can fill and ship to the states where Bayview is licensed; see the FAQ for shipping details. If you are weighing a local option first, how to find a compounding pharmacy near you covers what to ask before you hand over a prescription.
Frequently asked questions
What is enclomiphene used for?
Providers may prescribe enclomiphene off-label as part of hormone therapy for men with low testosterone caused by secondary hypogonadism, when they determine it is appropriate. It is often considered for men who want to raise testosterone while preserving fertility. Enclomiphene is not FDA-approved for this or any use, and only a licensed provider can decide whether it is right for you.
How does enclomiphene work?
Enclomiphene is a selective estrogen receptor modulator (SERM). It blocks estrogen's signal at the pituitary and hypothalamus, which is understood to increase the hormones (LH and FSH) that prompt the testes to make more of the body's own testosterone and support sperm production. It works through the body's own hormone axis rather than adding testosterone from outside.
Is enclomiphene FDA-approved?
No. There is no FDA-approved enclomiphene product. It is prepared by a licensed compounding pharmacy to an individual prescription and is prescribed off-label. Bayview compounds it only with a valid prescription and does not determine whether treatment is appropriate.
How is enclomiphene different from testosterone therapy?
Testosterone therapy supplies testosterone from outside the body and can suppress the body's own sperm production. Enclomiphene instead prompts the body to make more of its own testosterone and generally preserves fertility. The two are used differently, and your provider decides which approach, if any, fits your treatment plan. See our Testosterone for Men page.
Does enclomiphene affect fertility?
Because enclomiphene works through the body's natural hormone signals, it generally maintains the body's own sperm production, unlike exogenous testosterone, which can reduce it. Your provider may monitor a semen analysis if fertility is a goal.
Is enclomiphene a controlled substance?
No. Enclomiphene is not a controlled substance and does not require electronic prescribing for controlled substances (EPCS). A valid prescription from a licensed provider is still required.
What side effects can enclomiphene cause?
Reported effects can include headache, hot flashes or flushing, nausea or stomach upset, mood changes, and breast tenderness. Vision changes such as blurring, spots, or flashes can occur with medications in this class; if you notice any change in your vision, stop taking it and contact your provider. Report any effect that concerns you.
How do I get enclomiphene from Bayview?
A licensed provider decides whether enclomiphene is appropriate and sends a valid prescription. Bayview Pharmacy does not provide consultations or determine appropriateness. Once we receive a valid prescription, we compound and dispense your order in the strength your provider specifies.
What is the difference between enclomiphene and clomiphene?
The difference is composition. Clomiphene citrate is a racemic mixture of two isomers, enclomiphene (the trans-isomer) and zuclomiphene (the cis-isomer). Enclomiphene is the trans-isomer on its own, without the longer-half-life estrogenic zuclomiphene isomer. That describes what each preparation contains. It is not a statement that either one is better tolerated or more likely to work for any given patient.
Is Clomid FDA-approved for men with low testosterone?
No. Clomiphene citrate, sold under the brand name Clomid, is an FDA-approved product approved for ovulation induction in women. Prescribing it to men for low testosterone is an off-label use. Off-label prescribing is legal and common, but it means the FDA has not reviewed the product for that population or that purpose. Your prescriber decides whether it is appropriate.
Is compounded enclomiphene the same as Clomid?
No, and Bayview does not present it as equivalent to any brand or manufactured product. Clomid is a manufactured tablet containing racemic clomiphene citrate. Compounded enclomiphene is a capsule containing enclomiphene citrate alone, prepared by a pharmacy on an individual prescription. There is no FDA-approved enclomiphene product, so it is compounded and used off-label.
Why is enclomiphene compounded instead of manufactured?
Because no company holds an FDA approval for an enclomiphene product, there is no commercial stock to dispense. When a prescriber writes for enclomiphene, a 503A compounding pharmacy prepares it to that prescription. Bayview compounds it as an oral capsule in small batches under USP 795 non-sterile compounding standards, in the strength the prescriber specifies, against a valid prescription naming the patient.
What strengths does compounded enclomiphene come in?
Bayview compounds enclomiphene citrate as oral capsules in 6.25 mg, 12.5 mg, 25 mg, and 50 mg. Typical off-label dosing is oral once daily, individualized and titrated to response and tolerability, and prescribers typically start low and adjust at follow-up. The strength, quantity, and whether the preparation is appropriate at all are your prescriber's decisions, not the pharmacy's.
What does compounded enclomiphene cost at Bayview?
Enclomiphene capsules start at $160 for 90 capsules. The price for your prescription depends on the strength and quantity your prescriber writes, so it may differ from that starting figure. Compounded preparations are generally not billed through insurance and are filled as cash prescriptions. Some patients submit a receipt to an HSA or FSA, which is a question for the plan administrator.
What Bayview compounds for this
Important: Compounded medications are prepared to a prescriber's order for an individual patient. They are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. This article is educational and is not a substitute for advice from your prescriber or pharmacist.
This preparation contains a controlled substance. Controlled-substance prescriptions carry refill limits, must be e-prescribed, and can only be shipped to states where Bayview holds the required licensure.
Uses discussed here may be off-label, meaning they are not part of any FDA-approved labeling. Off-label use is a decision for you and your prescriber, based on the available evidence.
Veterinary preparations are compounded to a veterinarian's order for a specific animal and are not FDA-approved animal drugs. Never give a compounded human medication to an animal without veterinary direction.
Compounded prescriptions are paid for directly rather than billed through insurance. Most are HSA/FSA-eligible, and many patients submit the receipt to their plan for possible reimbursement. Pricing depends on the strength, dose form and quantity your prescriber orders. Read more about cost and insurance.
Compounded enclomiphene capsules start at $160 for 90 capsules, and the final price depends on the strength and quantity on your prescription. Compounded preparations are generally not billed through insurance because they are prepared for an individual patient rather than dispensed as an FDA-approved manufactured product, so Bayview fills them as cash prescriptions. An HSA or FSA receipt is a question for your plan administrator.
Bayview Pharmacy is a compounding pharmacy in Warwick, Rhode Island, licensed to fill and ship compounded prescriptions for patients in Rhode Island, Massachusetts, Connecticut, New Jersey, New Hampshire, Florida, Maine and Pennsylvania. Prescriptions for New York patients are filled on a limited basis, and controlled substances are not shipped to New York addresses. See every state we ship to.
Related reading
