Ormeloxifene Side Effects
Critical Safety Warning
Ormeloxifene (Centchroman) has been associated with significant uterine effects including menorrhagia, massive uterine enlargement, extensive decidual changes in hyperplastic endometrium, and diffuse microglandular cervical hyperplasia, requiring medical surveillance during prolonged therapy. 1
Primary Side Effects Profile
Gastrointestinal and Renal Precautions
- Kidney disease requires medical consultation before use, as ormeloxifene may be contraindicated in patients with renal impairment 2
- Patients on magnesium-restricted diets should consult a physician before initiating therapy 2
- Drug interactions with prescription medications are possible and require pharmacist or physician review 2
Uterine and Endometrial Effects
- Prolonged unsupervised use has resulted in menorrhagia requiring norethisterone for control 1
- Massive uterine enlargement with extensive decidual changes in hyperplastic endometrium has been documented 1
- Diffuse microglandular cervical hyperplasia occurs with extended therapy 1
- These findings suggest a prominent estrogenic effect on the uterus, representing a significant adverse effect related to prolonged therapy 1
Comparison to Related SERMs (Raloxifene Context)
While ormeloxifene data is limited, raloxifene (a related SERM) provides context for the class:
Common Side Effects:
- Hot flashes are the most frequently reported adverse event with SERMs 3, 4, 5
- Leg cramps occur more frequently than placebo (statistically significant increase) 3, 4, 5
Serious Thromboembolic Risks:
- Venous thromboembolism risk is increased 3.1-fold compared to placebo with raloxifene 3
- Deep vein thrombosis risk increases (OR 1.5,95% CI 1.1-2.1) 6
- Pulmonary embolism risk increases (OR 1.9,95% CI 1.0-3.5) 6
- Fatal stroke risk increases significantly (HR 1.49,95% CI 1.0-2.2) in women with underlying heart disease 6
Cardiovascular Concerns:
- Uncertainty exists regarding myocardial infarction, stroke, and death risk with romosozumab (ROM), another SERM 6
- ROM should not be started in patients with myocardial infarction or stroke within 12 months 6
Critical Clinical Pitfalls
Prolonged Unsupervised Use
Lengthy intake of ormeloxifene requires medical surveillance, as the case report demonstrates severe uterine pathology can develop without monitoring 1. Long-term studies are needed to fully characterize safety 1.
Pregnancy and Lactation
Pregnant or breastfeeding women must consult a healthcare professional before use 2
Pediatric Safety
Keep out of reach of children 2
Monitoring Requirements
Medical surveillance is mandatory for prolonged ormeloxifene therapy given the documented uterine effects 1. This should include:
- Regular gynecologic evaluation for menstrual changes, particularly menorrhagia
- Assessment for uterine enlargement
- Endometrial monitoring given the hyperplastic changes observed
- Symptom education regarding thromboembolic events (leg pain, chest pain, shortness of breath)
When to Discontinue
Stop use and consult a physician if symptoms persist beyond 2 weeks 2. Immediate discontinuation is warranted for: