Comparison
Clomiphene vs Semaglutide
Side-by-side of Clomiphene and Semaglutide. Every row below is pulled from the compound schema and will update as our data grows. For deeper reads, follow through to each compound page.
Clomiphene
Clomiphene citrate raises LH/FSH and endogenous testosterone in men. SERM TRT alternative, 25 to 50 mg, fertility preserved, visual side effects flagged.
Semaglutide
Semaglutide for weight loss: GLP-1 agonist (Ozempic, Wegovy) drives 15-17% mean loss at 2.4 mg/week in STEP trials. Watch lean-mass loss.
Effects at a glance
Clomiphene
- •SERM that blocks estrogen-receptor negative feedback at the hypothalamus, raising LH and FSH
- •FDA approved 1967 for ovulation induction in anovulatory women at 50 to 100 mg cycle days 5 to 9
- •Off-label in men at 12.5 to 25 mg daily raises endogenous testosterone while preserving fertility
- •Enclomiphene (trans-isomer) is preferred for male use; cleaner PK and less estrogenic side effect burden
- •Visual disturbances occur in ~1 to 2% of users; persistent symptoms warrant immediate cessation
- •Letrozole has displaced clomiphene as first-line ovulation induction in PCOS (Legro 2014)
Semaglutide
- •Long-acting GLP-1 receptor agonist with a ~7-day half-life that supports once-weekly subcutaneous dosing
- •STEP trials reported ~15 to 17% mean body-weight loss at 2.4 mg/week over 68 weeks in adults with obesity
- •Lowers HbA1c by ~1.0 to 1.8 percentage points in type 2 diabetes versus placebo
- •SELECT trial showed reduced major cardiovascular events in adults with prior CVD and overweight or obesity
- •Up to 25 to 40% of weight lost can be lean mass; pairing with resistance training and protein intake mitigates this
- •GI effects (nausea, vomiting, constipation) drive most discontinuations and ease with slow titration
Side-by-side
| Attribute | Clomiphene | Semaglutide |
|---|---|---|
| Category | pharmaceutical | pharmaceutical |
| Also known as | Clomid, clomiphene citrate, Serophene, enclomiphene | Ozempic, Wegovy, Rybelsus |
| Half-life (hr) ↗ | 168 | 168 |
| Typical dose (mg) ↗ | 25 | 2.4 |
| Dosing frequency | 5-day pulse cycle days 5 to 9 (women); daily or every other day (men, off-label) | weekly (SC); daily (oral Rybelsus) |
| Routes | oral | subcutaneous, oral |
| Onset (hr) | 6 | 24 |
| Peak (hr) | 7 | 72 |
| Molecular weight | 405.96 | 4113.58 |
| Molecular formula | C26H28ClNO | - |
| Mechanism | Selective estrogen receptor modulator that antagonizes estrogen at the hypothalamus and pituitary, increasing GnRH and gonadotropin output, which drives gonadal steroidogenesis. | Long-acting GLP-1 receptor agonist; potentiates glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and acts on hypothalamic satiety centers. |
| Legal status | Prescription only (FDA approved for ovulation induction; off-label in men) | Prescription only (FDA-approved, EMA-approved) |
| WADA status | banned | allowed |
| DEA / Rx | Rx only (not a controlled substance) | Rx only (not a controlled substance); FDA-approved for type 2 diabetes (2017) and chronic weight management (2021) |
| Pregnancy | Category X; contraindicated in pregnancy | Not recommended; discontinue 2 months before planned pregnancy |
| CAS | 911-45-5 | 910463-68-2 |
| PubChem CID | 1548953 | 56843331 |
| Wikidata | Q416785 | Q27089394 |
Safety profile
Clomiphene
Common side effects
- hot flushes
- mood changes
- abdominal discomfort
- breast tenderness
- visual disturbances (rare)
- headache
Contraindications
- pregnancy
- active liver disease
- ovarian cysts (not PCOS-related)
- uncontrolled thyroid or adrenal disorder
- abnormal uterine bleeding of undetermined origin
- hormone-sensitive cancer
Interactions
- tamoxifen: competing SERM activity; not used together(moderate)
- ospemifene: competing SERM activity(moderate)
- anastrozole: additive estrogen reduction; sometimes combined in male protocols(minor)
- TRT (exogenous testosterone): TRT suppresses HPT axis that clomiphene targets; do not combine(moderate)
Semaglutide
Common side effects
- nausea
- vomiting
- diarrhea
- constipation
- decreased appetite
- injection-site reactions
- fatigue
Contraindications
- personal or family history of medullary thyroid carcinoma
- multiple endocrine neoplasia type 2
- pregnancy
- history of pancreatitis (use caution)
Interactions
- insulin: additive hypoglycemia risk; insulin dose typically reduced(major)
- sulfonylureas (glipizide, glyburide): hypoglycemia risk, sulfonylurea dose often reduced(major)
- oral medications (general): delayed gastric emptying can alter absorption kinetics(moderate)
- warfarin: monitor INR due to altered absorption(moderate)
Which Should You Take?
Clomiphene and Semaglutide score evenly on the criteria we weight (goal breadth, legal accessibility, evidence depth). The conditionals below should drive the decision more than any aggregate score.
- → If your priority is hormonal optimization, pick Clomiphene.
- → If your priority is fertility, pick Clomiphene.
- → If your priority is metabolic health and glucose control, pick Semaglutide.
- → If your priority is fat loss, pick Semaglutide.
Edge case: Clomiphene is contraindicated in pregnancy; Semaglutide is the safer pick if that applies.
Default choice: either is defensible. Clomiphene edges out on goal breadth + legal accessibility; Semaglutide is the right call if your priority sits in the goals listed above.
This verdict is generated from each compound's schema (goals, legal status, evidence outcomes, dosing route). It updates automatically as our compound data evolves; the deeper read sits on each individual compound page.
Common questions
What is the difference between Clomiphene and Semaglutide?
Clomiphene and Semaglutide differ in category (pharmaceutical vs pharmaceutical), mechanism, and typical dosing. See the side-by-side table for full details.
Which has a longer half-life, Clomiphene or Semaglutide?
Clomiphene half-life is 168 hours; Semaglutide half-life is 168 hours.
Can you stack Clomiphene with Semaglutide?
Stack compatibility depends on mechanism overlap, legal status, and individual response. Check each compound page for specific interactions and contraindications before combining.
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