Name: Rana Ismail Mohamed El-sayed Essa

Section: 2
No: 45

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 Case Study
A 25-year-old female presents to the clinic with a history of
irregular menstrual periods for 5 years , hirsutism, acne,
and difficulty conceiving. She has been diagnosed with
Polycystic Ovary Syndrome (PCOS) based on her
symptoms and hormonal profile. The patient is also
struggling with infertility and is undergoing fertility
treatments. Her Current Medications are:
1) Metformin (1000mg daily) – prescribed to help
regulate insulin levels and improve ovulation in
patients with PCOS.
2) Clomiphene (50mg daily) – prescribed to stimulate
ovulation and improve fertility.
3) Spironolactone (100mg daily) – prescribed to help
reduce hirsutism and acne associated with PCOS.
4) Levothyroxine (50mcg daily) - prescribed for
hypothyroidism, which is commonly seen in patients
with PCOS.
5) Ibuprofen (400mg as needed) – used for pain relief
during menstrual periods.

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Interactions:
1) Levothyroxine sodium 50mcg tablets + clomipramine 50mg
capsules
Levothyroxine sodium 50microgram tablets may increase effect
of clomipramine 50mg capsules
- Usually avoid combination. Use combination only under
special circumstances, taking any necessary action to reduce
risk.
2) Ibuprofen 400mg tablets + spironolactone 100mg tablets
Interaction found between ibuprofen 400mg tablets and
spironolactone 100mg tablets: May increase risk of
hyperkalaemia and antagonise diuretic effect
- Minimise risk. Take action necessary to reduce risk. Counsel
patient.
3) spironolactone 100mg tablets + clomipramine 50mg capsules
Interaction found between spironolactone 100mg tablets and
clomipramine 50mg capsules : Increased hypotensive effect
- Minimise risk. Take action necessary to reduce risk. Counsel
patient.

❖ Overall, this patient with PCOS and infertility is on a complex

medication regimen that requires close monitoring for potential
drug interactions and side effects. The healthcare team should
work together to optimize the treatment plan and support the
patient in achieving her goal of conceiving.

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