Enclomiphene Dosage: What the Research and Telehealth Protocols Use

Enclomiphene is an oral pill that raises testosterone by prompting the body to make more of its own, rather than replacing it. Clinical trials used 6.25, 12.5 or 25 mg once daily, and most telehealth programs prescribe 12.5–25 mg a day, adjusting based on blood tests. It isn't FDA-approved, so it's dispensed by compounding pharmacies.

Doses used in clinical trials

Trial	Doses	Length	Key finding
Wiehle et al., phase II (48 men)	6.25, 12.5, 25 mg daily vs testosterone gel	6 weeks	At 25 mg, average testosterone reached 604 ng/dL vs 500 on gel; LH and FSH rose instead of falling
Kaminetsky et al., phase IIB (12 men)	Enclomiphene vs testosterone gel	6 months	Similar testosterone (525 vs 545 ng/dL); sperm counts stayed normal on enclomiphene, fell on gel
Kim et al., two phase III trials (ZA-304/305)	12.5 and 25 mg daily vs AndroGel 1.62%	16 weeks	Testosterone rose in all groups; sperm concentration stayed normal on enclomiphene and dropped sharply on gel

The pattern across studies is consistent: enclomiphene raises testosterone to a similar level as testosterone gel, but because it works through the brain's signals to the testes (LH and FSH), it doesn't shut down sperm production the way testosterone therapy does.

How telehealth clinics dose it

Telehealth programs typically prescribe a daily pill of 12.5 mg to 25 mg. Some start lower, at 6.25 mg, and increase based on a follow-up testosterone test. Doses above 25 mg aren't supported by the trials above.

Because the half-life is about 7 hours, it's taken once a day. In trials, testosterone fell back toward baseline within about a week of stopping.

Side effects and monitoring

Enclomiphene has a shorter safety record than testosterone therapy. What's known:

• A 2024 retrospective study of 66 men found fewer side effects on enclomiphene than on clomiphene (Clomid), and smaller changes in estradiol.
• Clomiphene's label warns about visual symptoms (blurring, flickering spots) that rise with dose and can persist. Report any vision change and stop the drug until you've been examined.
• Responsible programs recheck total testosterone, estradiol, LH and FSH after starting or changing the dose.

Regulatory status

• Never FDA-approved. The developer, Repros Therapeutics, applied in 2015 under the name Androxal; the FDA declined, saying the phase III design was no longer adequate to show clinical benefit.
• Compounding. In 2022 an FDA advisory committee voted 8–4 against adding enclomiphene to the list of substances compounders may use, but that vote isn't binding. As of May 2026 the FDA's list still shows enclomiphene as under evaluation, which generally lets compounding continue until a final decision.

What enclomiphene costs through telehealth

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