Why is Tamoxifen
prescribed?
Tamoxifen, an anticancer drug, is given to
treat breast cancer. It also has proved effective when cancer
has spread to other parts of the body. Tamoxifen is most
effective in stopping the kind of breast cancer that thrives
on estrogen.
Tamoxifen is also prescribed to reduce
the risk of invasive breast cancer following surgery and
radiation therapy for ductal carcinoma in situ. The drug can
also be used to reduce the odds of breast cancer in women at
high risk of developing the disease. It does not completely
eliminate your chances, but in a five-year study of over 1,500
high-risk women, it slashed the number of cases by 44
percent.
Tamoxifen is also used by men, in
conjunction with human chorionic gonadotropin (HCG) and
clomiphene, to stimulate the hypothalamic-pituitary-testicular
axis (HPTA) at the termination of anabolic steroid use.
Tamoxifen is also used by men during anabolic steroid use as
an anti-estrogen/estrogen blocker.
Most important fact about
Tamoxifen
Although Tamoxifen reduces the risk of breast
cancer, it increases the possibility of developing endometrial
(uterine) cancer. Women taking Tamoxifen should have routine
gynecological examinations and report any abnormal vaginal
bleeding, changes in menstrual periods, change in vaginal
discharge, or pelvic pain or pressure to the doctor
immediately. Even after Tamoxifen therapy has stopped, any
abnormal vaginal bleeding should be reported at once.
How should you take Tamoxifen?
Take
Tamoxifen exactly as prescribed. Do not stop taking this
medication without first consulting your doctor. It may be
necessary to continue taking the drug for several
years.
--If you miss a dose...
Do not try to make it up. Go back to your
regular schedule with the next dose.
--Storage instructions...
Tamoxifen may be stored at room
temperature.
What side effects may occur?
Side
effects from Tamoxifen are usually mild and rarely require the
drug to be stopped. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking
Tamoxifen.
More common side effects may
include:
Hot flashes, nausea, vomiting
Less common side
effects may include:
Bone pain, diarrhea, menstrual
irregularities, skin rash, tumor pain, vaginal bleeding,
vaginal discharge
Rare side effects may include:
Blood
clots, depression, distaste for food, dizziness, hair thinning
or partial loss, headache, light-headedness, liver disorders,
swelling of arms or legs, vaginal itching or dryness, visual
problems
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Why should Tamoxifen not be
prescribed?
Do not take Tamoxifen if you are sensitive to
it or have ever had an allergic reaction to it.
If you are taking the blood-thinning drug
Coumadin or have had problems with clots in your veins or your
lungs, you should not take Tamoxifen to reduce the risk of
breast cancer, and when taking it to treat an actual case of
the disease, you should use it with caution.
Special warnings about Tamoxifen
In
addition to increasing the risk of uterine cancer, Tamoxifen
also raises the odds of developing endometriosis (the spread
of endometrial tissue outside the uterus), uterine fibroids,
uterine polyps, and ovarian cysts.
Women who take Tamoxifen also face a
greater risk of stroke and of blood clots lodging in their
lungs. The risk increases further when Tamoxifen is combined
with toxic cancer drugs. Tamoxifen can also cause liver
damage, and should be used with caution if you already have
liver problems.
If you experience visual problems while
taking Tamoxifen, notify your doctor immediately.
In a few women Tamoxifen may raise the
level of cholesterol and other fats in the blood. Your doctor
may periodically do blood tests to check your cholesterol and
triglyceride levels.
Tamoxifen may produce an abnormally high
level of calcium in the blood. Symptoms include muscle pain
and weakness, loss of appetite, and, if severe, kidney
failure. If you experience any of these symptoms, notify your
doctor as soon as possible.
If tests show that your blood contains
too few white blood cells or platelets while you are taking
Nolvadex, your doctor should monitor you with special care.
These problems have sometimes been found in women taking
Tamoxifen; whether the drug caused the blood-cell
abnormalities is uncertain.
Possible food and drug
interactions
when taking Tamoxifen
If Tamoxifen is taken
with certain other drugs, the effects of either could be
increased, decreased, or altered. It is especially important
to check with your doctor before combining Tamoxifen with the
following:
Aminoglutethimide (Cytadren)
Blood-thinning
drugs such as Coumadin
Bromocriptine (Parlodel)
Cancer
drugs such as Cytoxan
Letrozole
(Femara)
Phenobarbital
Rifampin (Rifadin)
Special information
if you are
pregnant or breastfeeding
It is important to avoid
pregnancy while taking Tamoxifen, because the drug could harm
the unborn child. Since Tamoxifen is an anti-estrogen drug,
you will need to use a non-hormonal form of contraception,
such as a condom and/or diaphragm, and not birth control
pills. If you accidentally become pregnant while taking
Nolvadex, or within 2 months after you have stopped taking it,
discuss this with your doctor immediately.
Because Tamoxifen might cause serious
harm to a nursing infant, you should not breastfeed your baby
while taking this drug. If this medication is essential to
your health, your doctor may advise you to discontinue
breastfeeding until your treatment is finished.
Recommended dosage
ADULTS
Breast Cancer Treatment
The daily dosage ranges from 20 to 40
milligrams. If you are taking more than 20 milligrams a day,
your doctor will have you divide the total into 2 smaller
doses taken in the morning and evening.
Ductal Carcinoma in Situ
The recommended dose is 20 milligrams
once daily for 5 years.
Breast Cancer Prevention
The recommended dose is 20 milligrams
once a day for up to 5 years.
Anti-Estrogen/Estrogen Blocker (during
Anabolic Steroid Use in Males)
The typical daily dose is 10 to 20
milligrams.
CHILDREN
Safety and efficacy in children have not
been established.
Overdosage
Any medication taken in
excess can have serious consequences. If you suspect an
overdose of Tamoxifen, seek medical attention
immediately.
Symptoms of Tamoxifen overdose may
include:
Dizziness, overactive reflexes, tremor, unsteady
gait
Nolvadex® is a registered trademark of
AstraZenica International
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