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Tamoxifen Citrate
Generic Name:
Tamoxifen Citrate
Typical Brand Name(s): Nolvadex
What Is It
Used For?
Tamoxifen Citrate (Nolvadex), an
anticancer drug, is given to treat breast cancer.
It also has proved effective when cancer has spread to other parts
of the body. Nolvadex is most effective in stopping the kind of
breast cancer that thrives on estrogen.
Nolvadex 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.
Most important
fact about this drug
Although Nolvadex reduces the risk of breast cancer, it increases
the possibility of developing endometrial (uterine) cancer. Women
taking Nolvadex 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 Nolvadex therapy has stopped, any abnormal
vaginal bleeding should be reported at once.
How Is It Used?
Take Nolvadex 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.
Are There
Possible Side Effects?
Side effects from Nolvadex 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 Nolvadex.
- 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 problem
Why should this drug not be prescribed?
Do not take Nolvadex 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 Nolvadex
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
this medication
In addition to increasing the risk of
uterine cancer, Nolvadex 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 Nolvadex also face a greater risk of stroke and of
blood clots lodging in their lungs. The risk increases further when
Nolvadex is combined with toxic cancer drugs. Nolvadex can also
cause liver damage, and should be used with caution if you already
have liver problems.
If you experience visual problems while taking Nolvadex, notify
your doctor immediately.
In a few women Nolvadex 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.
Nolvadex 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 Nolvadex; whether the drug caused the blood-cell
abnormalities is uncertain.
What
About Interactions With Other Drugs?
If Nolvadex 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
Nolvadex 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 Nolvadex, because
the drug could harm the unborn child. Since Nolvadex 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 Nolvadex 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.
Nolvadex comes in 10- and 20-milligram tablets.
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.
CHILDREN
Safety and efficacy in children have not been established.
In case of
emergency/overdose
Any medication taken in excess can have serious consequences. If
you suspect an overdose of Nolvadex, seek medical attention immediately.
What If I
Miss A Dose?
Do not try to make it up. Go back to your regular schedule with
the next dose.
How Should It Be Stored?
Nolvadex may be stored at room temperature. NOTE: The above information
is intended to supplement, not substitute for, the expertise and
judgment of your physician, pharmacist, or other healthcare professional.
It should not be construed to indicate that the use of the product
is safe, appropriate, or effective for you. Consult your healthcare
professional before taking the product.
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