Nolvadex (Tamoxifen)

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What are tamoxifen tablets?

TAMOXIFEN (Nolvadex®) blocks the effects of estrogen hormone in the body. Tamoxifen is most commonly used to treat breast cancer in women or men. This drug may reduce the chance of breast cancer coming back in women previously treated with surgery, radiation, or chemotherapy. This drug may also help prevent breast cancer in certain women with a high risk of developing breast cancer. Occasionally this drug is used for other conditions. Generic tamoxifen tablets are available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• blood clots
• blood disorders
• cataracts or impaired eyesight
• endometriosis, uterine fibroids
• high calcium levels
• high cholesterol
• irregular menstrual cycles
• an unusual or allergic reaction to tamoxifen, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take tamoxifen tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. You may take tamoxifen with or without food. Take your doses at regular intervals. Do not stop taking except on your prescriber's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you remember, and then take the next dose as usual. Do not take double or extra doses. If you vomit after taking a dose call your prescriber or health care professional for advice.

What drug(s) may interact with tamoxifen?

• aminogluthemide
• bosentan
• bromocriptine
• chemotherapy drugs
• cyclosporine
• delavirdine
• dietary supplements like black cohosh, chasteberry, melatonin, or soy isoflavones
• efavirenz
• estrogen hormones, including some birth control products
• nevirapine
• protease inhibitors
• rifampin
• warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also, tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking tamoxifen?

Some side effects will only apply to women.

Side effects that you should report to your prescriber or health care professional as soon as possible:

• changes in your menstrual cycle
• changes in vaginal discharge
• changes in vision
• confusion
• difficulty walking or talking
• difficulty breathing
• excessive thirst
• new breast lumps
• numbness
• pelvic pain or pressure
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• shortness of breath
• skin rash
• swelling, pain or tenderness in your calf or leg
• swelling of lips, face, or tongue
• sudden chest pain
• unusual bruising or bleeding
• weakness
• vaginal bleeding
• yellowing of the whites of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• bone pain
• fatigue
• headache
• hair loss, although uncommon and is usually mild
• hot flashes
• impotence (in men)
• nausea, vomiting
• pain at tumor site
• weight loss

What should I watch for while taking tamoxifen?

Visit your prescriber or health care professional for regular checks on your progress. You may need to have blood drawn to check your blood counts, calcium, and/or cholesterol. Serious side effects to tamoxifen occur rarely. However, you should contact your health care professional if you think you are having any problems with your tamoxifen therapy. Some side effects of tamoxifen may occur soon after starting the drug, but others may first appear at any time during your treatment.

When you start taking tamoxifen to treat breast cancer, bone or tumor pain may increase. This means that tamoxifen is working and the pain should soon decrease. If the pain is severe, call your prescriber or health care professional. During this initial time, if you experience confusion or increased nausea, thirst, urination, or vomiting call your health care professional immediately.

If you are taking tamoxifen to reduce your risk of getting breast cancer, you should know that tamoxifen does not prevent all types of breast cancer. You should have regular gynecological check-ups, including breast exams and mammograms, and follow your prescriber's recommendations. If breast cancer or other problem occurs, there is no guarantee that it will be detected at an early stage. This is why it is important to continue with regular check-ups. Women who are or have taken tamoxifen should inform their prescriber or health care professional of any irregular menstrual cycles, abnormal vaginal bleeding, changes in vaginal discharge, or pelvic pain or pressure.

Women should not become pregnant while taking tamoxifen or for 2 months after tamoxifen therapy has stopped. You should see your prescriber immediately if you think you may have become pregnant while taking tamoxifen. Use of tamoxifen early in pregnancy may harm your unborn child. Women who can have children should use barrier birth control (condoms) or other methods of birth control that do not use hormones. Talk with your health care provider for birth control advice. Because tamoxifen may cause women to ovulate, it may increase the risk of getting pregnant if appropriate birth control is not used.

Women who take tamoxifen are at increased risk for developing blood clots. Some women may develop more than one clot, even if tamoxifen is stopped. If you experience pain or swelling in your calves, sudden chest pain, shortness of breath, or coughing up blood, call your prescriber or health care professional right away. Tamoxifen may increase the chance of having a stroke. If you experience symptoms of a stroke such as weakness, difficulty walking or talking, or numbness, contact your prescriber immediately.

Tamoxifen may cause cataracts or changes to parts of the eye known as the cornea or retina. If you experience any changes in your vision, including difficulty in telling colors apart, tell your prescriber or health care professional immediately.

Men who take tamoxifen may notice decreased sexual desire and impotence.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

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