Nolvadex D

Tamoxifen is a prescription medication used to treat breast cancer and lower the the chance of developing breast cancer. Certain types of breast cancers need estrogen to grow. Tamoxifen belongs to a group of drugs called anti-estrogens, which can block estrogen’s effects, slowing the growth of cancer cells. 

This medication comes in a tablet and an oral solution and is usually taken once or twice a day.

Common side effects of tamoxifen include hot flashes and vaginal discharge.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of tamoxifen there are no specific foods that you must exclude from your diet when receiving tamoxifen.

Tell your doctor if you:

• are allergic to any ingredient in tamoxifen.
• have ever had a blood clot in the lungs or legs, a stroke, or a heart attack (see Black Box Warning).
• have high blood pressure.
• have diabetes.
• take blood thinners such as warfarin (Coumadin).
• smoke.
• have high cholesterol.
• are pregnant or breastfeeding.

Tell your doctor about all the prescription medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if tamoxifen is excreted in human breast milk or if it will harm your nursing baby.

Take tamoxifen exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

Recommended Dosage

For patients with breast cancer, the recommended daily dose is 20-40 mg. Dosages greater than 20 mg per day should be given in divided doses (morning and evening).

Ductal Carcinoma in Situ (DCIS): The recommended dose is tamoxifen 20 mg daily for 5 years.

• A 20 mg dose of tamoxifen oral solution is administered as 10 mL (equivalent to 2 teaspoons).

Reduction in Breast Cancer Incidence in High Risk Women: The recommended dose is tamoxifen 20 mg daily for 5 years. There are no data to support the use of tamoxifen other than for 5 years.

For Women with Ductal Carcinoma in Situ (DCIS) and Women at High Risk for Breast Cancer: Serious and life-threatening events associated with tamoxifen in the risk reduction setting (women at high risk for cancer and women with DCIS) include uterine malignancies, stroke and pulmonary embolism. Incidence rates for these events were estimated from the NSABP P-1 trial. Uterine malignancies consist of both endometrial adenocarcinoma (incidence rate per 1,000 women-years of 2.20 for tamoxifen vs 0.71 for placebo) and uterine sarcoma (incidence rate per 1,000 women-years of 0.17 for Nolvadex vs 0.04 for placebo)*. For stroke, the incidence rate per 1,000 women-years was 1.43 for Nolvadex vs 1.00 for placebo**. For pulmonary embolism, the incidence rate per 1,000 women-years was 0.75 for tamoxifen versus 0.25 for placebo**.

Some of the strokes, pulmonary emboli, and uterine malignancies were fatal.

Health care providers should discuss the potential benefits versus the potential risks of these serious events with women at high risk of breast cancer and women with DCIS considering tamoxifen to reduce their risk of developing breast cancer.

The benefits of tamoxifen outweigh its risks in women already diagnosed with breast cancer.

*Updated long-term follow-up data (median length of follow-up is 6.9 years) from NSABP P-1 study.