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Nolvadex (tamoxifen) is an antiestrogen drug which inhibits the ability of estrogen to bind with estrogen receptors on certain types of cancer; namely hormone receptor-positive or estrogen receptor-positive breast cancer. It does not lower levels of estrogen in the body or interfere with estrogen production.

The medication may be used in both men and women, and in both pre- and post-menopausal women, in several scenarios:

  • To inhibit tumor growth;
  • To inhibit spread of breast cancer;
  • To prevent regrowth of breast cancer following surgery or radiation;
  • To prevent breast cancer from developing in high-risk individuals.

Less commonly Nolvadex is used for other purposes, including:

  • To improve fertility in women with anovulatory disorders;
  • To treat gynecomastia (development of breasts in males);
  • To treat mania in patients with bipolar disorder;
  • To inhibit premature puberty in patients with McCune-Albright syndrome.

The medication is also used in a range of research applications.

Dosage & Administration

Nolvadex comes in tablets containing 10 or 20 mg of tamoxifen, which may be taken with or without food. Taking tablets on a full stomach may ease nausea, if it occurs.

Treatment is usually straightforward when Nolvadex is used as a preventive measure in high-risk patients:

  • Take 20 mg per day.
  • Each daily dose may be divided into two smaller 10 mg doses if desired.
  • If taking a single daily dose, it should be taken in the morning.
  • Treatment typically lasts for 5 years.

There may be some variation in dosing when used to treat existing cancer:

  • Take 20 to 40 mg per day.
  • 20 mg doses may be divided into two smaller doses if desired.
  • Daily doses greater than 20 mg should be divided into two smaller doses.
  • Treatment typically lasts for 5 years.

Doctor instructions may deviate from the standard guidelines above, and may vary considerably between individual patients according to response to treatment, other medications being taken, other medical conditions, and so forth. Regular doctor checkups are crucial to determine that the medication is continuing to work as intended.

Ideally Nolvadex will be taken at the same time each day, to keep levels of the drug consistent in the body. Missed doses should be taken as soon as remembered, unless it is very near time for the next dose, in which case a missed dose can be skipped.

As with many cancer treatments, the condition may temporarily worsen when treatment with Nolvadex begins. This is normal and generally not cause for concern, though it should be brought to the attention of a doctor to be on the safe side. Symptoms should quickly subside over the next several days.

Precautions & Adverse Effects

Nolvadex should not be used while pregnant or breast-feeding.

It may interact with a range of other medications, reducing effectiveness or causing complications. Check with a doctor or pharmacist before starting or ceasing other treatments while Nolvadex is being taken.

Side effects are typically mild and may stop occurring after a few weeks of treatment. Most common side effects include:

  • Hot flashes
  • Fatigue
  • Nausea
  • Weight gain

The above symptoms are not cause for concern unless severe enough to be disruptive.

A small number of patients using Nolvadex have experienced stroke, blood clots in the legs or lungs, and cancer of the uterus. Warning signs which call for immediate medical attention include:

  • Pain or swelling in the calf
  • Pain in the chest
  • Difficulty breathing
  • Difficulty speaking
  • Confusion
  • Vision changes
  • Weakness, especially on one side of the body
  • Pain or pressure in the lower abdomen
  • Unusual vaginal discharge

Regular doctor exams will help catch any developing adverse reactions before they become serious.


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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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