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(marketed as Nolvadex) is one of the most commonly used
anti-estrogen breast cancer treatments in the world. The
medications works by blocking estrogen receptors in estrogen
receptor-positive (ER-Positive or ER+) cancer, which accounts for
over 70% of breast cancer. Deprived of estrogen, cancer may fail to
develop, grow or spread.
Most often tamoxifen is given to:
is used most commonly in women, both premenopausal and
postmenopausal, though it also used in men and, rarely, children.
It also serves other functions, though far less frequently, as a
fertility treatment, to inhibit early puberty, in certain other
cancers, and in treating a handful of other conditions.
Effective Use of Tamoxifen
The medication comes in tablets of 10 to 20 mg, which should be
swallowed whole without chewing, dissolving or splitting. The
prescribed daily dosage will depend on the condition being treated
as well as any other medications being taken at the same
If dosage exceeds 20 mg, or one tablet, the total daily dose is
usually divided into two doses of equal strength. If taking a
single tablet, it should be taken in the morning. If taking
multiple tablets divided into two doses, they should be taken as
close to 12 hours apart as possible. If an uneven amount of tablets
are being divided, the higher number should be taken in the
Ideally tablets are 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 possible.
Treatment is likely to last 5 years or longer, and it is very
common for other supplementary medications to be given along with
tamoxifen during this time. Regular checkups are vital to ensure
the medication is working as desired, adjust dosage strength if
needed, and to check for developing adverse effects.
Some patients do not respond well to tamoxifen, either seeing
little benefit or experiencing disruptive side effects. In these
cases there are many similar medications available which may be
more suitable; it is worth discussing alternative options with a
doctor if tamoxifen doesn't seem to be providing
To ensure treatment goes smoothly there are a few things to keep in
- Prevent the development of cancer in high-risk patients
- Inhibit growth or spread of existing cancer
- Prevent regrowth of cancer after surgery, chemotherapy or other
- Tamoxifen's estrogen-blocking properties may render hormonal
birth control methods, such as pills, patches and some implants,
ineffective. Alternative birth control methods should be used
during treatment, and for several months after treatment
- Women who are pregnant or breast feeding should not use
tamoxifen; this medication may be quite harmful. Likewise, women
who pregnant or nursing should not even handle tablets, as the
medication is easily absorbed into the skin.
- The medication may cause inaccuracies in lab tests; be sure lab
technicians are aware tamoxifen is being taken.
- Some patients, particularly those with existing cancer, may
experience increased pain and even tumor growth shortly after
treatment begins. Though it may be alarming, it is actually a sign
the medication is working. Symptoms should diminish after a few
days of treatment.
Side effects, if experienced at all, often stop after a few days of
treatment. The most common side effects are generally mild and not
cause for alarm:
- Tamoxifen may cause easy bleeding. Be sure all doctors,
dentists and other health care providers are aware the medication
is being taken before undergoing any procedures.
with a history of blood clots or stroke, or who are taking blood
thinners, should use tamoxifen with caution and receive regular
checkups to monitor the medication's effect.
- Hot flashes
- Stomach upset
- Leg cramps
- Menstrual changes
- Loss of interest in sex
- Hair thinning
No current Rx required
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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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