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Nolvadex (tamoxifen) is a commonly used breast cancer treatment and prevention therapy used in both men and women who are at high risk of, have a history of, or currently have breast cancer. 

It is also occasionally used to treat other types of cancer, as well as a treatment for infertility, mania caused by bi-polar disorder, premature puberty, certain thyroid disorders, and several other conditions. 

Nolvadex Basics

The conditions Nolvadex is used to combat are complicated; likewise treatment can be quite involved. For breast cancer, which is its most common use, treatment is typically given in one of three scenarios:
  • To prevent cancer from developing in high risk patients
  • To inhibit growth or spread of existing cancer
  • To prevent cancer regrowth following surgery or chemotherapy
The medication works by blocking estrogen reception; since breast cancer (and some other cancers) thrive on estrogen, depriving the cancer of its fuel will prevent its growth and spread. 

Unfortunately Nolvadex doesn't work well for all patients, and may not be sufficient on its own. It is not unusual for other medications to be given along with Nolvadex, and alternative therapies may be tried if results are insufficient.

Tablets come in strengths of 10 to 20 mg each, though daily doses may be higher. Lower doses are typically given in preventative cases, such as when there is a family history of breast cancer. Higher doses tend to be in cases of actively combatting cancer. There are, however, a lot of other factors which may influence daily dosage amounts. 

Lower doses of 20 mg or less are usually taken once daily. Higher doses may be split into two daily doses of equal strength. Treatment will be most effective if doses are taken at the same time each day, to maintain consistent levels of the drug in the body. 

Tablets may be taken with food or without, depending on preference. Taking with food may ease side effects of stomach upset. 

Nolvadex as a cancer therapy tends to be long term, often longer than 5 years. During this time dosage strength may be adjusted numerous times. 

Side Effects & Other Considerations

The most common side effects associated with Nolvadex are both rare and typically mild. These side effects are not cause for concern unless severe:
  • Hot flashes 
  • Stomach upset 
  • Leg cramps 
  • Menstrual changes 
  • Headache 
  • Loss of interest in sex 
  • Hair thinning 
More serious side effects are also rare, but may be cause for concern. A doctor should be consulted if the following side effects are experienced: 
  • Pain in eyes 
  • Blurred vision 
  • Easy bleeding or bruising 
  • Extreme fatigue 
  • Severe stomach pain
  • Symptoms of infection
  • Yellowing of eyes or skin
  • Severe chest pain
Patients with existing breast cancer may experience an increase in pain; this should be temporary and is generally an indication that the medication is working as desired. 

A few things to keep in mind while taking Nolvadex: 
  • Hormonal birth control (pills, patches and some implants) may not work while using Nolvadex; alternative birth control methods should be used while treatment lasts, and for several months after treatment ceases. 
  • Children and women who are pregnant or nursing should not even handle tablets; the medication is easily absorbed into the skin and can interfere with proper development.
  • Other medications and nutritional supplements may reduce effectiveness of the treatment; ask a doctor or pharmacist about potential interactions before mixing products. 
  • Certain lab tests may be inaccurate while taking Nolvadex; be sure technicians and doctors involved are aware the medication is being taken. 
Patients with a history of blood clots or stroke, or who are taking blood thinners, should use Nolvadex with caution and receive regular checkups to monitor the medication's effect.


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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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