Tamoxifen is used to treat estrogen hormone-dependent breast cancers, stimulate ovulation and prevent breast cancer in high risk patients. It belongs to a class of medicines called ‘Non-Steroidal Anti-Estrogens.’
Uses of Tamoxifen
- Some types of breast cancer in women and men
- Stimulate release of eggs from the ovary (ovulation) in females with who are problems (anovulation)
- Prevent development of breast cancer in high-risk patients (e.g. family history of breast cancer)
Contraindications of Tamoxifen
When should one not use Tamoxifen
- If you are allergic to Tamoxifen
- If you are taking Anastrozole
- If you or someone in your family has had blood clots due to unknown causes (idiopathic)
- If you have a history of blood clot formation in the legs or lungs (deep vein thrombosis or pulmonary embolism)
- If you are taking medicines used to prevent blood clots such as Warfarin
- If you are not sure, discuss to your doctor or pharmacist before taking Tamoxifen tablets
Side effects of Tamoxifen
Common side effects of this drug are:
- Fluid retention
- Skin rash
- Hot flushes (feeling of heat and sweats)
- Vaginal bleeding or discharge
- Uterine fibroids
- Anaemia (a blood problem which means you have too few red blood cells)
- Changes in vision due to cataracts or changes to the retina of your eye
- Increased amounts of fats in your blood (shown by blood tests)
- Allergic reactions
- Cataracts and eye problems
- Increased risk of blood clots (including clots in small vessels)
- Changes in the womb (including changes to its lining and benign growths)
- Feeling light-headed
- Liver problems
- Loss of hair
- Muscle pain
- Sensory changes (including taste disturbances and numbness or tingling in the skin)
- Severe blood problems (reduced blood cell counts) - this can get you to bruise more easily, get serious infections or feel very tired or breathless (rare)
- Changes to the cornea of your eye (rare)
- Problems with the nerve that connects your retina to your brain (swelling of the optic nerve)
- Severe life-threatening liver diseases – include liver infections, liver cirrhosis, liver cell damage, reduced bile formation and complete liver failure (rare)
- Severe life-threatening allergic reactions (angioedema, vasculitis, Stevens-Johnsons syndrome, etc.)
- Suppression of menstruation (rare)
- Vaginal growths (polyps)
- Infections and increased thickness of lining of the uterus (endometrium)
- Other uncommon cancers (rare)
Precautions and Warnings of Tamoxifen
Can I take Tamoxifen during pregnancy?
Do not start the medication of Tamoxifen if you are pregnant. It can cause birth defects, harm the unborn baby (fetus) and abortions.
Can I take Tamoxifen while breastfeeding?
Since Tamoxifen can suppress the production of breast milk after giving birth (postpartum lactation), it is not known if it is secreted in breast milk, it should be avoided in nursing mothers.
Can I drive if I have consumed Tamoxifen?
Tiredness has been reported in some patients. Hence caution is recommended and it is advised to avoid driving if you have such symptoms.
Can I consume alcohol with Tamoxifen?
It is recommended not to use alcohol with Tamoxifen as both Tamoxifen and alcohol increase liver enzymes. Also, alcohol interacts with Tamoxifen, decreasing its efficacy. It also increases the risk of breast cancer and delays recovery.
Other General Warnings
Talk to your doctor if
- You have delayed breast reconstruction operation (repeated procedure after the primary breast operation)
- Tamoxifen may increase the risk of the formation of blood clots
- Menstruation may be suppressed in some patients
- Changes in the lining (endometrium) of the uterus (increased thickness and unwanted growths)
- Cancerous growths (secondary tumors) at sites other than breast and lining of the uterus (endometrium)
Mode of Action of Tamoxifen
How Does It Work?
- Estrogen dependent breast cancers are the most common type of breast cancers
- Tamoxifen blocks the uncontrolled breast growth due to signals from estrogen hormone and thus stops progression of breast cancer
- In females with ovulation problems (releasing eggs from ovaries between 10-15th day of a regular menstrual cycle)
- Tamoxifen acts on structures in the brain, regulates estrogen levels and causes release of the eggs (improving female fertility)
Interactions of Tamoxifen
Interactions with other medicines
- Carbamazepine (used to treat seizures)
- Erythromycin (anti-bacterial)
- Amiodarone (used to treat irregular heartbeats)
- Warfarin (blood-thinning agent)
- Rifampicin (used to treat TB)
- Ritonavir (HIV medicine)
- Dexamethasone (steroid used to treat allergies, skin and joint diseases)
- Certain antidepressants (Paroxetine, Fluoxetine, Bupropion)
- Quinidine (used to treat irregular heartbeats)
Dietary Restrictions of Tamoxifen
Multivitamins, herbal supplements and soya products may trigger breast tumor growth and interfere with the action of Tamoxifen.
Dosage of Tamoxifen
Accidental overdose of Tamoxifen may not be life-threatening as there will be no immediate effects. But take your doctor’s advice in case of overdose. Medical attention may be necessary in case of extreme overdose.
Missed a Dose
Take the missed dose as early as you remember. If the time for next dose is near, skip the missed dose & do not take two doses together to compensate for the missed dose.
Frequently Asked Questions (FAQs)
Q: What should I discuss with my health care expert before taking Tamoxifen?
- You cannot use this Tamoxifen if you are allergic to it
- Inform your doctor if you currently are or had suffered from clots in your lungs or veins
- Inform your doctor if you are on blood thinners like Warfarin
- Tell your doctor if you are on chemotherapy or radiation
- You must inform your doctor if you are suffering from any heart disease or have a history of stroke, cataract or blood clot
- If you have high cholesterol or triglycerides
Q: What else should I know if I am prescribed Tamoxifen?
A: Use effective contraception methods (to prevent pregnancy) like condoms or loops. Pill based contraception is not recommended while using Tamoxifen. It is important to use contraception until two months after stopping the medication of Tamoxifen.
Last Updated on: 05 Oct 2020 | 10:47 PM (IST)
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