How to Take Tamoxifen
Tamoxifen is available in tablet form to be taken orally (by mouth). It should be taken around the same time every day. This medication should be swallowed whole with a full glass of non-alcoholic liquid. Do not crush, chew or break the tablets. A liquid version (Soltamox®) of this medication is also available. Talk with your provider if you have trouble swallowing pills. If you miss a dose take it as soon as you remember. If it is close to your next scheduled dose do not double your dose, rather skip the missed dose and continue your regular schedule.
It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.
The blood levels of this medication can be affected by certain medications and supplements. These include: warfarin, paroxetine, fluoxetine, and amiodarone among others. Make sure your providers are aware of all medications (over-the-counter and prescription) and supplements you are taking.
Storage and Handling
Store this medication at room temperature in the original container. If you prefer to use a pillbox, discuss this with your oncology pharmacist. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.
Where do I get this medication?
Tamoxifen is available through retail and mail order pharmacies. Your oncology team will give you a prescription, which you can fill at your local pharmacy.
This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may be available. Your care team can help you find these resources if they are available.
Possible Side Effects of Tamoxifen
There are a number of things you can do to manage the side effects of tamoxifen. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:
There is a very small risk of developing endometrial (uterine) cancer while taking this medication. Healthcare professionals believe that the benefits of this medication outweigh this risk. Women should report any menstrual irregularities, vaginal bleeding, pelvic pressure/pain, or any vaginal discharge, as these may be symptoms of endometrial cancer. An endometrial biopsy should be done if any concerning symptoms occur.
Blood Clots and Stroke
This medication increases the risk of developing a blood clot, which most frequently occurs in the calves, and can travel from there to the lungs. Blood clots can also cause a stroke. Women at higher risk for developing blood clots include those with a family history of blood clots, heavy smokers, those who have an inactive lifestyle, older women, and those with other predisposing medical problems. Women with any one of these risk factors may want to consider another therapy that does not have this side effect.
Being immobile increases the risk of a blood clot. You should stop taking this medication 3 days prior to and during any prolonged immobilization (hospitalization or bed rest). When traveling, be sure to get up and move around frequently to reduce the risk of a clot.
Signs of a blood clot in the leg may include any of the following: leg pain, warmth, swelling of one leg more than the other. Signs of a blood clot in the lung could include: fever, shortness of breath that comes on very quickly, racing heart, chest pain (that tends to be worse when you take a deep breath). Signs of a stroke include: numbness or weakness on one side of the body, trouble talking, confusion, or mental status changes.If you have any of these signs or symptoms of blood clots, you will need to be seen immediately so that you can be treated. Blood thinners can be given. Call your healthcare provider.
There are a few things you can do to help with hot flashes. Several medications have been shown to help with symptoms, including clonidine (a blood pressure medication), low doses of certain antidepressants (such as venlafaxine and fluoxetine), and gabapentin.Talk to your healthcare team about these prescription products to determine if they are right for you.
Non-medical recommendations include:
- Keep well-hydrated with eight glasses of water daily.
- Drink ice water or apply an ice pack at the onset of a hot flash.
- Wear cotton or lightweight, breathable fabrics and dress in layers so you can adjust as needed.
- Exercise on a regular basis.
- Try practicing meditation or relaxation exercises to manage stress, which can be a trigger.
- Avoid triggers such as warm rooms, spicy foods, caffeinated beverages, and alcohol.
Vaginal Discharge and Bleeding
This medication can cause increased vaginal discharge. White/clear discharge is normal. Report any bloody or foul-smelling discharge to your healthcare provider immediately.
Your periods may become irregular or stop all together. In some women, normal periods resume after completing tamoxifen therapy. However, women who are already post-menopausal at the time they start tamoxifen should report any vaginal bleeding to their oncologist, primary physician or gynecologist. You will need to be checked to determine why you are bleeding. Tamoxifen can stimulate the lining of the uterus to grow, which can result in uterine polyps, and rarely, in uterine cancer.
Nausea and/or Vomiting
Talk to your healthcare provider so they can prescribe medications to help you managenausea and vomiting. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms.
Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
Women on tamoxifen have an increased risk of developing cataracts. You should have a yearly eye exam by an ophthalmologist. Report any vision changes, cloudy or blurry vision, difficulty with night vision, sensitivity to light, fading or yellowing of colors, as these can be symptoms of cataracts.
Vaginal dryness, itching, and related painful intercourse are one of the more common side effects of cancer therapy in women. Vaginal lubricants and moisturizers (longer-lasting form of moisturizers) can help with these concerns. Talk to your healthcare team for more suggestions in managing this side effect.
Weakening of the Bones (Osteoporosis)
Premenopausal women who take hormone therapy for extended periods of time are at risk forbone thinning(osteoporosis). In post-menopausal women, tamoxifen preserves bone strength. You may be advised to take calcium and vitamin D supplements to help prevent bone loss. Weight-bearing exercise and a healthy diet rich in calcium and vitamin D can also help protect your bone health. You may have a bone density scan (DEXA scan) to assess your bone health. If your healthcare provider determines that you are at high risk of developing osteoporosis, they may recommend additional treatment with a type of medication called a bisphosphonate to help strengthen the bones.
This medication can cause liver toxicity, which your healthcare provider may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or pain in your abdomen, as these can be signs of liver toxicity.
While rare, tamoxifen can lead to radiation recall.It may present as a skin reaction that looks like a sunburn (redness, swelling, soreness, peeling skin) in areas where radiation was previously given. Notify your oncology care team if you notice this side effect. Treatment can include topical steroid ointments and a delay in your next chemotherapy dose.
Patients with cancer that has spread to the bone may experience pain or discomfort at the tumor site after starting this medication, but this should decrease over time and should be managed with pain medication.
Lesscommon but important side effects:
- Muscle and joint aches:Acetaminophen may help with these side effects. Talk to your care provider if they become bothersome.
- Weight gain:Weight gain can occur and can be managed with dietary modifications and exercise.
- Loss or Thinning of Scalp and Body Hair (Alopecia):Your hair may becomethin, brittle, or may fall out. This typically begins two to three weeks after treatment starts. This hair loss can be all body hair, including pubic, underarm, legs/arms, eyelashes, and nose hairs. The use of scarves, wigs, hats, and hairpieces may help. Hair generally starts to regrow soon after treatment is completed. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun.
- Mood changes or depression:Please talk to your healthcare provider if you feel that you experience depressed moods, loss of interest in activities, or changes in sleep and eating habits.
- Hypercalcemia: Patients with bone metastases may develop hypercalcemia (high levels of calcium in the blood) and may require hospitalization to correct this. Symptoms of hypercalcemia include increased thirst and urination, nausea, constipation, muscle weakness, confusion, or changes in mental status. Report any symptoms to your care provider.
Sexual & Reproductive Concerns
This medication may affect your reproductive system, resulting in the menstrual cycle or sperm production becoming irregular or stopping permanently. Women may experience menopausal effects including hot flashes and vaginal dryness. In addition, the desire for sex may decrease during treatment. You may want to consider sperm banking or egg harvesting if you may wish to have a child in the future. Discuss these options with your oncology team.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective non-hormonal birth control (such as condoms) is necessary during treatment and for at least 2 months after treatment, even if your menstrual cycle stops or you believe you are not producing sperm. You should not breastfeed while receiving this medication.
Tamoxifen (Nolvadex® or Soltamox®) is a drug that treats hormone receptor-positive (hormone-positive) breast cancer. (Hormone-positive breast cancer is a type of cancer that needs estrogen and/or progesterone to grow.)What does Nolvadex do for bodybuilders? ›
Bodybuilders and athletes using anabolic steroids often take Nolvadex for gynecomastia during post-cycle therapy. Clinical studies have indicated that Nolvadex can reverse gynecomastia and inhibit the further growth of breast tissue in men.What happens when you take Nolvadex? ›
Hot flashes, nausea, leg cramps, muscle aches, hair thinning, headache, and numb/tingling skin may occur. A loss of sexual ability/interest may occur in men. If these effects last or get worse, tell your doctor promptly.Is tamoxifen the same as Nolvadex? ›
Tamoxifen (brand names: Nolvadex, Soltamox) is a selective estrogen receptor modulator (SERM) used to treat all stages of hormone receptor-positive breast cancer in women and men.Does Nolvadex increase testosterone levels? ›
It has the ability to significantly spike testosterone levels. Some small-scale studies on healthy men have found that Nolvadex and Clomid both have the ability to increase testosterone by around 100% in just a few weeks.Can Nolvadex get rid of gyno? ›
For boys with severe gynecomastia that is causing substantial tenderness or embarrassment, a short course of a drug called tamoxifen (sample brand name: Nolvadex) or raloxifene (brand name: Evista) may be recommended. These drugs block the effects of estrogen in the body and can reduce the size of the breasts somewhat.Is Nolvadex bad for men? ›
Some men have had sexual problems when taking Nolvadex (tamoxifen tablets). These include lowered interest in sex and not able to get an erection. Call your doctor right away if you have sexual problems when taking Nolvadex (tamoxifen tablets).How much does tamoxifen raise testosterone? ›
Treatment of the TVD group with tamoxifen caused increases in estradiol, testosterone, and FSH of 40% (P<0.0001), 82% (P<0.0001), and 44% (P=0.001), respectively, by day 28, with only small further changes at 56 days of treatment (Figure 2A through 2C), as for all other blood parameters.Does tamoxifen increase muscle mass? ›
Exposure to a tamoxifen-enriched diet from 3 weeks of age resulted in significant improvement in muscle contractility without increase in fibre size in both models, underlying an increase in the capacity of the muscle fibres to produce more force.Does tamoxifen increase belly fat? ›
Recent research doesn't support a strong link between tamoxifen and gaining weight.
Most male breast cancers are hormone-dependent, so estrogen-blocking treatments including Tamoxifen are often used. Possible side effects for men taking Tamoxifen include headaches, nausea, hot flashes, skin rash, fatigue, sexual dysfunction, and weight and mood changes.What does tamoxifen do to teeth? ›
You may be more likely to lose teeth if you take tamoxifen or other hormonal therapies for breast cancer treatment. One study found that postmenopausal breast cancer survivors had lost more teeth compared with a control group (participants who hadn't had the disease).
AstraZeneca is discontinuing US sales of its cancer drug Nolvadex (tamoxifen) from June, after mounting competition from generic products has substantially eroded sales of the brand.What is the biggest risk with tamoxifen? ›
Because tamoxifen acts like estrogen in the uterus, it can increase your risk of cancers of the uterus, including endometrial cancer and uterine sarcoma. It's also linked to a higher risk of endometrial pre-cancers. The increased risk seems to affect women over 50, but not younger women.What are the benefits of taking tamoxifen? ›
In addition to treating breast cancer and lowering risk, tamoxifen may have other health benefits. It may [100-101]: Improve blood cholesterol profile by lowering LDL levels (the “bad” cholesterol). A better cholesterol profile may lower the risk of heart disease.Why do patients take tamoxifen? ›
Tamoxifen is used to treat breast cancer that has spread to other parts of the body in men and women. It is used to treat early breast cancer in women who have already been treated with surgery, radiation, and/or chemotherapy.Does tamoxifen make you gain weight? ›
Recent research doesn't support a strong link between tamoxifen and gaining weight. That's not to say that tamoxifen doesn't have side effects. It can raise your chances of endometrial (uterine) cancer. Blood clots are also possible.