Tamoxifen

Brand names of tamoxifen

  • Alpha-Tamoxifen
  • Apo-Tamox
  • Dom-Tamoxifen
  • Gen-Tamoxifen
  • Nolvadex
  • Nolvadex-D
  • Novo-Tamoxifen
  • PMS-Tamoxifen
  • Tamofen
  • Tamone

Anti-estrogens like tamoxifen are prescribed by doctors for the prevention of breast cancers which are formed with the help of the female hormone, estrogen. Tamoxifen is taken both for the prevention as well as the treatment of breast cancer as it hinders the effectiveness of estrogen to form tumors.

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Depending on the condition of the patient, doctors prescribe tamoxifen for various lengths of time in treating breast cancer. As a preventive measure tamoxifen is usually taken for a period of five years.

Things you need to tell your physician before taking tamoxifen

Before you begin taking tamoxifen your doctor and pharmacist both should be told about your allergic reactions to medications including tamoxifen. They should also be informed about any prescription or nonprescription remedies you might be taking or plan on taking including vitamins, supplements or any herbal products. Any high cholesterol levels in your blood should also be reported to your doctor. In case you are undergoing some other treatment besides the treatment for breast cancer then all your doctors and all your health care providers should know that you take tamoxifen.

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Your doctor will take a pregnancy test to determine if you are pregnant before he prescribes tamoxifen. To doubly ensure that you are not pregnant the doctors usually ask patients to begin treatment during the menstrual period. The doctor will also advise you not to get pregnant during your treatment as tamoxifen is harmful for the fetus.

On your part you will have to ensure that you use a safe and secure non hormonal method to prevent pregnancy during treatment and even two months after the treatment is stopped. The doctor can offer you advice on the best methods of birth control. Birth control is continued throughout the duration of treatment whether you have your menstrual period or if it stops due to some reason, other than pregnancy.

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If you are already pregnant before treatment begins the doctor will have to be told about it so he can decide on the risk factor involved in taking tamoxifen. In case you get pregnant while taking tamoxifen you need to immediately tell the doctor. If you have a baby whom you are breast-feeding you will have to stop as tamoxifen can reach your baby through the milk and can harm the baby.

Sometimes even with the treatment in progress cancer could develop. You should ask your doctor how often a breast examination is advisable either by the doctor or through self examination. It is possible that even a mammogram (breast x-ray) could be required for early detection. In case you find a new lump in the breast the doctor has to be informed right away.

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Usage

Tamoxifen is used to treat breast cancers in patients, both men and women, when cancer begins to spread to other parts of the body. Women who have already been treated with surgery, chemotherapy or radiation continue to be treated further with tamoxifen. It is also used on women who have been treated with surgery or radiation for ductal carcinoma in situ (DCIS) so it does not develop into a more serious cancer, even though this kind of cancer usually does not spread outside the milk duct. Some women are at high risk for breast cancer because of age, personal or family medical history and so are given tamoxifen to reduce their risk of breast cancer.

Besides cancer, tamoxifen is also used to stimulate egg production during ovulation in women who have difficulty in becoming pregnant. McCune Albright syndrome, which causes bone disease, early sexual development and dark spots on children, is also treated with tamoxifen.

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It is however, always advisable to consult with your doctor about the risks involved in taking medication for any condition that requires treatment with tamoxifen.

How to use tamoxifen

Tamoxifen is available under different brand names both as a tablet and as a sugar free syrup. The tablets that are of various strengths like 10mg, 20mg, and 40mg need to be swallowed whole with a glass of water and the syrup is prescribed for patients who cannot swallow tablets.

The medication is prescribed as a daily dose and it's best to take it with food as the tablets have a metallic taste that could sicken you. Tablets should be taken at any convenient time but at the same everyday.

Labels on the bottles should be read for clarity and any doubts pertaining to the amount of medication prescribed should be clarified with your doctor and directions should be followed precisely. Take neither too much of the medication nor too little. Neither should the medication be taken more often than has been directed by your doctor or pharmacist.

In case a dose is missed at a particular time, it should be taken immediately on remembering. However, in case the time of the next dosage is quite close to when you are taking the missed dose then it is better to miss out one of the two doses and take that one which is scheduled. Never take the medication twice just to make up for the missed dose as the dosage could become too strong and cause side effects.

How tamoxifen works

It is not fully understood how tamoxifen works to stop the growth of estrogen. What is understood of the complicated process is that it is a drug that is anti-estrogen.

Some types of breast cancers develop when the level of the female hormone estrogen increases. Estrogen gets attached to receptor proteins in the breast cancer cells and fits into them in such a way that cancer cells are stimulated to divide. These continuously dividing cells cause tumors. Cancers formed in this way are known as 'estrogen-receptor positive' or ER-positive breast cancer.

When tamoxifen is administered to the patient it fits into the estrogen receptor cell and then walls out estrogen from entering the cancerous cell. Once estrogen cannot reach the cancer cell then the cancerous growth stops altogether or slows down perceptively.

Side effects

Serious
  • cataracts
  • confusion, weakness, or drowsiness
  • new breast lumps
  • yellowish tinge to eyes or skin
  • deep vein thrombosis and pulmonary embolism (pain or swelling in legs, sudden chest pain, shortness of breath, coughing up blood)
  • endometrial cancer (abnormal nonmenstrual vaginal bleeding, menstrual irregularities, pelvic pain or pressure, changes in vaginal discharge)
Common
Less common

Possible interactions

Herbal medicines or minerals:
To boost their immune system patients sometimes use Echinacea. However people who have a damaged immune system should avoid Echinacea. In fact this herbal remedy, if taken for too long or used regularly could actually weaken the immune system.

Discontinuation

Tamoxifen should not be stopped without consulting your doctor.

Storage instructions

Tamoxifen should be stored out of reach of children, tightly closed in the same container it came in. Do not store it in the bathroom as it must be kept away from heat as well as moisture. Any medication that is not required or is outdated should be thrown away. Your pharmacist could advise you on the proper and safe disposal of tamoxifen.

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