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Tamoxifen

 

Tamoxifen (generic Nolvadex) Review

brand name: Nolvadex
generic names: Tamoxifen citrate, Tamoxifen

Why is Nolvadex prescribed?

Nolvadex, an anticancer drug, is given to treat breast cancer. It also has proved effective when cancer has spread to other parts of the body. Nolvadex is most effective in stopping the kind of breast cancer that thrives on estrogen.

Nolvadex is also prescribed to reduce the risk of invasive breast cancer following surgery and radiation therapy for ductal carcinoma in situ. The drug can also be used to reduce the odds of breast cancer in women at high risk of developing the disease. It does not completely eliminate your chances, but in a five-year study of over 1,500 high-risk women, it slashed the number of cases by 44 percent.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.

Special warnings about Nolvadex (Tamoxifen)

In addition to increasing the risk of uterine cancer, uterine polyps, uterine fibroids, Nolvadex also raises the odds of developing endometriosis (the spread of endometrial tissue outside the uterus), and ovarian cysts. Women who take Nolvadex (Tamoxifen) also face a greater risk of stroke and blood clots lodging in their lungs. The risk increases further when Nolvadex is combined with toxic cancer drugs. Nolvadex (Tamoxifen) can also cause liver damage, and should be used with caution if you already have liver problems.

Nolvadex (Tamoxifen) may produce an abnormally high level of calcium in the blood. Symptoms include muscle pain and weakness, loss of appetite, and, if severe, kidney failure. If you experience any of these symptoms, notify your doctor as soon as possible.

If you experience visual problems while taking Nolvadex (Tamoxifen), notify your doctor immediately.

If tests show that your blood contains too few white blood cells or platelets while you are taking Nolvadex (Tamoxifen), your doctor should monitor you with special care. These problems have sometimes been found in women taking Nolvadex; whether the drug caused the blood-cell abnormalities is uncertain.

In a few women Nolvadex (Tamoxifen) may raise the level of cholesterol and other fats in the blood. Your doctor may periodically do blood tests to check your cholesterol and triglyceride levels.

How does it work?

Nolvadex D tablets contain the active ingredient tamoxifen citrate, which is a type of medicine known as an 'anti-oestrogen'. (NB. Tamoxifen is also available without a brand name, ie as the generic medicine.) Tamoxifen is mainly used to treat women with breast cancers that respond to the female sex hormone, oestrogen.

Most breast cancers are sensitive to oestrogen, and their growth is increased in the presence of this hormone. Oestrogen binds to oestrogen receptors on the breast cancer cells and causes changes within the cells that result in faster growth of the cancer. Breast cancers that are sensitive to oestrogen are called oestrogen receptor positive cancers.

Tamoxifen works by blocking the oestrogen receptors, thereby blocking the effect of oestrogen on the cancer. This starves the breast cancer cells and stops them from growing.

Tamoxifen helps prevent breast cancer from spreading to other areas of the body and also reduces risk of developing cancer in the other breast.

Tamoxifen is also used in the treatment of female infertility that is caused by problems with ovulation. Again, it acts by blocking oestrogen receptors, this time in a part of the brain called the hypothalamus. The effect of this is an increase in the levels of the hormones that control the development and release of an egg. These hormones are released from the pituitary gland and are known as follicle stimulating hormone (FSH) and luteinising hormone (LH). FSH stimulates the ovaries and LH causes the release of an egg from the ovaries (ovulation).

In the normal menstrual cycle, oestrogen acts on receptors in the hypothalamus after ovulation. This causes the pituitary gland to stop releasing FSH and LH. As tamoxifen blocks the oestrogen receptors in the hypothalamus, it prevents this action of oestrogen. FSH and LH levels therefore increase, which increases the chances of egg development and ovulation.

How should you take Nolvadex (Tamoxifen)?

Take Nolvadex (Tamoxifen) exactly as prescribed. Do not stop taking this medication without first consulting your doctor. It may be necessary to continue taking the drug for several years.

--If you miss a dose...

Do not try to make it up. Go back to your regular schedule with the next dose.

--Storage instructions...

Nolvadex (Tamoxifen) may be stored at room temperature.

What should I watch for while taking tamoxifen?

Visit your prescriber or health care professional for regular checks on your progress. You may need to have blood drawn to check your blood counts, calcium, and/or cholesterol. Serious side effects to tamoxifen occur rarely. However, you should contact your health care professional if you think you are having any problems with your tamoxifen therapy. Some side effects of tamoxifen may occur soon after starting the drug, but others may first appear at any time during your treatment.

When you start taking tamoxifen to treat breast cancer, bone or tumor pain may increase. This means that tamoxifen is working and the pain should soon decrease. If the pain is severe, call your prescriber or health care professional. During this initial time, urination, thirst, if you experience confusion or increased nausea, or vomiting call your health care professional immediately.

If you are taking tamoxifen to reduce your risk of getting breast cancer, you should know that tamoxifen does not prevent all types of breast cancer. You should have regular gynecological check-ups, including breast exams and mammograms, and follow your prescriber's recommendations. If breast cancer or other problem occurs, there is no guarantee that it will be detected at an early stage. This is why it is important to continue with regular check-ups. Women who are or have taken tamoxifen should inform their prescriber or health care professional of any irregular menstrual cycles, changes in vaginal discharge, abnormal vaginal bleeding, or pelvic pain or pressure.

Women should not become pregnant while taking tamoxifen or for 2 months after tamoxifen therapy has stopped. You should see your prescriber immediately if you think you may have become pregnant while taking tamoxifen. Use of tamoxifen early in pregnancy may harm your unborn child. Women who can have children should use barrier birth control (condoms) or other methods of birth control that do not use hormones. Talk with your health care provider for birth control advice. Because tamoxifen may cause women to ovulate, it may increase the risk of getting pregnant if appropriate birth control is not used.

Women who take tamoxifen are at increased risk for developing blood clots. Some women may develop more than one clot, even if tamoxifen is stopped. If you experience pain or swelling in your calves, shortness of breath, sudden chest pain, or coughing up blood, call your prescriber or health care professional right away. Tamoxifen may increase the chance of having a stroke. If you experience symptoms of a stroke such as or numbness, difficulty walking or talking, weakness, contact your prescriber immediately.

Tamoxifen may cause cataracts or changes to parts of the eye known as the cornea or retina. If you experience any changes in your vision, including difficulty in telling colors apart, tell your prescriber or health care professional immediately.

Men who take tamoxifen may notice decreased sexual desire and impotence.