Tamoxifen (Systemic)

Brand Names : Nolvadex, Apo-Tamox, Gen-Tamoxifen, Nolvadex-D, Novo-Tamoxifen, PMS-Tamoxifen, Tamofen, Tamone

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tamoxifen, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to tamoxifen.

Pregnancy - Tell your doctor if you are pregnant or if you intend to become pregnant. Tamoxifen should not be used to reduce the risk of breast cancer if you are pregnant of if you intend to become pregnant. Tamoxifen use in women has been shown to cause miscarriages, birth defects, death of the fetus, and vaginal bleeding. Studies in rats and rabbits have shown that tamoxifen causes miscarriages, death of the fetus, and slowed learning. Studies in animals also have shown that tamoxifen may cause some of the same problems as those caused by an estrogen called diethylstilbestrol (DES). DES causes genital tract problems and, rarely, an increased risk of cancer of the cervix or vagina in daughters of women who took it during their pregnancy. It is not known whether tamoxifen causes these same problems.

Be sure that you have discussed this with your doctor before taking this medicine. It is best to use some kind of birth control while you are taking tamoxifen and for about 2 months after you stop taking it. However, do not use oral contraceptives (�the Pill�) since they may interfere with this medicine. Tell your doctor right away if you think you have become pregnant while taking tamoxifen.

Breast-feeding - Because this medicine may cause serious side effects, breast-feeding is generally not recommended while you are taking it.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of tamoxifen in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine. If you are taking tamoxifen to reduce the risk of breast cancer, it is especially important that your health care professional know if you are taking the following:

• Anticoagulant, coumarin-type (blood thinners) - Blood thinners (e.g., warfarin [Coumadin]) should not be used with tamoxifen when used to reduce the risk of developing breast cancer in women who have a high risk of developing breast cancer. If you need to take blood thinners, your blood clotting times should be monitored by your doctor.

• Cytotoxic medicines - These are medicines that damage cells. If you take these medicines with tamoxifen, you may have an increased risk of blood clots.

Other medical problems - The presence of other medical problems may affect the use of tamoxifen. Make sure you tell your doctor if you have any other medical problems, especially:

For all patients
• Blood problems or
• Cataracts or other eye problems - Tamoxifen may also cause these problems

• High cholesterol levels in the blood - Tamoxifen can increase cholesterol levels

When used for reducing the risk for developing breast cancer in high-risk women or in women with Ductal Carcinoma in Situ (DCIS)
• Blood clots (or history of) or
• Pulmonary embolism (or history of) or
• Stroke or
• Uterine (womb) cancer - May increase risk of serious side effects from tamoxifen.