Nolvadex (Tamoxifen) is a prescription medicine for breast cancer treatment, especially hormone-positive (HR+) breast cancer in both men and women. Also, it is used in cancer prevention in persons who are at high risk. The medicine works by blocking estrogen within the breast structure. Nolvadex comes in the form of 10 mg or 20 mg round tablets. The benefits of taking this drug may last up to 20 hours even after your last dose.
Uses of Nolvadex
Your doctor will prescribe this medicine for various purposes such as:
- Breast cancer treatment
- To decrease the chances of breast cancer spreading to the other breast in people who are at higher risk of developing the disease
- To prevent recurrence of breast cancer in people with ductal carcinoma in situ (DCIS)
How Does Nolvadex Work?
Tamoxifen (Nolvadex) works by interfering with the activities of estrogen in the breast tissue. For breast cancer cells to grow and multiply, they need signals from estrogen when it attaches to them. However, Nolvadex blocks those signals by attaching themselves to the estrogen receptors in the cells.
When this happens, the cancer cells will not be able to receive signals. As a result, they will die gradually or stop spreading.
Nolvadex Dosing and Administration
Nolvadex is an oral medicine and should be swallowed with enough water or any suitable drink. Also, you can consume it with food or without food. Even if you feel well, be sure to complete your prescribed dose to prevent the occurrence of unpleasant effects.
It is worth noting that Nolvadex is a daily drug and you ought to take it every day, at a particular time to prevent missed doses. Also, you may have to ingest it twice (that is morning and night daily), depending on the doctor’s assessment. The medicine is usually consumed for a minimum of 5 years post-breast surgery.
While taking Nolvadex, the healthcare professional can ask you to undergo some medical tests such as pelvic examination, complete blood count, liver function test, eye examination, and mammogram.
When the doctor diagnoses your health condition, they will determine the most appropriate dose. However, the general daily dosage is between 20 mg to 40 mg. If you miss a dose, do not double dose, tell your doctor immediately you remember it.
Precautions
Your doctor has prescribed Nolvadex because they believe the benefits outweigh the risks. However, patients should heed these warnings to ensure the safety and efficacy of the drug:
- Before taking Nolvadex, inform your doctor if you have allergies, including Tamoxifen allergy.
- Tell the healthcare professional your history, especially if you’ve experienced any of the following:
○ Deep vein thrombosis
○ High blood cholesterol
○ High blood triglycerides
○ Pulmonary embolism
○ Any other conditions that could cause blood clots
○ Stroke
○ High blood pressure
○ Diabetes
○ Liver disorders
○ Cataract
- Ensure you mention all the drugs you have been consuming, including OTC medications, supplements, and herbal products.
- Do not take Nolvadex while breastfeeding as it can pass into breastmilk.
- Your doctor will request a pregnancy test before prescribing Nolvadex. But if you become pregnant while taking this drug or within eight weeks after your last dose, call your doctor immediately.
Note: It is safer to use non-hormonal birth control pills while using this drug.
Side Effects of Nolvadex
The typical negative outcomes associated with this drug include:
- Depression
- Vaginal bleeding
- Decrease in sexual desire
- Hair thinning
- Nausea
- Hot flashes
- Dry skin
- Mood swings
- Constipation
- Fatigue
Some people may experience more severe side effects. Call your doctor or emergency unit immediately if you experience any of the following:
- Endometrial cancer (characterized by changes in the amount and time of menstrual flow, abnormal vaginal discharge with rusty brown hue, or pain below the belly button).
- Cataracts (blurry/cloudy vision, photosensitivity, very poor night vision, requiring brighter light intensity to see clearly).
- Liver problems (dark/brown urine, easy bruising, pain in the upper right abdomen, yellowing of eye/skin, loss of appetite, extreme fatigue).
- Blood clots (characterized by chest pains, coughing out blood, pains/tenderness/swelling in the leg, and shortness of breath).
- Stroke (loss of balance/coordination, tingling/numbness in the limbs/face, severe headache with unknown cause).
Interactions
Nolvadex interacts with several drugs and some disease conditions. It is also believed to cause a false positive typhoid test. The major drug interactions are with:
- Bupropion
- Chloroquine
- Amisulpride
- Dicumarol
- Primidone
- Dehydroepiandrosterone
- Efavirenz
- Cimetidine
- Fluoxetine
- Haloperidol
- Iloperidone
- Nilotinib
- Pacritinib
- Procainamide
- Ozanimod
- Sparfloxacin
- Mitotane
- Ritonavir
- Warfarin
- Thalidomide
- Thioridazine
- Ziprasidone
- Phenobarbital
- Venetoclax
Nolvadex disease interactions are described below.
- Pulmonary Embolism: The use of Nolvadex is contraindicated in women with this condition, especially those who would require concomitant coumarin therapy.
- Liver Dysfunction: Nolvadex should be administered with caution in people with a history of hepatic diseases.
- Endometrial Dysplasia: This condition and other related endometrial abnormalities have been reported in women using Nolvadex.
- Visual Defects: Retinopathy, cataracts, and corneal change have been reported in women using Nolvadex.
- Bone Marrow Suppression leading to hematological disorders, including pancytopenia and anemia has been observed.
Storage
Nolvadex should be stored at room temperature, away from light and moisture. It should also be kept out of the reach of children and pets.