Tamoxifen

Indications & Dose:

Adjuvant therapy of axillary node-negative breast cancer and of node positive cancer in post-menopausal women following mastectomy, axillary dissection, and breast , irradiation; treatment-of metastatic breast cancer in both women and men; most beneficial in estrogen receptorpositive tumors; reduction in incidence of breast cancer in high-risk women (defined as >35 yr with a 5 yr predicted risk of breast cancer >1.67% as calculated by the Gail Model); also used in mastalgia, gynecomastia

DOSE

Adults

Breast cancer:  20mg daily increasing to 40mg daily if necessary.

Anovulatory infertility:  20mg daily on four successive days commencing on second day of menstruation. Increase if necessary to 40mg then 80mg for subsequent courses.

Children: Not recommended.

Contraindications:

 Pregnancy

Side Effects:

CNS: Depression, headache, hot flashes, (33%) lightheadedness
CV: Chest pain
EENT: Blurred vision (high doses), corneal opacity, ocular lesion, retinopathy
GI: Abnormal liver function tests, altered taste, anorexia, hepatic necrosis, nausea, vomiting
GU: Endometrial cancer, menstrual changes (irregularity, oligomenorrhea, amenorrhea), pruritus vulvae, vaginal bleeding
HEME: Deep vein thrombosis, leukopenia, thrombocytopenia
METAB: Hypercalcemia
RESP: Pulmonary embolism
SKIN: Alopecia, rash 

Cautions:

Precautions:

 Leukopenia, thrombocytopenia, cataracts, liver disease, hypercalcemia, undiagnosed abnormal vaginal bleeding

Interaction:

Drugs
Aminoglutethimide: Reduces tamoxifen concentrations

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: