Tamoxifen Generic (Nolvadex) US$ 0.40 ea

What is the most important information I should know about tamoxifen?

Do not use tamoxifen if you are pregnant. It could harm the unborn baby. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) while you are using this medication and for at least 2 months after your treatment ends.

You should not use tamoxifen if you are allergic to it, or if you have a history of blood clots in your veins or your lungs, or if you are also taking a blood thinner such as warfarin (Coumadin).

Before using tamoxifen, tell your doctor if you have liver disease, high triglycerides (a type of fat in the blood), a history of cataract, or a history of stroke or blood clot. Also tell your doctor if you if you are receiving chemotherapy or radiation treatment.

If you are taking tamoxifen to reduce your risk of breast cancer, you may need to take your first dose while you are having a menstrual period. You may also need to have a pregnancy test before you start taking tamoxifen, to make sure you are not pregnant. Follow your doctor's instructions.

Taking tamoxifen may increase your risk of uterine cancer, stroke, or a blood clot in the lung, which can be fatal. Talk with your doctor about your specific risks in taking this medication.

To make sure this medication is not causing harmful effects, your doctor may want you to have mammograms and to perform routine breast self exams on a regular basis. Your liver function may also need to be tested. Visit your doctor regularly.

What is tamoxifen?

Tamoxifen blocks the actions of estrogen, a female hormone. Certain types of breast cancer require estrogen to grow.

Tamoxifen is used to treat some types of breast cancer in men and women. Tamoxifen is also used to lower a woman's chance of developing breast cancer if she has a high risk (such as a family history of breast cancer).

Tamoxifen may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking tamoxifen?

You should not use tamoxifen if you are allergic to it, or if you have:

• a history of blood clots in your veins or your lungs; or
• if you are also taking a blood thinner such as warfarin (Coumadin).

To make sure you can safely take tamoxifen, tell your doctor if you have any of these other conditions:

• liver disease;
• high cholesterol or triglycerides (a type of fat in the blood);
• a history of stroke or blood clot;
• a history of cataract; or
• if you are receiving chemotherapy or radiation.

Taking tamoxifen may increase your risk of uterine cancer, stroke, or a blood clot in the lung, which can be fatal. Talk with your doctor about your specific risks in taking this medication.

FDA pregnancy category D. Do not use tamoxifen if you are pregnant. It could harm the unborn baby. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) while you are using this medication and for at least 2 months after your treatment ends.

Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.

It is not known whether tamoxifen passes into breast milk or if it could harm a nursing baby. However, this medication may slow breast milk production. You should not breast-feed while taking tamoxifen.

How should I take tamoxifen?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medication with a full glass (8 ounces) of water.

Tamoxifen can be taken with or without food.

If you are taking tamoxifen to reduce your risk of breast cancer, you may need to take your first dose while you are having a menstrual period. You may also need to have a pregnancy test before you start taking tamoxifen, to make sure you are not pregnant. Follow your doctor's instructions.

Use tamoxifen regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. You may need to keep using this medication for up to 5 years.

To make sure this medication is not causing harmful effects, your doctor may want you to have mammograms and to perform routine breast self exams on a regular basis. Your liver function may also need to be tested. Visit your doctor regularly.

Store at room temperature away from moisture, heat, or cold. Do not freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking tamoxifen?

Avoid eating soy or soy products without first asking your doctor.

Avoid coming into contact with your body fluids (including urine, feces, vomit, semen, vaginal fluid). Chemotherapy can pass into body fluids. Patients or caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

What are the possible side effects of tamoxifen?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using tamoxifen and call your doctor at once if you have a serious side effect such as:

• sudden numbness or weakness, especially on one side of the body;
• sudden severe headache, confusion, problems with vision, speech, or balance;
• chest pain, sudden cough, wheezing, rapid breathing, fast heart rate;
• pain, swelling, warmth, or redness in one or both legs;
• nausea, loss of appetite, increased thirst, muscle weakness, confusion, and feeling tired or restless;
• unusual vaginal bleeding or discharge;
• irregular menstrual periods;
• pain or pressure in your pelvic area;
• blurred vision, eye pain, or seeing halos around lights;
• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
• fever, chills, body aches, flu symptoms;
• new breast lump; or
• upper stomach pain, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• hot flashes;
• bone pain, joint pain, or tumor pain;
• swelling in your hands or feet;
• vaginal itching or dryness;
• decreased sex drive, impotence, or difficulty having an orgasm;
• headache, dizziness, depression; or
• thinning hair.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect tamoxifen?

Many drugs can interact with tamoxifen. Below is just partial list. Tell your doctor if you are using any of these medications:

• bromocriptine;
• cimetidine;
• clozapine;
• cyclophosphamide;
• isoniazid (for treating tuberculosis);
• letrozole;
• methimazole;
• nicardipine;
• pioglitazone;
• rifampin;
• ropinirole;
• ticlopidine;
• tranylcypromine;
• anti-malaria medication such as chloroquine or pyrimethamine, or quinine;
• an antibiotic such as terbinafine;
• an antidepressant such as bupropion, clomipramine, desipramine, duloxetine, fluoxetine, imipramine, paroxetine, sertraline, or tranylcypromine;
• a heart rhythm medication such as amiodarone or quinidine;
• HIV or AIDS medicine such as delavirdine or ritonavir; or
• medicine to treat psychiatric disorders, such as aripiprazole, chlorpromazine, fluphenazine, haloperidol, perphenazine, or thioridazine.

This list is not complete and other drugs may interact with tamoxifen. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about tamoxifen.