Tamoxifen (Nolvadex®)

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About This Drug

Tamoxifen is used to treat cancer. It is given orally (by mouth). 

Possible Side Effects

  • Hot flashes or sudden skin flushing may happen. You also may feel warm or red.
  • Nausea
  • Swelling in your legs, ankles, and/or feet
  • Vaginal discharge
  • Menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
  • Non-cancerous changes to the lining of the uterus. 

Note: Not all possible side effects are included above.

Warnings and Precautions 

  • Blood clots and events such as stroke and heart attack. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain. 
  • Effects on the eye including clouding of the lens in your eye. This drug may make cataracts worse or may raise the chance of new cataracts. 
  • This drug may raise your risk of getting a second cancer.
  • Increased calcium.
  • Changes in your liver function
  • Decrease in the number of platelets. This may raise your risk of bleeding.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

How to Take Your Medication

  • Swallow the medicine whole with or without food. Do not chew, break, cut, or crush it.
  • Missed dose: If you miss a dose, take it as soon as you think about it. If it’s almost time for your next dose, then skip the missed dose and take your next dose at the regular time and contact your physician. Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • Storage: Store this medicine in the original container at room temperature. Avoid excessive heat (over 104°F/40°C). Protect from light.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To help with nausea, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms.
  • To decrease risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools. 
  • Use an electric shaver instead of a razor.

Food and Drug Interactions

  • There are no known interactions of tamoxifen with food
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking  before starting this medicine as there are known drug interactions with tamoxifen. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • There are known interactions of tamoxifen with blood thinning medicine such as warfarin. Ask your doctor what precautions you should take. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Blurred vision or other changes in eyesight
  • Your leg or arm is swollen, red, warm and/or painful
  • Wheezing and/or trouble breathing
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Easy bleeding or bruising 
  • Weight gain of 5 pounds in one week (fluid retention)
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Changes in monthly vaginal bleeding
  • Pain or pressure in lower abdomen
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective nonhormonal methods of birth control during your cancer treatment and for at least 9 months after treatment. Men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 6 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breastfeed during treatment and for 3 months after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby. 
  • Fertility warning: In women, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on egg banking.

Revised June 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.