Nolvadex

Nolvadex (Tamoxifen) is an anticancer agent prescribed for breast cancer patients. While it has been extensively used in the prevention of breast cancer, it is also being considered for other cancers in humans. Nolvadex is available in the form of tablets or suspensions. It is usually white or off-white.

Uses of Nolvadex

Drug Name:	Nolvadex
Tablet Strength:	20mg x 30 Pills
Best Price:	$36.34 (Per Pill $$0.52)
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Doctors prescribe this drug for the following:

• Treatment of early puberty in McCune Albright’s syndrome
• Treatment of estrogen receptor-positive breast cancer in women
• Prevention of recurrence of breast cancer in risk individuals
• Ovulation induction in anovulatory women (infertility)
• Management of pain in dysmenorrhea
• Prevention and treatment of gynecomastia
• Prevention of osteoporosis

How Nolvadex Works

Being a selective estrogen receptor modulator, Nolvadex works both as an antagonist of estrogen receptor activities as well as a promoter of estrogen receptor activities. In the breast tissue, estrogen is needed for the growth of breast tissues which breast cancer tissues thrive on.

Nolvadex inhibits estrogen receptor genes thereby causing breast cancer cells to shrink. In bone tissues, it acts as an estrogen receptor agonist, inhibiting osteoclasts and preventing osteoporosis.

Precautions

Patients should heed these instructions before consuming Nolvadex:

• Do not take this drug without a doctor's prescription and close monitoring as it can predispose you to stroke, other forms of cancer, or blood clots.
• Avoid using Nolvadex if you are allergic to Tamoxifen.
• It is important you tell your doctor about any of the following:

○ History of blot clots or currently experiencing blood clotting-related disorders like deep vein thrombosis or pulmonary embolism

○ You’re using medications like St John's wort, Carbamazepine, Rifampin, Phenytoin

○ Breastfeeding (give a 3 months gap after your last dose before breastfeeding and do not breastfeed while on Nolvadex)

○ Taking drugs like warfarin, anastrozole, or letrozole

○ Diabetes, high blood pressure, or liver diseases

○ Dyslipidemias, cataract

○ Pregnant or planning to become pregnant

○ Limited or inability to walk

How to Use Nolvadex

Take this drug exactly as directed by your doctor. It should be taken by mouth. Nolvadex can be taken with or without food. Swallow the tablets/capsules whole with water or any suitable drink. You are likely to take this drug for a minimum of 5 years for breast cancer.

While on Nolvadex therapy, you may need to run some blood tests occasionally. The drug may affect certain Lab test parameters so you need to inform the Lab personnel that you are on Nolvadex. Additionally, you may experience low blood counts that can predispose you to infections, bleeding problems, or anemia.

Ensure you do regular breast exams while on this drug. It can increase your chances of developing cataracts or requiring cataract surgery.

You will have to use non-hormonal birth control methods like condoms while using this drug and for 8 weeks after you have stopped using it.

Nolvadex Dosing Information

The dose to take is dependent on your condition as determined by your doctor. It can also be modified as you progress with the therapy.

For reduction in breast cancer incidence in high-risk women and the treatment of ductal carcinoma in situ (DCIS), the recommended dose is 20 mg every day for 5 years.

For treatment of breast cancer, the recommended dose is between 20-40 mg daily. Even though no evidence shows whether doses greater than 20 mg per day are more effective, some doctors will advise you to take doses greater than 20 mg daily in two divided doses, that is, morning and evening daily.

Side Effects of Nolvadex

Side effects due to allergies to this drug include the following: rash, itching, skin reactions (red, swollen, or blistered skin), trouble swallowing, trouble breathing, tightness in the chest, and swelling (eyes, face, tongue, lips, and throat).

Other side effects include:

• Weakness and unusual tiredness
• Stomach pain or constipation
• Blood in the urine
• Pain/burning sensation while urinating
• Frequent urination
• Abdominopelvic pain
• Vomiting
• Lumpy or sore breast
• Change in balance
• Depression
• Headaches
• Changes in vision
• Drooping on one side of the face
• Low libido
• Lack of erection in men
• Swellings on the limbs
• Confusion

Missed Dose and Overdose

If you miss a dose, take it as soon as you remember. But if you suspect overdose or accidental poisoning, call the poison control center in your area.

Interactions

Nolvadex interacts with some soy products, causing more stimulation of breast tumor growth and reducing the effectiveness of the drug. Its major drug interactions include:

• Bedaquiline
• Arsenic trioxide
• Chloroquine
• Cimetidine
• Dexfenfluramine
• Efavirenz
• Fluoxetine
• Givosiran
• Haloperidol
• Ivosidnib
• Methadone
• Lorcaserin
• Procainamide
• Ribociclib
• Sertraline
• Terbinafine
• Vigabatrin
• Warfarin
• Ziprasidone

Your doctor will tell you the drugs to avoid when you start taking Nolvadex. The disease interactions are listed below.

• Deep vein thrombosis/ pulmonary embolism
• Liver dysfunction (diseases)
• Visual disturbances (including cataracts, retinopathy, and corneal changes)
• Endometrial dysplasia
• Myelosuppression (bone marrow depression, low blood counts, bleeding)

Storage

Nolvadex should be stored at room temperature and away from heat, light, and moisture. It should be kept out of the reach of children and pets.