- Hormone receptor-positive breast cancer:
- Adjuvant treatment: PO 20mg OD *5-10 years
- Max: 20 mg/day
- For use following total/partial mastectomy, axillary dissection, and breast XRT and to decrease CA risk in contralateral breast
- Adjuvant treatment: PO 20mg OD *5-10 years
-
- Metastatic disease: PO 20-40mg/day divided OD/BD
- For male and female metastatic breast cancer treatment
- Divide dose BD if >20mg/day
- Metastatic disease: PO 20-40mg/day divided OD/BD
- Ductal carcinoma in situ (DCIS):
- PO 20mg OD *5 years
- For use following breast surgery and XRT to decrease invasive breast cancer risk
- Prevention of breast cancer in women at high risk:
- PO 20mg OD *5 years
- PO 20mg OD *5 years
- Mastalgia (Off-label):
- PO 10mg OD *4/12
- PO 10mg OD *4/12
- Ovulation induction (Off-label):
- PO 5-40mg BD *4/7
- PO 5-40mg BD *4/7
- Precocious puberty in female patients with McCune-Albright syndrome children (Off-label):
- PO 20mg OD
- Tablet:
- 10mg
- 20mg
- Taken without regards to food
Antiestrogens
It selectively binds to estrogen receptors, producing estrogenic and anti-estrogenic effects (estrogen receptor modulator). It acts as estrogen antagonist in breast cancer cells, preventing tumor growth.
It can also act as an estrogen agonist in hypothalamus of premenopausal women, increasing gonadotropins and inducing ovulation
- Hot flashes
- Edema
- Vaginal discharge
- Nausea
- Vomiting
- Menstrual irregularities
- Vaginal bleeding
- Weight changes
- Asthenia
- Pain
- Arthritis
- URI
- Rash
- Mood disturbance
- Hypertension
- Arthralgia
- UTI
- Infection
- Insomnia
- Cough
- Headache
- Constipation
- Dizziness
- Dyspnea
- Diarrhea
- Fractures
- Cataracts
- Flu syndrome
- Dyspepsia
- Sweating
- Alopecia
- Ovarian cysts
- Neoplasm
- Anemia
- Myalgia
- Paresthesia
- Vaginitis
- Elevated LFTs
- Hypercholesterolemia
- Transient tumor flare
- Impotence
- Hypersensitivity to drug/class
- Pregnancy
- Undiagnosed vaginal bleeding
- Thromboembolism history (breast cancer prevention or DCIS use)
- Breastfeeding during treatment and for 3 month after discontinuing
WARNING
- Serious, life-threatening and sometimes fatal events in risk reduction setting (ductal carcinoma in situ and high breast cancer risk women) including uterine malignancies (endometrial adenocarcinoma and uterine sarcoma), stroke and PE
- Warfarin
Drug Status
| Availability | Prescription only |
| Pregnancy | Category D; benefit outweighs risk |
| Breastfeeding | Contraindicated; benefit outweighs risk |
| Schedule | Not controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Nolvadex | 20mg | Tablet | 30’s | AstraZeneca | AstraZeneca |
| Tamoxifen | 20mg | Tablet | 30’s | Sandoz GMBH | Novartis Kenya |