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Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: PO Breast cancer 20 mg/day as a single or in 2 divided doses. Max: 40 mg/day. Reduction of breast cancer incidence in women at high risk 20 mg/day for 5 yr. Anovulatory infertility 20 mg/day on days 2-5 of the menstrual cycle, increase if necessary in subsequent cycles. Max: 80 mg/day.
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Administration
Tamoxifen: May be taken with or without food.
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Contraindications
History of DVT or pulmonary embolism. Pregnancy and lactation. Concomitant coumarin-type anticoagulant therapy.
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Special Precautions
Patient w/ leucopenia and thrombocytopenia, hyperlipidaemias. CYP2D6 poor and intermediate metaboliser. Monitoring Parameters Perform periodic CBC (e.g. platelet counts) and LFTs. Routine gynaecological monitoring and any abnormal symptoms (e.g. abnormal vag bleeding or discharge, pelvic pain, menstrual irregularities).
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Adverse Reactions
Hot flushes, GI intolerance, nausea, fluid retention, vag bleeding or discharge, pruritus vulvae, dry skin, rashes, alopecia, headache, depression, dizziness, fatigue, confusion, muscle cramps, transient thrombocytopenia and leucopenia, thromboembolism, uterine fibroids, endometrial changes (e.g. polyps, hyperplasia), menstruation suppression, cystic ovarian swelling, increased liver enzymes, hypertriglyceridaemia. Rarely, loss of visual acuity, blurred vision, cataracts, retinopathies, corneal opacities, retinopathies, hepatitis, cholestasis, interstitial pneumonitis.
Potentially Fatal: Stroke, pulmonary embolism, uterine sarcoma, endometrial cancer. |
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Drug Interactions
Increases dopaminergic effect of bromocriptine. Increased risk of thromboembolic events w/ cytotoxic drugs. Increased risk of bleeding w/ platelet aggregation inhibitors. May mutually reduce effects w/ hormone preparations particularly oestrogens (e.g. OCs). Reduced plasma levels w/ CYP3A4 inducers (e.g rifampicin) and CYP2D6 inhibitors. Increased plasma levels w/ CYP3A4 inhibitors.
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CIMS Class
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ATC Classification
L02BA01 - tamoxifen ; Belongs to the class of anti-estrogens.
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