Therapeutic indications of tamoxifen

Tamoxifen is a drug indicated for the treatment of breast cancer. It is an anti-estrogen drug that belongs to the class of drugs called hormone therapies. Tamoxifen is effective only when the patient has been diagnosed with hormone receptive positive breast cancer. It is prescribed for the treatment of early stage of breast cancer as well as advanced cancer. Tamoxifen is a drug that may be obtained only with prescription. Patients need to consult a doctor first and make the necessary laboratory studies in order to detect the positive breast cancer cells. It is also recommended to read carefully the package insert before starting to take tamoxifen in order to get better informed about indications of administration, potential interaction with other drugs, risks and other details not mentioned previously by a healthcare provider.

 

Tamoxifen profile

Tamoxifen is used as hormonal therapy in the treatment of breast cancer. It works by blocking the effects if estrogen on cancer cells and attacks them. That is why it is called anti-estrogen drug. It stops breast cancer cells from growing. Tamoxifen also helps preventing the recurrence of breast cancer and it is considered very effective. The incidence of recurrence of breast cancer is decreased by tamoxifen in a proportion of 40%. The benefit of the therapy with tamoxifen lies in the fact that it is a drug prescribed in the initial treatment of breast cancer. Generally, this drug needs to be taken for a period of at least 2 years, up to 5 years. After the treatment with tamoxifen, physicians prescribe aromatase inhibitors such as letrozole, exemestane and anastrozole. Studies have shown that if the patient with a diagnosis of breast cancer is first given tamoxifen and then switch the therapy with other drugs, the results are more effective. Unlike other hormonal therapies, tamoxifen may be prescribed in women both before and after the menopause.

Benefits of the treatment with tamoxifen are the following:

·It reduces the risk of cancer recurrence;

·It has positive effect on bones, therefore it is efficient in preventing or slowing down osteoporosis in postmenopausal women;

·Clinical studies have demonstrated that it also reduces the level of cholesterol and thus reduces the incidence of heart disease.

 

Indications of administration and dosage

Tamoxifen is a drug that is available for oral administration as tablets and liquid. Patients need to follow the therapy exactly as prescribed in order to decrease the incidence of adverse events and not aggravate other existing medical conditions. The usual recommended dose of tamoxifen is 20 mg taken once daily. It is indicated to take the dose at the same time each day in order to help you make a dosing schedule and organize your meals. Physicians recommend taking the dose with food in order to avoid any gastrointestinal disturbances.

The length of treatment with tamoxifen depends on the condition of the menopausal condition of the women. Generally, women who have not yet been through the menopause, tamoxifen needs to be taken for a period of 5 years. It also depends on the tolerance to the drug. Therefore, your healthcare provider will prescribe what is best suitable for you and your condition.

 

Possible side effects with tamoxifen

Like all medicines, tamoxifen may also cause side effects when used in prescribed doses. It is important to assess that from the very beginning of the therapy with this drug, due to the fact that each patient reacts in a different way to the drug. Generally, it is considered that during therapy with tamoxifen, many women experience side effects at the initial phase of therapy with the drug. These disappear once the body gets used to it. The most common side effects patients may experience with tamoxifen are the following:

·Hot flushes;

·Fatigue;

·Vaginal dryness;

·Mood changes;

·Poor concentration;

·Irregular menstruation periods;

·Night sweats.

If you get to experience any of the enumerated side effects, do not get alarmed, it is a somehow normal event. However, report to your healthcare provider about the side effects you experience. If these are persistent and bothersome it might be appropriate to decrease the doses until you treat the symptoms and then turn back to usual dosing schedule.

Other side effects patients may experience are the following:

·Headache;

·Vaginal irritation or discharge;

·Leg cramps at night;

·Joint pain;

·Thinning of hair;

·Mild nausea.

The enumerated adverse reactions with tamoxifen are mild to moderate severity. Rarely it may cause polyps or ovarian cysts or cancer of the womb. Patients with a history of deep vein thrombosis are slightly more susceptible to the risk of blood clotting than other patients. There have also been reported cases of disturbed vision and these are more frequent if the patient has already cataract.

 

Potential interaction with other drugs

Prior to initiation of therapy with tamoxifen, your healthcare provider needs to know what other medicines you use to take, including prescription, non-prescription, minerals, vitamins, herbal products and natural supplements. It is a general precaution in order to avoid interaction with tamoxifen. It is not recommended the concurrent administration of tamoxifen with oral anticoagulants such as warfarin. Other medicines that generally interfere with this drug are SSRI antidepressants such as Prozac. Get a list of medicines that might interfere with the mechanism of action of tamoxifen from your healthcare provider and try to not take them concurrently with it.

 

Important facts about tamoxifen:

·Tamoxifen may be taken even if the patient is still having menstrual periods. These might become irregular, lighter or stop completely. If you are close to the natural menopause, then there is an increased chance for not having periods at all. For other details, discuss with a specialized physician.

·It is not recommended the use of the drug during pregnancy. If you are pregnant or intend to become pregnant while on therapy with it, report about it immediately. Discuss with your healthcare provider about the reliable and non-hormonal contraception before starting the therapy with tamoxifen. However, if you become pregnant during treatment with tamoxifen it is necessary to discontinue with the drug. There should not be any interaction between the drug and the fetus.

·Do not stop the treatment at your own consideration. Always discuss with your healthcare provider about the risks and benefits from the treatment with tamoxifen.

·If you forgot to take a dose of tamoxifen, do not double the dose to make up for the skipped one. If you do not have time left to take the missed dose, leave it and return to your usual dosing schedule. The level of drug remains high and there is no need of increasing the dose. However, try to not miss more than two doses in a row.

·It is recommended to store the medicine at the room temperature below 30 degrees C. Keep it away from direct sunlight, heat and moisture. Do not let the drug at the reach and sight of children.

·Do not use expired medicine. Always look carefully at the expiry date at the bottom of the package. If you have any questions, ask a pharmacist or contact a physician.