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Drug Formulary
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tamoxifen

( ta-MOX-i-fen )
Other Name(s): Nolvadex®-D
Appearance: tablet in various strengths
pdf download tamoxifen patient.pdf
pdf download tamoxifne pour le patient.pdf

Medication Information Sheet
tamoxifen (ta-MOX-i-fen)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Nolvadex®-D, Tamofen®

Appearance:
tablet

in various strengths

What is this medication for?
  • For treating breast cancer which expresses hormone receptors in women, ovarian, and other cancers

What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:
    • blood clots,
    • stroke,
    • liver problems,
    • severe depression,
    • low blood counts,
    • eye problems (including cataracts),
    • or any allergies.
       
  • Some brands of tamoxifen contain a small amount of lactose. If you cannot tolerate lactose, talk to your doctor.
     
  • People who have cancer or leukemia are at a higher risk of developing other cancers/leukemias (usually some years later) or blood clots. Some cancer medications may increase these risks, especially if used for a prolonged period of time. You should discuss any concerns with your doctor.
How will this medication affect sex, pregnancy and breastfeeding?
  • Tamoxifen can harm the unborn baby and should not be used in pregnant women. 
     
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must: 
    • ►Use 2 effective forms of birth control at the same time while taking this drug. Do not take birth control pills if you have breast cancer. Keep using birth control until 9 months after the last dose. Discuss with your healthcare team.
       
  • Tell your doctor right away if you or your partner becomes pregnant.
     
  • Do not breastfeed while taking this drug.
     
  • Tamoxifen may affect fertility (ability to get pregnant).
How is this medication given?

  • Swallow whole with a glass of water, with or without food.

  • Do not crush or chew the tablets.

  • Take the dose at about the same time each day.

  • Do not stop taking it, even if you feel better. You may need to take this medication for a long time, as directed by your doctor. Make sure you understand the instructions.

What else do I need to know while on this medication?

  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

  • Do not take any treatment containing estrogen (including herbal supplements).
How should I safely store this medication?

  • Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

  • Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.

 

 

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
More Common Side Effects (more than 10 out of 100 people)

Hot flashes, feeling or wave of warmth

You may sweat more or have trouble sleeping because of this.
 

To help prevent hot flashes :

  • Avoid triggers such as spicy food, alcohol and caffeine (tea, coffee, and soft drinks),
  • Exercise regularly. Ask your health care team what exercises are appropriate for you before you start any new exercise.
  • Quitting smoking may also help.


If you have hot flashes :

  • Keep cool; dress lightly or in layers that you can easily remove and drink plenty of liquids unless you have been told otherwise.

Hot flashes may improve over time. Talk to your health care team if this is bothersome for you.
 

Other symptoms of having low estrogen levels

  • Vaginal dryness (possibly with discharge or bleeding)
  • Memory loss
  • Mood changes, depression

Contact your health care team if these feelings bother you.

 Contact your health care team if no improvement or if severe

Fatigue (tiredness), weakness

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

 Contact your health care team if no improvement or if severe

Mild swelling in arms and legs; puffiness

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

 Contact your health care team if no improvement or if severe

Nausea and vomiting (generally mild)

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

 Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours

Rash; dry, itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

  • Use skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.

Rarely rash may be severe with blistering or peeling of your skin.  Get emergency medical help right away if this happens.

 Contact your health care team if no improvement or if severe

 

 

 

 

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • pain, swelling and hardening of the vein in an arm or leg
  • chest pain, trouble breathing, coughing up blood
  • confusion
  • severe belly pain
  • sudden loss of vision or changes to vision
  • trouble speaking or using your arms or legs
  • feeling more thirsty than normal (due to high calcium level)
  • unusual bleeding from your vagina
  • symptoms of an allergic reaction: itchiness, rash, swollen lips, face or tongue, chest and throat tightness
  • redness or rash in areas where you had radiation in the past

 

Who do I contact if I have questions or need help?          

My cancer health care provider is: ______________________________________________

During the day I should contact:________________________________________________

Evenings, weekends and holidays:______________________________________________

 

Other Notes:

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May 2022 Updated info sheet

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Funding & Reimbursement

Several payment sources exist for cancer drugs in Ontario, depending on the drug, disease indication, and how and where it is delivered.

View Funding & Reimbursement

Symptom Management

Many people living with cancer experience nausea, diarrhea and other symptoms from their treatment or disease.

View Symptom Management

Drug Safety and Administration

Find documents on drug safety and administration for healthcare providers, including calculations and recommendations.

View Drug Safety and Administration