Tamoxifen
Brand: Soltamox
Boxed warning
Uterine malignancies, stroke, and pulmonary embolism in women treated for breast cancer risk reduction or DCIS.
- Caution
- Blood clots, endometrial changes, and cataracts; CYP2D6 inhibitors such as paroxetine reduce its activation.
- Pregnancy
- Contraindicated in pregnancy: fetal harm; use non-hormonal contraception during and for 2 months after treatment.
Common side effects
- Hot flashes
- Vaginal discharge
- Blood clot risk
- Endometrial changes
Key interactions
- Paroxetine and fluoxetine reduce its activation via CYP2D6
- Raises warfarin's effect
Counseling points
- Report leg swelling, chest pain, or abnormal vaginal bleeding
- Gynecologic exams are recommended
- Avoid strong CYP2D6-inhibiting antidepressants
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