Treatment Name: Tamoxifen (Nolvadex®)
How does tamoxifen work?
Tamoxifen is designed to block estrogen receptors on the surface of breast cancer cells. In patients with Estrogen Receptor positive (ER+) disease, estrogen binds to these receptors and causes the breast cancer cells to grow and divide out of control. Tamoxifen blocks this signal and helps stop the breast cancer cells from growing. It can be taken by both pre-menopausal and post-menopausal women.
Goals of therapy:
Tamoxifen is commonly taken to decrease symptoms and prevent breast cancer from spreading to other parts of the body. Tamoxifen, when taken for metastatic breast cancer, is not commonly given with the goal of cure.
- Usual starting dose: Tamoxifen 20 mg oral tablet by mouth daily
Tamoxifen is dispensed by a pharmacy and taken at home.
It is taken for three to five years, or discontinued if unacceptable side effects occur.
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported side effects with tamoxifen are shown here. Side effects sometimes have percentage ranges [example: 30-38% hot flashes] because they differed between in clinical studies.
How often is monitoring needed?
Labs (blood tests) may be checked every one to three months. Labs often include: Complete Blood Count (CBC), and Comprehensive Metabolic Panel (CMP).
How often is imaging needed?
Imaging may be checked before treatment and every two to six months during treatment. Imaging may include: bone scans, magnetic resonance imaging (MRI), and computerized tomography (CT) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue tamoxifen as planned, or delay or switch therapy.
- Hot flashes are one of the most commonly reported side effects with tamoxifen. If this is having a significant effect on everyday life, talk to your doctor about ways to minimize and treat hot flashes. There are many herbal medications and natural supplements that claim to help treat hot flashes. These medications could interact with tamoxifen or other medications you are taking. Do not take any medicines, herbs, or natural supplements without speaking with your doctor or pharmacist first
- Tamoxifen is also available in an oral solution. Talk to your doctor about switching to the oral solution if you are having trouble swallowing the oral tablets
- There are many possible drug interactions with tamoxifen that may decrease the effectiveness of tamoxifen or increase the risk of side effects. Talk to your doctor or pharmacist before starting any new medication. Two SSRI drugs, fluoxetine and paroxetine, are known to decrease effects of tamoxifen. A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for breast cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications.
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Tamoxifen (Nolvadex®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Tamoxifen (Nolvadex®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Tamoxifen (Nolvadex®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Tamoxifen (Nolvadex®)