IMPORTANT TAMOXIFEN WARNING:

About your Tamoxifen treatment

Your doctor has ordered the drug Tamoxifen (nolvadex) to help treat your illness. Tamoxifen (nolvadex) comes as tablet to take by mouth.

Tamoxifen is used to:

• treat breast cancer
• reduce the risk of breast cancer in women at high risk for the disease

Tamoxifen (nolvadex) is in a class of drugs known as antiestrogens; it blocks the activity of estrogen, a female hormone produced by the body in the breast. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

Other uses for Tamoxifen

Tamoxifen (nolvadex) is also used sometimes to induce ovulation (egg production) in women who do not produce ova (eggs) but wish to become pregnant, to treat breast pain, and to decrease the size and pain of gynecomastia (swelling and tenderness of the breast). Tamoxifen (nolvadex) may be useful in in treating carcinoid tumors. Talk to your doctor about the possible risks of using this Tamoxifen for your condition.

Tamoxifen may be prescribed for other uses; ask your doctor or pharmacist for more Tamoxifen information.

Tamoxifen Precautions

Before taking Tamoxifen (nolvadex),

• tell your doctor and pharmacist if you are allergic to Tamoxifen (nolvadex) or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aminoglutethimide (Cytadren); anticoagulants (blood thinners) such as warfarin (Coumadin); bromocriptine (Parlodel); cancer chemotherapy drugs; letrozole (Aromasin); phenobarbital (Luminal, Solfoton); and rifampin (Rifadin, Rimactane). Your doctor may need to change the Tamoxifen doses of your medications or monitor you carefully for Tamoxifen side effects.
• in addition to the conditions listed in the IMPORTANT TAMOXIFEN WARNING section, tell your doctor if you have or have ever had liver disease or high blood levels of cholesterol.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should not plan to have children while taking Tamoxifen (nolvadex) or for 2 months after treatments. (Talk to your doctor for further details.) Use a reliable non-hormonal method of birth control to prevent pregnancy. Tamoxifen (nolvadex) may harm the fetus.

Tamoxifen Side effects

Tamoxifen (nolvadex) may cause side effects. Tell your doctor if any of these Tamoxifen symptoms are severe or do not go away:

• increased bone or tumor pain
• hot flashes
• upset stomach
• swelling of the hands, feet, ankles, or lower legs
• vaginal discharge
• excessive tiredness
• dizziness
• depression
• headache
• thinning of hair
• loss of appetite
• stomach cramps
• constipation
• loss of sexual desire or ability (in men)

Some Tamoxifen side effects can be serious. The following Tamoxifen symptoms are uncommon, but if you experience any of them or those listed in the IMPORTANT TAMOXIFEN WARNING section, call your doctor immediately:

• persistent pain or reddening around the tumor site
• vision problems
• pain or swelling of the legs
• shortness of breath

Tamoxifen (nolvadex) may cause other side effects. Call your doctor if you have any unusual problems while taking Tamoxifen.

Tamoxifen Storage conditions

Keep Tamoxifen (nolvadex) in the container it came in, tightly closed, and out of reach of children. Store Tamoxifen at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any Tamoxifen that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your Tamoxifen.

In case of Tamoxifen emergency/overdose

In case of Tamoxifen overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of Tamoxifen overdose may include:

• tremor
• unsteadiness
• dizziness

Special Tamoxifen instructions

• Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your bodys response to Tamoxifen (nolvadex). You should visit your gynecologist regularly. Follow your doctors directions for examining your breasts; report any lumps immediately.
• Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking Tamoxifen (nolvadex).