NOLVADEX D (Tamoxifen)
NOLVADEX D (Tamoxifen)
NOLVADEX D (Tamoxifen)
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NOLVADEX D (Tamoxifen)

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What is this medication?

Tamoxifen, Nolvadex D/Soltamox
Antineoplastic agent, selective estrogen receptor modulator (SERM)

Tamoxifen is officially indicated for treatment of breast cancer in some scenarios and to reduce the risk of breast cancer in high risk patient.  It is also prescribed off-label for use in desmoid tumors, endometrial carcinoma, gynecomastia, idiopathic male infertility, induction of ovulation in breast cancer patients, severe mastalgia, and advanced or severe ovarian cancer.

How does this medication work?

Tamoxifen, Nolvadex D/Soltamox is a selective estrogen receptor modulator (SERM) that has a complex mechanism of action.  Its primary action is to block the proliferative actions of estrogen on mammary epithelium.  Soltamox, Nolvadex D/Tamoxifen have also been shown to decrease DNA synthesis evident by the accumulation of cells in the G0 and G1 phases of the cell cycle implying it has a cytostatic rather than a cytocidal mechanism of action.

How should I take this medication?

Breast Cancer, Risk Reduction
Oral: Take 20mg once daily for 5 years.

Breast Cancer, Treatment
Oral: Take 20mg once daily.

Endometrial Carcinoma, Recurrent, Metastatic, or High-Risk (Off-Label Use)
Oral: Take 20mg twice daily until disease progression or unacceptable toxicity.

Gynecomastia (Off-Label Use)
Oral: Take 20mg once daily for up to 12 months.

Idiopathic Male Infertility (Off-Label Use)
Oral: Take 20mg to 30mg once daily for 3 to 6 months.

Induction of Ovulation (Off-Label Use)
Oral: Take 60mg once daily starting on the 2nd or 3rd day of the menstrual cycle (in combination with a low dose of follicle stimulating hormone and continue until the day of hCG administration.

How to Take:  Soltamox, Nolvadex D/Tamoxifen can be taken with or without food.  Take the medication exactly as prescribed by your doctor at the same time each day.  If you miss a dose, make sure to take it as soon as possible.  However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule

You Need to Avoid: If you have a known hypersensitivity to Soltamox, Nolvadex D/Tamoxifen or any component of the formulation; concurrent warfarin therapy or history of deep vein thrombosis or pulmonary embolism.

What should I watch for while using this medication?

Can cause bone marrow suppression 

Serious and life-threatening cancers such as uterine malignancies, endometrial adenocarcinoma and uterine sarcoma has been reported

Visual disturbances including retinal thrombosis, retinopathy, corneal changes, color perception changes and increased incidence of cataracts has been reported

Serious and life-threatening events such as stroke and pulmonary embolism has been reported

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?


Cardiovascular: Vasodilation (41%), flushing (33%), hypertension (11%), peripheral edema (11%)

Dermatologic: Skin changes (6% to 19%), skin rash (13%)

Endocrine and Metabolic: Hot flash (3% to 80%), fluid retention (32%), weight loss (23%), amenorrhea (16%)

Gastrointestinal: Nausea (5% to 26%), nausea and vomiting (12%)

Genitourinary: Vaginal discharge (12% to 55%), irregular menses (13% to 25%), vaginal hemorrhage (2% to 23%)

Hematologic: Lymphedema (11%)

Nervous System: Fatigue (≤18%), mood changes (12% to 18%), pain (3% to 16%), depression (2% to 12%)

Neuromuscular and Skeletal: Asthenia (≤18%), arthritis (14%), arthralgia (11%)

Respiratory: Pharyngitis (14%)