{"id":53723,"date":"2022-09-06T09:44:15","date_gmt":"2022-09-06T13:44:15","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=53723"},"modified":"2022-09-06T09:44:15","modified_gmt":"2022-09-06T13:44:15","slug":"tamoxifen-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/tamoxifen-side-effects\/","title":{"rendered":"Tamoxifen side effects and how to avoid them"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#common-tamoxifen-side-effects\">Common tamoxifen side effects\u00a0<\/a>| <a href=\"#serious-side-effects\">Serious side effects<\/a> | <a href=\"#weight-gain\">Weight gain<\/a> | <a href=\"#pain\">Pain<\/a> | <a href=\"#mood-disturbances\">Mood disturbances<\/a> | <a href=\"#side-effects-timeline\">Side effects timeline<\/a> | <a href=\"#contraindications\">Contraindications<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a> |<a href=\"#how-to-treat-side-effects\"> How to treat side effects<\/a><\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/tamoxifen-citrate\"><span style=\"font-weight: 400;\">Tamoxifen<\/span><\/a><span style=\"font-weight: 400;\"> is a generic prescription drug used for hormone receptor-positive <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/breast-cancer-treatment-and-medications\"><span style=\"font-weight: 400;\">breast cancer<\/span><\/a><span style=\"font-weight: 400;\"> treatment or breast cancer prevention in people with a high risk of breast cancer. Also prescribed as brand-name <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/soltamox\"><span style=\"font-weight: 400;\">Soltamox<\/span><\/a><span style=\"font-weight: 400;\"> or Nolvadex, tamoxifen is used to treat metastatic breast cancer, breast cancer that has spread to the lymph nodes in postmenopausal women, and early-stage breast cancer (ductal carcinoma in situ or DCIS) to prevent it from developing into invasive cancer.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tamoxifen is a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/selective-estrogen-receptor-modulators\"><span style=\"font-weight: 400;\">selective estrogen receptor modulator<\/span><\/a><span style=\"font-weight: 400;\"> (SERM). It blocks the effects of estrogen, the female hormone that promotes tumor growth in HER+ breast cancers. Like many anticancer drugs, tamoxifen is a powerful drug with a long list of side effects. Fortunately, <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=7ee3d3d2-85d1-4018-8e70-5ed8a64ae1f0\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">most of its side effects will be mild<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"common-tamoxifen-side-effects\"><span style=\"font-weight: 400;\">Common side effects of tamoxifen<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most commonly experienced <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/28705\/tamoxifen\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">side effects<\/span><\/a><span style=\"font-weight: 400;\"> of tamoxifen are as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hot flashes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Flushing<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fluid retention<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Joint pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mood disturbances<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Arthritis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Menstrual changes, menstrual period delays, or absence of menstruation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vaginal bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tiredness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sore throat<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Infection<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Skin rash<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vomiting<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Depression<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vaginal discharge<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Elevated blood pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling of the hands, feet, and lower legs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Back pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight gain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abdominal pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Insomnia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cough<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cataracts<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Constipation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Trouble breathing<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<\/ul>\n<h2 id=\"serious-side-effects\"><span style=\"font-weight: 400;\">Serious side effects of tamoxifen<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most serious side effects of tamoxifen include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blood clots<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stroke<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">New malignancies<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Endometrial cancer<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ovarian cysts<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Death or spontaneous abortion of a fetus<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Birth defects<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cataracts<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Damage to the retina<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver dysfunction<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lowered white blood cell or platelet counts<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High blood calcium<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pancreas problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe allergic reactions<\/span><\/li>\n<\/ul>\n<h3 id=\"weight-gain\"><span style=\"font-weight: 400;\">Weight gain<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Weight gain may be a possible side effect of <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/tamoxifen-citrate\/what-is\"><span style=\"font-weight: 400;\">tamoxifen<\/span><\/a><span style=\"font-weight: 400;\">. In clinical trials, weight gain was only a significant problem when tamoxifen was taken for early-stage breast cancer. <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=7ee3d3d2-85d1-4018-8e70-5ed8a64ae1f0\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">In that trial<\/span><\/a><span style=\"font-weight: 400;\">, 9% of participants gained weight over several years of treatment. However, in clinical trials in which tamoxifen was used with other drugs to treat later-stage breast cancer, 23% of participants experienced weight loss. If any unintended weight changes are experienced in that time, talk to the prescribing healthcare provider for medical advice.<\/span><\/p>\n<h3 id=\"pain\"><span style=\"font-weight: 400;\">Pain<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pain is a common side effect of tamoxifen. In all the initial clinical trials, a variety of pains were reported: headache, joint pain, bone pain, muscle pain, abdominal cramps, chest pain, breast pain, and generalized pain. The alternative to tamoxifen is to take an <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/aromatase-inhibitors\"><span style=\"font-weight: 400;\">aromatase inhibitor<\/span><\/a><span style=\"font-weight: 400;\"> (AI) such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/arimidex\"><span style=\"font-weight: 400;\">Arimidex<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/anastrozole\"><span style=\"font-weight: 400;\">anastrozole<\/span><\/a><span style=\"font-weight: 400;\">) or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/femara\"><span style=\"font-weight: 400;\">Femara<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/letrozole\"><span style=\"font-weight: 400;\">letrozole<\/span><\/a><span style=\"font-weight: 400;\">), but these medications have a higher incidence of pain as a side effect. If pain is a problem, talk with the prescriber about pain management options.<\/span><\/p>\n<h3 id=\"mood-disturbances\"><span style=\"font-weight: 400;\">Mood disturbances<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">It would make sense that tamoxifen might cause mood changes because many of its side effects are similar to menopause symptoms, such as hot flashes, flushing, and night sweats. However, mood disturbances may or may not be a side effect of tamoxifen. In clinical trials, mood problems were only reported in one trial using tamoxifen to treat early-stage breast cancer. Mood disturbances were not a significant problem in all other tamoxifen trials. In addition, <\/span><a href=\"https:\/\/ascopubs.org\/doi\/full\/10.1200\/JCO.2001.19.7.1885\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">one later study<\/span><\/a><span style=\"font-weight: 400;\"> followed almost 500 women taking tamoxifen over five years and found no problems with mood disturbances. Mood disturbances are always a possibility with or without drug treatment. It\u2019s possible that mood problems may be due to tamoxifen treatment, but it\u2019s also possible they\u2019re not. If they\u2019re experienced, talk to the prescriber about options for managing them.<\/span><\/p>\n<h2 id=\"side-effects-timeline\"><span style=\"font-weight: 400;\">How soon do tamoxifen side effects start?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Like all prescription drugs, many of tamoxifen\u2019s side effects can start early in treatment. Some, like flushing, can start even after the first dose. It takes about <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2740485\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">four weeks<\/span><\/a><span style=\"font-weight: 400;\"> of continual daily dosing for tamoxifen to reach steady-state levels in the body, so it\u2019s normal to start experiencing side effects by that time.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How long do tamoxifen side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some side effects will improve over time as the body adapts to the drug. Unfortunately, estrogen-blocking cancer treatment is usually a long-term therapy, so the drug\u2019s side effects may become a part of everyday life. <\/span><a href=\"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.18.01160\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Guidelines<\/span><\/a><span style=\"font-weight: 400;\"> call for tamoxifen treatment to continue for three, five, or 10 years to prevent breast cancer from recurring. Long-term treatment <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3596060\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">substantially reduces the risk<\/span><\/a><span style=\"font-weight: 400;\"> of future breast cancer or death. As long as the side effects aren\u2019t too serious, healthcare professionals will want their patients to continue with tamoxifen treatment. Guidelines also call for tamoxifen therapy, if it\u2019s used for three or five years, to be followed by five to seven years using a different estrogen-blocking therapy, an aromatase inhibitor. These drugs, too, will cause side effects. Most side effects of estrogen-blocking therapy will resolve when treatment ends.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the long-term side effects of tamoxifen?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Tamoxifen is a long-term drug treatment. Daily dosing could last for a decade. Delayed side effects, such as menstruation irregularities, new cancers, blood clots, or vision problems, usually take a few weeks or months of treatment to occur, but they can happen at any time during the years-long treatment. The length of treatment does not add any new side effects or significantly increase the risk of other side effects. According to the largest study of tamoxifen treatment, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3596060\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">ATLAS<\/span><\/a><span style=\"font-weight: 400;\">, the risk of many of the most severe side effects of tamoxifen only goes up slightly if tamoxifen is taken for 10 years, rather than five years.<\/span><\/p>\n<h2 id=\"contraindications\"><span style=\"font-weight: 400;\">Tamoxifen contraindications<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Tamoxifen is contraindicated in anyone with the following medical conditions:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A history of blood clot problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pregnancy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Undiagnosed vaginal bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A known allergy to the drug<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Pregnancy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Tamoxifen can cause birth defects, kill a fetus, or cause a spontaneous abortion. It is never used in pregnant women. Healthcare professionals will urge women of reproductive age to use nonhormonal contraception and to be tested for pregnancy.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Breastfeeding<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Because of the risk to a nursing infant, women should not breastfeed when taking tamoxifen. Breastfeeding should not be resumed until tamoxifen has been discontinued for at least three months.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Children<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The Food and Drug Administration (FDA) has not approved tamoxifen to treat children or adolescents. However, some healthcare providers have prescribed tamoxifen to young girls (2\u201310 years of age) to treat the early onset of puberty. This is not common, though, because there are effective, well-studied, FDA-approved puberty blockers that can be used instead.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Older adults<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In one clinical trial, tamoxifen was found to be effective in older women without any increased risk of side effects relative to younger adults.<\/span><\/p>\n<h2 id=\"warnings\"><span style=\"font-weight: 400;\">Tamoxifen warnings<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most cancer drugs come with a host of warnings. However, tamoxifen does not attack or kill the cancer cells. It simply blocks the female hormone, estrogen. Therefore, there are fewer hazards with tamoxifen than with other cancer drugs.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Cautions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A few medical conditions will require caution or extra monitoring:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People at risk for blood clots will need closer monitoring because tamoxifen is associated with potentially hazardous blood clots.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with high fats or high cholesterol may have their condition worsened when taking tamoxifen.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with cataracts or vision problems might have their condition worsened by tamoxifen.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Women of reproductive age will need to use nonhormonal contraception to prevent pregnancy.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People whose cancer has spread to the bones may be at a higher risk for a tumor flare accompanied by high calcium levels in the body.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some people do not break down tamoxifen very well, so doses may need to be adjusted.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Tamoxifen is not associated with drug abuse and does not cause physical dependence or withdrawal.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Get medical attention or call a poison control center if too much tamoxifen is taken. The maximum daily dose approved by the FDA is 20 mg, but the maximum off-label daily dose is 120 mg. Extremely large doses have been known to cause neurological problems such as tremors, heightened reflexes, and even seizures.<\/span><\/p>\n<h2 id=\"interactions\"><span style=\"font-weight: 400;\">Tamoxifen interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some drugs can cause problems when combined with tamoxifen. They are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticoagulants\"><span style=\"font-weight: 400;\">Anticoagulants<\/span><\/a><span style=\"font-weight: 400;\">: Tamoxifen can increase the effects of anticoagulants, making bleeding episodes more likely. In particular, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/warfarin-sodium\"><span style=\"font-weight: 400;\">warfarin<\/span><\/a><span style=\"font-weight: 400;\"> is never used when tamoxifen is prescribed for breast cancer prevention.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aromatase inhibitors: AIs are also used to block estrogen in women with hormone receptor-positive breast cancer. They block the ability of the body to produce estrogen. They are not supposed to be used at the same time as tamoxifen, but years of AI treatment typically follow tamoxifen treatment.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Some tamoxifen drug interactions increase the risk of heart rhythm abnormalities. These drugs include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antiarrhythmics\"><span style=\"font-weight: 400;\">Antiarrhythmics<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/beta-blockers\"><span style=\"font-weight: 400;\">Beta blockers<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antipsychotics\"><span style=\"font-weight: 400;\">Antipsychotics<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/opioids\"><span style=\"font-weight: 400;\">Opioids<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some types of <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-do-antibiotics-work\/\"><span style=\"font-weight: 400;\">antibiotics<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some types of <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/ssris\"><span style=\"font-weight: 400;\">SSRIs<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Inhaled anesthetics<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/hiv-treatment-and-medications\"><span style=\"font-weight: 400;\">HIV\/AIDS<\/span><\/a><span style=\"font-weight: 400;\"> drugs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some cancer chemotherapy drugs<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Some drugs speed up the body\u2019s metabolism of tamoxifen, causing tamoxifen levels in the body to fall quickly and making treatment less effective. These include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticonvulsants\"><span style=\"font-weight: 400;\">anticonvulsants<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Barbiturates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/conditions\/tuberculosis-treatment-and-medications\"><span style=\"font-weight: 400;\">Tuberculosis<\/span><\/a><span style=\"font-weight: 400;\"> antibiotics<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cocaine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">St. John\u2019s wort<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-avoid-side-effects\"><span style=\"font-weight: 400;\">How to avoid tamoxifen side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Tamoxifen is taken for years, so learning how to avoid side effects is essential. Everyone may experience a different set of side effects and can find different ways to avoid them. When starting the drug, though, start with the following:<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. Make sure the prescriber has a complete medical history<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">This is standard advice for anyone prescribed a drug. It\u2019s one of the surest ways to avoid serious side effects. It\u2019s safe to say, however, that an oncology specialist will obtain a thorough medical history and perform many tests before starting treatment. The oncologist will particularly pay attention to:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any history of blood clot problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cataracts or other vision problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High fats or high cholesterol<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pregnancy or pregnancy plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Breastfeeding or breastfeeding plans<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">2. Take tamoxifen as instructed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Follow all the instructions for the medication given by the prescriber or written on the prescription label. Take doses as scheduled, and don\u2019t miss any doses.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3. Cut back on smoking, alcohol, and hot drinks<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Avoiding nicotine, alcohol, and hot drinks can help reduce the severity of hot flashes.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. Have regular eye exams<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Schedule regular eye exams to catch possible vision problems before they become serious.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. Eat a healthy diet<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">To avoid weight changes and bone loss, eat a healthy diet. The prescriber or a nutritionist should be able to help.<\/span><\/p>\n<h2 id=\"how-to-treat-side-effects\"><span style=\"font-weight: 400;\">How to treat side effects of tamoxifen<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">About <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3500489\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">20% to 50%<\/span><\/a><span style=\"font-weight: 400;\"> of women with HER+ breast cancer stop hormone therapy because of the adverse effects. Managing side effects is important for the long-term success of the treatment. Here\u2019s some advice:<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Hot flashes<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Dress in layers and remove clothes when you get too hot. Cooling pads, cold drinks, and spraying the face with cool water can also help. If hot flashes are too burdensome, talk to the prescribing healthcare provider. Some <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5482277\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">antidepressants<\/span><\/a><span style=\"font-weight: 400;\">, particularly SSRIs or <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/snris\"><span style=\"font-weight: 400;\">SNRIs<\/span><\/a><span style=\"font-weight: 400;\">, can help reduce hot flashes.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Swelling<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">To help reduce swelling, elevate the feet. If swelling persists or gets worse, let the prescribing healthcare provider know about it.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Skin rash<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A skin rash may be the first sign of a potentially severe drug reaction, so tell the prescribing healthcare provider about it immediately. If it\u2019s a severe rash, go to an emergency room.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Problems with vision<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Immediately contact the prescribing healthcare provider at any sign of vision changes, such as blurred vision, halos around lights, or reduced night vision.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Vaginal bleeding or discharge<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Abnormal vaginal bleeding or unusual discharge may be a sign of a serious problem such as uterine cancer. Immediately contact the prescribing healthcare provider.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Blood clots<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Blood clots can\u2019t be seen, but they can cause health-threatening medical conditions such as a <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/deep-vein-thrombosis-treatment-and-medications\"><span style=\"font-weight: 400;\">deep vein thrombosis<\/span><\/a><span style=\"font-weight: 400;\"> or pulmonary embolism. Get immediate medical attention at any symptom of a possible blood clot, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Leg pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Leg swelling or redness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chest pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coughing up blood<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Shortness of breath<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Tumor flare-up<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Tamoxifen can cause breast cancer that has spread to the bones to flare up and serum calcium levels to increase. Immediately contact the prescribing healthcare provider when any of these symptoms are noticed:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bone pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Malaise<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Constipation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Confusion<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Liver problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Tamoxifen can affect liver function, so tell the prescriber if symptoms of liver problems are noticed, such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dark urine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pale stools<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Throwing up<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of appetite<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding and bruising<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Yellowing of the skin or eyes<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Sources<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.18.01160\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Adjuvant endocrine therapy for women with hormone receptor\u2013positive breast cancer: ASCO clinical practice guideline focused update<\/span><\/a><span style=\"font-weight: 400;\">, American Society of Clinical Oncology<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5482277\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Do SSRIs and SNRIs reduce the frequency and\/or severity of hot flashes in menopausal women<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">The Journal of the Oklahoma State Medical Association<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3596060\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Lancet<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2740485\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">New insights into the metabolism of tamoxifen and its role in the treatment and prevention of breast cancer<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Steroids<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/online.epocrates.com\/drugs\/28701\/tamoxifen\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tamoxi<\/span><\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3500489\/\" target=\"_blank\" rel=\"noopener\">Patient-reported discontinuation of endocrine therapy and related adverse effects among women with early-stage breast cancer<\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.pdr.net\/drug-summary\/Tamoxifen-Citrate-tamoxifen-citrate-664\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tamoxifen citrate drug summary<\/span><\/a><span style=\"font-weight: 400;\">, Prescriber\u2019s Digital Reference<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=7ee3d3d2-85d1-4018-8e70-5ed8a64ae1f0\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tamoxifen citrate prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/ascopubs.org\/doi\/full\/10.1200\/JCO.2001.19.7.1885\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tamoxifen for the prevention of breast cancer: Psychosocial impact on women participating in two randomized controlled trials<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Journal of Clinical Oncology<\/span><\/i><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Common tamoxifen side effects\u00a0| Serious side effects | Weight gain | Pain | Mood disturbances | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects | How to treat side effects Tamoxifen is a generic prescription drug used for hormone receptor-positive breast cancer treatment or breast cancer prevention in [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":53730,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[794,12752,8670],"coauthors":[8861],"class_list":["post-53723","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-cancer","tag-medication-side-effects","tag-womens-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Tamoxifen side effects and how to avoid them | SingleCare<\/title>\n<meta name=\"description\" content=\"Weight gain, pain, and mood disturbances are common tamoxifen side effects. 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