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Nolvadex (tamoxifen) Disease Interactions

There are 5 disease interactions with Nolvadex (tamoxifen):

Major

Tamoxifen (applies to Nolvadex) DVT/pulmonary embolism

Major Potential Hazard, Moderate plausibility. Applicable conditions: Thrombotic/Thromboembolic Disorder

The use of tamoxifen is contraindicated in women with a history of deep vein thrombosis or pulmonary embolus or in women who require concomitant coumarin- type anticoagulant therapy. There is evidence of an increased incidence of thromboembolic events, including deep vein thrombosis and pulmonary embolism, during tamoxifen therapy.

Moderate

Tamoxifen (applies to Nolvadex) endometrial dysplasia

Moderate Potential Hazard, Moderate plausibility.

Endometrial changes such as hyperplasia, polyps, and endometrial cancer have been reported during tamoxifen therapy. Patients should be instructed to immediately report any signs or symptoms of uterine abnormality such as menstrual irregularities, abnormal vaginal bleeding, change in vaginal discharge, or pelvic pain or pressure. Therapy with tamoxifen should be administered cautiously in patients with or history of gynecological abnormalities.

References

  1. Corley D, Rowe J, Curtis MT, Hogan WM, Noumoff JS, Livolsi VA "Postmenopausal bleeding from unusual endometrial polyps in women on chronic tamoxifen therapy." Obstet Gynecol 79 (1992): 111-6
  2. Coleman MP "Safety of tamoxifen." Lancet 347 (1996): 836-7
  3. Court C "International group evaluates tamoxifen risks for women." BMJ 312 (1996): 529
  4. Sasco AJ "Tamoxifen and menopausal status: risks and benefits." Lancet 347 (1996): 761
  5. Divers MJ "Massive endometrial polyp after tamoxifen therapy." Br J Clin Pract 49 (1995): 275-6
  6. Cecchini S, Ciatto S, Bonardi R, Mazzotta A, Grazzini G, Pacini P, Muraca MG "Screening by ultrasonography for endometrial carcinoma in postmenopausal breast cancer patients under adjuvant tamoxifen." Gynecol Oncol 60 (1996): 409-11
  7. Thylan S "Tamoxifen-associated ovarian cysts may be endometriomas." Am J Obstet Gynecol 175 (1996): 752
  8. Mcgonigle KF, Lantry SA, Odommaryon TL, Chai A, Vasilev SA, Simpson JF "Histopathologic effects of tamoxifen on the uterine epithelium of breast cancer patients: analysis by menopausal status." Cancer Lett 101 (1996): 59-66
  9. Fisher B "Commentary on endometrial cancer deaths in tamoxifen-treated breast cancer patients." J Clin Oncol 14 (1996): 1027-39
  10. Ford MR, Turner MJ, Wood C, Soutter WP "Endometriosis developing during tamoxifen therapy." Am J Obstet Gynecol 158 (1988): 1119
  11. Shushan A, Peretz T, Uziely B, Lewin A, Moryosef S "Ovarian cysts in premenopausal and postmenopausal tamoxifen-treated women with breast cancer." Am J Obstet Gynecol 174 (1996): 141-4
  12. Cuenca RE, Giachino J, Arrendondo MA, Hempling R, Edge SB "Endometrial carcinoma associated with breast carcinoma: low incidence with tamoxifen use." Cancer 77 (1996): 2058-63
  13. "Product Information. Nolvadex (tamoxifen)." Zeneca Pharmaceuticals, Wilmington, DE.
  14. Ismail SM "The effects of tamoxifen on the uterus." Curr Opin Obstet Gynecol 8 (1996): 27-31
  15. "Tamoxifen under scrutiny as carcinogen in California." Eur J Cancer 32A (1996): 567
  16. Neven P "Endometrial changes in patients on tamoxifen." Lancet 346 (1995): 1292
View all 16 references
Moderate

Tamoxifen (applies to Nolvadex) hepatic dysfunction

Moderate Potential Hazard, Low plausibility. Applicable conditions: Liver Disease

Tamoxifen is extensively metabolized by the liver and excreted in the feces. Alteration in liver enzyme levels have been noted. Severe hepatic injuries such as fatty liver, cholestasis, hepatitis, and hepatic necrosis are rare, however, deaths have been reported. Patients should be instructed to immediately report any sign or symptoms of hepatic dysfunction such as jaundice, dark urine, right upper quadrant pain, or anorexia. Therapy with tamoxifen should be administered cautiously in patients with or predisposed to compromised hepatic function.

References

  1. Loomus GN, Aneja P, Bota RA "A case of peliosis hepatis in association with tamoxifen therapy." Am J Clin Pathol 80 (1983): 881-3
  2. "Product Information. Nolvadex (tamoxifen)." Zeneca Pharmaceuticals, Wilmington, DE.
  3. Agrawal BL, Zelkowitz L "Bone 'flare,' hypercalcemia, and jaundice after tamoxifen therapy ." Arch Intern Med 141 (1981): 1240
  4. Blackburn AM, Amiel SA, Millis RR, Rubens RD "Tamoxifen and liver damage." Br Med J (Clin Res Ed) 289 (1984): 288
  5. Ching CK, Smith PG, Long RG "Tamoxifen-associated hepatocellular damage and agranulocytosis ." Lancet 339 (1992): 940
  6. Van Hoof M, Rahier J, Horsmans Y "Tamoxifen-induced steatohepatitis." Ann Intern Med 124 (1996): 855-6
View all 6 references
Moderate

Tamoxifen (applies to Nolvadex) myelosuppression

Moderate Potential Hazard, Low plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, Bleeding

Hematological abnormalities during tamoxifen therapy may include thrombocytopenia, leukopenia, and anemia. Rare hemorrhagic episodes, severe neutropenia and pancytopenia have been reported. Therapy with tamoxifen should be administered cautiously to patients with or predisposed to bone marrow suppression.

References

  1. "Product Information. Nolvadex (tamoxifen)." Zeneca Pharmaceuticals, Wilmington, DE.
  2. Ching CK, Smith PG, Long RG "Tamoxifen-associated hepatocellular damage and agranulocytosis ." Lancet 339 (1992): 940
  3. Mike V, Currie VE, Gee TS "Fatal neutropenia associated with long-term tamoxifen therapy." Lancet 344 (1994): 541-2
  4. Love RR, Surawicz TS, Williams EC "Antithrombin III level, fibrinogen level, and platelet count changes with adjuvant tamoxifen therapy." Arch Intern Med 152 (1992): 317-20
View all 4 references
Moderate

Tamoxifen (applies to Nolvadex) visual disturbances

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Visual Defect/Disturbance

Corneal changes, cataracts, and retinopathy have been reported during tamoxifen therapy. Therapy with tamoxifen should be administered cautiously in patients with or predisposed to visual disturbances.

References

  1. Jaiyesimi IA, Buzdar AU, Decker DA, Hortobagyi GN "Use of tamoxifen for breast cancer: twenty-eight years later." J Clin Oncol 13 (1995): 513-29
  2. Pavlidis NA, Petris C, Briassoulis E, Klouvas G, Psilas C, Rempapis J, Petroutsos G "Clear evidence that long-term, low-dose tamoxifen treatment can induce ocular toxicity. A prospective study of 63 patients." Cancer 69 (1992): 2961-4
  3. Griffiths MF "Tamoxifen retinopathy at low dosage." Am J Ophthalmol 104 (1987): 185-6
  4. Bentley CR, Davies G, Aclimandos WA "Tamoxifen retinopathy: a rare but serious complication." BMJ 304 (1992): 495-6
  5. Pugesgaard T, Von Eyben FE "Bilateral optic neuritis evolved during tamoxifen treatment." Cancer 58 (1986): 383-6
  6. Mihm LM, Barton TL "Tamoxifen-induced ocular toxicity." Ann Pharmacother 28 (1994): 740-2
  7. Heier JS, Dragoo RA, Enzenauer RW, Waterhouse WJ "Screening for ocular toxicity in asymptomatic patients treated with tamoxifen." Am J Ophthalmol 117 (1994): 772-5
  8. "Product Information. Nolvadex (tamoxifen)." Zeneca Pharmaceuticals, Wilmington, DE.
View all 8 references

Nolvadex (tamoxifen) drug interactions

There are 378 drug interactions with Nolvadex (tamoxifen)

Nolvadex (tamoxifen) alcohol/food interactions

There is 1 alcohol/food interaction with Nolvadex (tamoxifen)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.