Tamoxifen Disease Interactions

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.

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.

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.

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.

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.