This drug has a boxed warning. These are the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
- Tamoxifen can increase the risk of serious and life threatening events, including uterine cancer, blood clots, and stroke. These events can be fatal. You should discuss the potential benefits and risks of this drug with your doctor.
- Tamoxifen oral tablet is only available as a generic drug. There’s no brand-name version.
- Tamoxifen oral solution is available as a brand-name drug and as a generic drug. Brand name: Soltamox.
- Tamoxifen comes as an oral tablet and as an oral solution.
- Tamoxifen oral tablet is used to treat and help prevent breast cancer.
Tamoxifen is a prescription drug. It comes as an oral tablet and an oral solution.
Tamoxifen oral tablet is only available as a generic drug. Generic drugs usually cost less than a brand-name drug.
Why it’s used
Tamoxifen is used to treat and help reduce the risk of certain types of breast cancer. It’s used alone and with other drugs as part of endocrine therapy.
Endocrine therapy can help slow or stop the progression of breast cancer by changing the balance of hormones in the body.
Some types of breast cancer develop more quickly if high levels of estrogen are present. Lowering estrogen levels may help reduce this risk.
How it works
Tamoxifen belongs to a group of drugs called antiestrogens, also known as selective estrogen receptor modulators (SERMs).
A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Antiestrogens work by blocking the effects of the hormone estrogen in the body. Estrogen may cause the growth of some types of breast tumors. Tamoxifen may block the growth of tumors that respond to estrogen.
Tamoxifen can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking tamoxifen. This list does not include all possible side effects.
For more information on the possible side effects of tamoxifen, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.
More common side effects
The more common side effects that occur with tamoxifen include:
- hot flashes
- vaginal discharge
- fluid retention (swelling)
- weight loss
- mood changes
- skin rash
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects.
Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Changes in the lining (endometrium) of your uterus. These changes may mean serious problems are starting, including cancer of the uterus. Symptoms can include:
- vaginal bleeding or bloody discharge in a rusty or brown color. You should call your doctor even if a small amount of bleeding occurs.
- changes in your menstrual cycle, such as in the amount or timing of bleeding or increased clotting
- pain or pressure in your pelvis (below your belly button)
- Blood clots in your veins or lungs. These can occur for up to 2–3 months after you stop taking tamoxifen. Symptoms can include:
- sudden chest pain
- shortness of breath
- coughing up blood
- pain, tenderness, or swelling in one or both of your legs
- Stroke. Symptoms can include:
- sudden weakness, tingling, or numbness in your face, arm, or leg, especially on one side of your body
- sudden confusion
- trouble speaking
- trouble seeing in one or both eyes
- trouble walking
- dizziness
- loss of balance or coordination
- severe headache with no known cause
- Cataracts. Symptoms can include:
- blurred vision
- Liver problems. Symptoms can include:
- loss of appetite
- yellowing of your skin or the whites of your eyes (jaundice)
The tamoxifen dosage your doctor prescribes will depend on several factors. These include:
- type and severity of the condition you’re using tamoxifen to treat
- your age
- the form of tamoxifen you take
- other medical conditions you may have
Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.
All possible dosages and forms may not be included here.
Dosage for metastatic breast cancer
Generic: Tamoxifen
- Form: oral tablet
- Strengths: 10 mg, 20 mg
Adult dosage (ages 18 years and older)
The typical recommended dosage is 20–40 mg per day taken in one or divided doses for 5 years. If you take more than 20 mg per day, you should take half of your dose in the morning and half of your dose in the evening.
Child dosage (ages 0–17 years)
A safe and effective dosage in people under the age of 18 years hasn’t been determined.
Dosage for adjuvant treatment of breast cancer
Generic: Tamoxifen
- Form: oral tablet
- Strengths: 10 mg, 20 mg
Adult dosage (ages 18 years and older)
The typical recommended dosage is 20–40 mg per day taken in one or divided doses for 5 years. If you take more than 20 mg per day, you should take half of your dose in the morning and half of your dose in the evening.
Child dosage (ages 0–17 years)
A safe and effective dose in people under the age of 18 years hasn’t been determined.
Dosage for ductal carcinoma in situ (DCIS)
Generic: Tamoxifen
- Form: oral tablet
- Strengths: 10 mg, 20 mg
Adult dosage (ages 18 years and older)
The typical recommended dosage is 20 mg taken once per day.
Child dosage (ages 0–17 years)
A safe and effective dosage in people under the age of 18 years hasn’t been determined.
Dosage for reduction in breast cancer incidence for people at high risk
Generic: Tamoxifen
- Form: oral tablet
- Strengths: 10 mg, 20 mg
Adult dosage (ages 18 years and older)
The typical recommended dosage is 20 mg taken once per day.
Child dosage (ages 0–17 years)
A safe and effective dosage in people under the age of 18 years hasn’t been determined.
Tamoxifen is used for long-term treatment. It’s shown to be most effective if it’s used for 5 years. It comes with serious risks if you don’t take it as prescribed.
If you don’t take it at all: Not taking tamoxifen could affect your treatment outcome. If there’s a reason that you don’t want to take your medication, talk with your doctor.
If you take too much: Taking too much tamoxifen may cause the following symptoms:
- shaky hands
- dizziness
- unsteady walk
- changes in heart rhythm (QT prolongation)
What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before the time for your next dose, take only one dose at that time.
Never try to catch up by taking two doses at once. This could result in dangerous side effects.
How to tell if the drug is working:
- For breast cancer treatment: Your doctor will do blood tests and imaging studies periodically to check the progress of your cancer treatment. Your doctor will tell you if the drug is working to treat your cancer.
- For cancer prevention: Your doctor may order tests and do exams to check for cancer.
This drug comes with several warnings.
Cataracts warning
Tamoxifen can increase the risk of getting cataracts or needing cataract surgery.
Tell your doctor if you have blurred vision. This may mean that you have cataracts, and you may need surgery. Talk with your doctor about the risks and benefits of this drug.
Liver problems warning
This drug may increase your risk for liver problems. The signs of liver problems include loss of appetite and yellowing of your skin or the whites of your eyes.
Tell your doctor if you have these symptoms. Talk with your doctor about the risks and benefits of this drug.
Blood thinners warning
If you’re taking warfarin or a similar blood-thinning medication, tamoxifen can increase the amount of the drug in your body. This may make it easier for you to bleed.
If you have ductal carcinoma in situ (DCIS) or a history of blood clots and you must take warfarin, you should not use tamoxifen. Some blood thinners, like apixaban and Xarelto, are generally safe to take with tamoxifen.
Allergy warning
Tamoxifen can cause a severe allergic reaction. Symptoms include:
- trouble breathing
- swelling of your throat or tongue
- hives
Call 911 or go to the nearest emergency room if you develop these symptoms.
Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).
Warnings for people with certain health conditions
For people with changes in the lining of the uterus: Tamoxifen can further increase your risk for changes in the lining of the uterus. If you have a history of this condition, talk with your doctor before using this drug. Let your doctor know if you develop menstrual changes, abnormal vaginal bleeding, changes in vaginal discharge, or pelvic pain or pressure. Your doctor may adjust your dosage or have you stop taking tamoxifen.
For people with a history of blood clots: Tamoxifen can further increase your risk for blood clots. If you have a history of this condition, talk with your doctor before using this drug. If you develop leg pain or swelling, shortness of breath, cough, or chest pain, tell your doctor and go to the emergency room right away.
For people with a history of stroke: Tamoxifen can further increase your risk for stroke. If you have a history of this condition, talk with your doctor before using this drug.
For people with a history of eye problems: Tamoxifen can further increase your risk for eye problems, such as cataracts. If you have a history of vision problems, talk with your doctor before using this drug. Let your doctor know if you have any changes in vision. They may lower your dosage or have you stop taking the drug.
For people with liver problems: Tamoxifen can further increase your risk for liver problems. If you have a history of this condition, talk with your doctor before using this drug. If you develop signs of liver damage, such as yellowing of your skin or the whites of your eyes, tell your doctor. They may adjust your dosage of this medication.
Warnings for other groups
For pregnant people: Tamoxifen is not explicitly contraindicated in pregnancy but has stipulations around its use and pregnancy. People should be advised not to become pregnant while taking tamoxifen or within 2 months of discontinuing tamoxifen and should use barrier or nonhormonal contraceptive measures if sexually active.
Talk with your doctor if you’re pregnant or planning to become pregnant.
Ask your doctor to tell you about the specific harm that may be done during pregnancy. This drug should only be used if the potential risk to the pregnancy is acceptable given the drug’s potential benefit.
For people who are nursing: It isn’t known if tamoxifen passes into breast milk. If it does, it may cause side effects in a child who’s nursed. Talk with your doctor if you nurse your child. You may need to decide whether to stop nursing or stop taking this medication.
For seniors: Older adults may process drugs more slowly. This can cause the drug to build up in your body, which may increase your risk for side effects.
For children: This drug shouldn’t be used in people under the age of 18 years.
Call your doctor
You should contact your doctor right away if you have any of the following symptoms.
Some of these symptoms may suggest that you’re experiencing a rare but serious side effect associated with tamoxifen:
- new breast lumps
- vaginal bleeding
- changes in your menstrual cycle
- changes in vaginal discharge
- pelvic pain or pressure
- swelling or tenderness in your calf
- unexplained shortness of breath
- sudden chest pain
- coughing up blood
- changes in your vision
Tamoxifen can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with tamoxifen. This list does not contain all drugs that may interact with tamoxifen.
Before taking tamoxifen, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take.
Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Examples of drugs that can cause interactions with tamoxifen are listed below.
Adrenal gland disorder drugs
Taking tamoxifen with certain medications for adrenal gland disorders can decrease the amount of tamoxifen in your blood. You shouldn’t use these drugs together.
Examples of these drugs include:
- aminoglutethimide
Blood thinners
Taking tamoxifen with warfarin can increase the amount of the blood-thinning medication in your body. This may make it easier for you to bleed.
If you must take warfarin and you have ductal carcinoma in situ (DCIS) or want to reduce your risk for breast cancer, you should not use tamoxifen. Other types of anticoagulants exist, which are generally safe to take with tamoxifen.
Bromocriptine
Taking tamoxifen with bromocriptine increases the amount of tamoxifen in your body. If you need to take these drugs together, your doctor may adjust your dosage of tamoxifen.
Cancer-fighting drugs
Taking tamoxifen with certain cancer drugs decreases the amount of the cancer drugs in your body. This means they won’t work as well.
Taking tamoxifen with these drugs also increases your risk for blood clots. You should not use tamoxifen with these drugs.
Examples of these cancer drugs include:
- letrozole
- anastrozole
Seizure drugs
Taking tamoxifen with certain seizure drugs may lower the amount of tamoxifen in your body. If you need to take these drugs together, your doctor may adjust your dosage of tamoxifen.
Examples of these drugs include:
- phenobarbital
- fosphenytoin
- phenytoin
Tuberculosis drugs
Taking tamoxifen with certain tuberculosis drugs can decrease the amount of tamoxifen in your body.
If you need to take these drugs together, your doctor may increase your tamoxifen dosage. Examples of these drugs include:
- rifampin
- rifabutin
- rifapentine
Keep these considerations in mind if your doctor prescribes tamoxifen for you.
General
- You can take your tamoxifen with or without food.
- You should not cut or crush the tablet.
Storage
- Store tamoxifen at room temperature between 68°F and 77°F (20°C and 25°C).
- Don’t freeze tamoxifen.
- Keep it away from light and high temperature.
- Don’t store this medication in moist or damp areas, such as bathrooms.
Refills
A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.
Travel
When traveling with your medication:
- Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
- Don’t worry about airport X-ray machines. They can’t hurt your medication.
- You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
- Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
Clinical monitoring
Your doctor may order tests to make sure that your treatment is going well. They may check your:
- blood cell counts, including for red blood cells, white blood cells, and platelets
- liver function
There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk with your doctor about possible alternatives.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
When to call the doctor
Call your doctor if you feel any new lumps in your breasts.