tamoxifen (Novaldex, Soltamox)

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Introduction

Tradename: Novaldex.

Indications

* Hypothetical benefits:

Benefit/risk

  • 22 high-risk women needed to be treated with tamoxifen for 5 years to prevent 1 breast cancer over 20 years[7]

Dosage

Tabs: 10 mg., Liquid (Soltamox)

Pharmacokinetics

elimination via liver

1/2life = 4 days

Monitor

Adverse effects

* (relative risk)

Drug interactions

Test interactions

Laboratory

Mechanism of action

More general terms

More specific terms

Additional terms

Component of

References

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  4. Northern California Kaiser Permanente Videoconference, Nov. 11, 1999
  5. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  6. 6.0 6.1 Journal Watch 20(20):164, 2000 Bergman et al, Lancet 356:881, 2000
  7. 7.0 7.1 Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. Prescriber's Letter 9(9):50 2002
  9. Prescriber's Letter 10(11):65 2003
  10. 10.0 10.1 10.2 Prescriber's Letter 11(1):3 2004
  11. 11.0 11.1 Journal Watch 25(13):107, 2005 Chalas E, Costantino JP, Wickerham DL, Wolmark N, Lewis GC, Bergman C, Runowicz CD. Benign gynecologic conditions among participants in the Breast Cancer Prevention Trial. Am J Obstet Gynecol. 2005 Apr;192(4):1230-7; discussion 1237-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15846210
  12. 12.0 12.1 Abramson N, Costantino JP, Garber JE, Berliner N, Wickerham DL, Wolmark N. Effect of Factor V Leiden and prothrombin G20210-->A mutations on thromboembolic risk in the national surgical adjuvant breast and bowel project breast cancer prevention trial. J Natl Cancer Inst. 2006 Jul 5;98(13):904-10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16818854
  13. 13.0 13.1 Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Liver Function Test Scheduling Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260704&pb=PRL (subscription needed) http://www.prescribersletter.com
  14. 14.0 14.1 14.2 14.3 Kelly CM et al Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study. BMJ. 2010 Feb 8;340:c693. doi:http://dx.doi.org/ 10.1136/bmj.c693 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20142325
  15. 15.0 15.1 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
  16. 16.0 16.1 ARUP Consult: CYP2D6 Genotyping - Tamoxifen deprecated reference
  17. 17.0 17.1 17.2 Davies C et al 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. The Lancet, Early Online Publication, 5 December 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23219286 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61963-1/abstract
    Powles TJ Extended adjuvant tamoxifen for breast cancer-a new era? The Lancet, Early Online Publication, 5 December 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23219287 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)62038-8/fulltext
  18. 18.0 18.1 Davies C, Godwin J, Gray R, et al. Early Breast Cancer Trialists' Collaborative Group. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 2011; 378:771-784 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21802721
  19. 19.0 19.1 Physician's First Watch, April 16, 2013 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
    Nelson HD et al Use of Medications to Reduce Risk for Primary Breast Cancer: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 16 April 2013;158(8):604-614 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23588749 <Internet> http://annals.org/article.aspx?articleid=1676456
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  21. 21.0 21.1 21.2 Deprecated Reference
  22. Cuzick J et al Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial. The Lancet Oncology, Early Online Publication, 11 December 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25497694 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2814%2971171-4/fulltext
    Chlebowski RT IBIS-I tamoxifen update: maturity brings questions. The Lancet Oncology, Early Online Publication, 11 December 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25497695 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2814%2971184-2/fulltext
  23. 23.0 23.1 23.2 Kuznar W Guidance Issued for Tamoxifen Based on CYP2D6 Genotyping. Poor metabolizers may require increase in dose or a switch to an aromatase inhibitor. MedPage Today. ASCO Reading Room 03.20.2018 https://www.medpagetoday.com/reading-room/asco/breast-cancer/71868
    Goetz MP, Sangkuhl K, Guchelaar HJ, et al Clinical pharmacogenetics implementation consortium (CPIC) guideline for CYP2D6 and tamoxifen therapy Clin Pharmacol Ther. 2018 Jan 31 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29385237
  24. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 601: tamoxifen and uterine cancer. Obstet Gynecol 2014 Jun; 123:1394 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24848920
  25. 25.0 25.1 Brooks M Tamoxifen Ups Risk of Uterine Disease, Endometrial Cancer. Medscape, Dec 1, 2022 https://www.medscape.com/viewarticle/984846
    Ryu KJ, Kim MS, Lee JY et al Risk of Endometrial Polyps, Hyperplasia, Carcinoma, and Uterine Cancer After Tamoxifen Treatment in Premenopausal Women With Breast Cancer. JAMA Netw Open. 2022;5(11):e2243951. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36441547 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799011

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