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Nolvadex is a nonsteroidal antiestrogen that has an antitumor effect. Nolvadex is available as film-coated tablets that contain 10 mg or 20 mg of the active ingredient Tamoxifen citrate.

The action of Nolvadex lies in the reduction and/or prevention of the breast tumor growth by suppressing the synthesis of the hormone estrogen. Thus, Nolvadex improves survival rates and reduces the likelihood of breast cancerrecurrence.

Prescribing Information

Nolvadex is used to treat hormone receptor positive metastatic breast cancer or ductal carcinoma in situ (DCIS). Nolvadex is often prescribed in combination with such treatmentmethods for I or II stagebreast cancer, as:

  • Radiation therapy.
  • Removal of regional lymph nodes.
  • Segmental or radical breastresection.

Premenopausal women can use Nolvadex as an alternative to breast cancer treatments, such as mastectomy or ovarian irradiation.


The results of clinical studies indicate a gradual increase in the therapeutic effect of Nolvadex with its continued use. For this reason, Nolvadex is the drug of choice for long-term breast tumor therapy.

  • The minimum dose of Nolvadex for treatment of I or II degree breast cancer is 20 mg per day.
  • In insufficient effectiveness of Nolvadex 20 mg, the daily dose can be increased to a maximum of 40 mg.
  • Nolvadex can be taken once a day, or split into two equal doses.


Nolvadex can potentiate the therapeutic effect of coumarin-type anticoagulants. For this reason, you may need to adjust the dose of such drugs as Coumadin (Warfarin)during the course of Nolvadex.

Concentration of Nolvadex in blood plasma may decrease in its simultaneous use with:

  • Antidepressants of the SSRI group, in particular Luvox (Fluvoxamine), Paxil (Paroxetine) or Zoloft (Sertraline)
  • Broad-spectrum antibiotics, such as Rifadin (Rifampicin)

When Nolvadex is used in combination with chemotherapeutic drugs, such as Adriamycin (Doxorubicin) or Rheumatrex (Methotrexate), the likelihood of pulmonary embolism or deep vein thrombosis increases.

Side effects

The most common side effect of Nolvadex is bone pain, which can be alleviated with analgesics. Less often, Nolvadex can cause weight gain, vaginal dryness, excessive sweating, or impairment of the menstrual cycle.

These side effects of Nolvadex are mild in nature and quickly disappear with further use. With prolonged use, Nolvadex can cause such severe adverse reactions, as:

  • leukopenia
  • thrombocytopenia
  • endometrial adenocarcinoma

However, the likelihood of these severe adverse reactions of Nolvadex is very low. In addition, the positive effects of Nolvadex in the treatment of breast cancer significantly exceed the risk of its undesirable phenomena.


Women with a history of thromboembolic events should evaluate the extent of the benefits and risks of Nolvadex use before they start a hormone therapycourse.

Patients on Nolvadex are recommended to undergo blood tests on a regular basis to determine the concentration of leukocytes and platelets.

At the beginning of a Nolvadex course, the level of blood calcium should be measuredon a regular basis. If symptoms of hypercalcemia (hypertension, polyuria, or nausea) are present, it may be necessary to discontinue Nolvadex.