TM Owner AstraZeneca
Nolvadex D 20mg Tablet
Global Shipping : Reliable Global Distribution Network
Express Delivery : Priority Shipping for Every Order
Secure Payments : Trusted Payment Protection System
Disclaimer
Secure Handling
24/7 Worldwide Support
Global Access
Worldwide Access to Health
Cold-Chain Expert
Excellence in Cold-Chain
Trusted Supply
Certified Medical Supply
Indications & Clinical Uses
- Nolvadex D 20 mg film-coated tablets contain tamoxifen citrate, an oestrogen-receptor modulator, and are the higher-strength, octagonal tablet in the same AstraZeneca UK product family as the 10 mg Nolvadex tablet; the two share one combined product leaflet.
- Nolvadex D is used to treat hormone-receptor-positive breast cancer in women and men, for the primary prevention of breast cancer in women at moderate or high risk, and for anovulatory infertility in some markets.
- In the US, AstraZeneca discontinued the Nolvadex brand (including the 20 mg strength) in 2006 as a commercial decision, and only generic tamoxifen is now supplied there; Nolvadex D remains authorised and marketed in the UK.
- The standard breast cancer dose is a single 20 mg Nolvadex D tablet once daily, taken by mouth at home; for infertility it is taken as one 20 mg tablet daily on cycle days 2 to 5.
- Higher breast-cancer doses give no added benefit.
Side Effects
- In the United States, tamoxifen (including the historic 20 mg Nolvadex brand) carries a BOXED WARNING for serious, sometimes fatal events in women taking it to reduce breast cancer risk or after ductal carcinoma in situ: uterine cancer, stroke and pulmonary embolism (blood clots in the lungs) all occur more often than with placebo.
- Very common side effects (more than 1 in 10 people) include hot flushes, vaginal discharge or bleeding, fluid retention and tiredness; nausea is also common.
- Serious reactions needing urgent medical attention include unusual vaginal bleeding, calf pain or swelling, sudden breathlessness or chest pain, sudden visual disturbance, and signs of a severe skin reaction such as blistering or peeling skin (Stevens-Johnson syndrome has been reported).
- Report any of these to a healthcare provider immediately or seek emergency care.
Precautions & Warnings
- Nolvadex D must not be used in pregnancy and is contraindicated with concurrent anastrozole; women who could become pregnant must use effective non-hormonal contraception during treatment and for at least 9 months afterwards, and breastfeeding is not recommended.
- Regular gynaecological review is advised because of an increased risk of endometrial changes, including hyperplasia, polyps, cancer and uterine sarcoma, so any abnormal vaginal bleeding should be reported promptly.
- Nolvadex D increases the risk of blood clots (deep vein thrombosis, pulmonary embolism) and can prolong the QT interval on an ECG, so caution is needed in people with heart rhythm problems or on other QT-prolonging drugs.
- Regular eye checks are recommended with long-term use because of a risk of cataracts and other visual changes, and liver function should be monitored, since rare liver abnormalities have occurred.
- Store below 30°C in the original container.
Avoid Interactions
- Nolvadex D increases the effect of coumarin-type anticoagulants such as warfarin, raising bleeding risk, so anticoagulant dosing may need closer monitoring.
- Combining it with cytotoxic chemotherapy increases the risk of blood clots.
- Strong CYP2D6-inhibiting antidepressants, particularly paroxetine and fluoxetine, reduce levels of tamoxifen's active metabolite and may lower its effectiveness, so alternative antidepressants are often preferred if one is needed.
- Rifampicin markedly lowers tamoxifen blood levels, and aromatase inhibitors such as letrozole or anastrozole should not be combined with Nolvadex D.
- Other drugs that prolong the QT interval add to that risk when taken together.
- As with any hormonal cancer treatment, tell your healthcare provider or pharmacist about every prescription, over-the-counter medicine, herbal product and supplement before starting or continuing Nolvadex D.
References
Frequently Asked Questions
Nolvadex D (tamoxifen citrate 20 mg) treats hormone-receptor-positive breast cancer and reduces breast cancer risk in women at higher risk. It is the 20 mg tablet in AstraZeneca's Nolvadex family; the US brand was discontinued in 2006, but it remains sold in the UK.
Nolvadex D is a single 20 mg tablet taken by mouth once daily, with or without food, self-administered at home. For infertility use it is taken on cycle days 2 to 5 only. Higher breast-cancer doses give no extra benefit, so do not exceed what is prescribed.
Very common effects include hot flushes, vaginal discharge or bleeding, and fluid retention. Nolvadex D carries a boxed warning for uterine cancer, stroke and blood clots in the lungs in risk-reduction use. Report unusual bleeding, leg swelling, chest pain or breathlessness urgently.
Avoid pregnancy and use non-hormonal contraception during treatment and for 9 months after stopping. Avoid combining Nolvadex D with anastrozole, and tell your prescriber if you take warfarin, paroxetine or fluoxetine, since these change bleeding risk or reduce how well Nolvadex D works.
Nolvadex D and Nolvadex both contain tamoxifen citrate from AstraZeneca and share one patient leaflet, but Nolvadex D is the 20 mg octagonal tablet while plain Nolvadex is a 10 mg tablet. Do not assume one tablet of either strength equals the same dose.
No. Nolvadex D is contraindicated in pregnancy because tamoxifen can harm a developing baby. Women who could become pregnant must use effective non-hormonal contraception while taking it and for at least 9 months after the last dose, and should not breastfeed during treatment.
Trusted & Reliable – Your Partner in Global Distribution.
We provide comprehensive lines of pharmaceutical products to support all your healthcare distribution needs.
