Tamoxifen Citrate interactions

Food & lifestyle

• soybean

  Moderate

  Antagonism

  Due to their estrogenic effect, isoflavones present in soy such as genistein and daidzein may stimulate breast tumor growth and antagonize the antiproliferative action of tamoxifen.

  What to do: Until more information is available, patients treated with tamoxifen may consider avoiding or limiting the consumption of soy-containing products. Consumption of green tea and green tea extracts during tamoxifen therapy appears to be safe.

  2 sources

  1. Therapeutic Research Faculty "Natural Medicines Comprehensive Database. http://www.naturaldatabase.com" (2008):
  2. Braal CL, Hussaarts KGAM, Seuren L, et al. "Influence of green tea consumption on endoxifen steady-state concentration in breast cancer patients treated with tamoxifen." Breast Cancer Res Treat 184 (2020): 107-13

Conditions

Conditions in which Tamoxifen Citrate needs care, as documented in this source.

• Pulmonary Embolism

  Major

  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.

  1 source

  1. "Product Information. Soltamox (tamoxifen)." Cytogen Corporation (2018):

• Bone Marrow Failure Disorders

  Moderate

  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.

  4 sources

  1. Love RR, Surawicz TS, Williams EC "Antithrombin III level, fibrinogen level, and platelet count changes with adjuvant tamoxifen therapy." Arch Intern Med 152 (1992): 317-20
  2. Ching CK, Smith PG, Long RG "Tamoxifen-associated hepatocellular damage and agranulocytosis ." Lancet 339 (1992): 940
  3. "Product Information. Nolvadex (tamoxifen)." Astra-Zeneca Pharmaceuticals (2001):
  4. Mike V, Currie VE, Gee TS "Fatal neutropenia associated with long-term tamoxifen therapy." Lancet 344 (1994): 541-2

• Endometrial Hyperplasia

  Moderate

  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.

  16 sources

  1. Ford MR, Turner MJ, Wood C, Soutter WP "Endometriosis developing during tamoxifen therapy." Am J Obstet Gynecol 158 (1988): 1119
  2. Corley D, Rowe J, Curtis MT, Hogan WM, Noumoff JS, Livolsi VA "Postmenopausal bleeding from unusual endometrial polyps in women on chronic tamoxifen therapy." Obstet Gynecol 79 (1992): 111-6
  3. "Product Information. Nolvadex (tamoxifen)." Astra-Zeneca Pharmaceuticals (2001):
  4. Divers MJ "Massive endometrial polyp after tamoxifen therapy." Br J Clin Pract 49 (1995): 275-6
  5. Neven P "Endometrial changes in patients on tamoxifen." Lancet 346 (1995): 1292
  6. Shushan A, Peretz T, Uziely B, Lewin A, Moryosef S "Ovarian cysts in premenopausal and postmenopausal tamoxifen-treated women with breast cancer." Am J Obstet Gynecol 174 (1996): 141-4
  7. Mcgonigle KF, Lantry SA, Odommaryon TL, Chai A, Vasilev SA, Simpson JF "Histopathologic effects of tamoxifen on the uterine epithelium of breast cancer patients: analysis by menopausal status." Cancer Lett 101 (1996): 59-66
  8. Court C "International group evaluates tamoxifen risks for women." BMJ 312 (1996): 529

  Show all 16 sourcesShow fewer sources

  9. Cecchini S, Ciatto S, Bonardi R, Mazzotta A, Grazzini G, Pacini P, Muraca MG "Screening by ultrasonography for endometrial carcinoma in postmenopausal breast cancer patients under adjuvant tamoxifen." Gynecol Oncol 60 (1996): 409-11
  10. Fisher B "Commentary on endometrial cancer deaths in tamoxifen-treated breast cancer patients." J Clin Oncol 14 (1996): 1027-39
  11. Sasco AJ "Tamoxifen and menopausal status: risks and benefits." Lancet 347 (1996): 761
  12. Coleman MP "Safety of tamoxifen." Lancet 347 (1996): 836-7
  13. Cuenca RE, Giachino J, Arrendondo MA, Hempling R, Edge SB "Endometrial carcinoma associated with breast carcinoma: low incidence with tamoxifen use." Cancer 77 (1996): 2058-63
  14. Ismail SM "The effects of tamoxifen on the uterus." Curr Opin Obstet Gynecol 8 (1996): 27-31
  15. "Tamoxifen under scrutiny as carcinogen in California." Eur J Cancer 32A (1996): 567
  16. Thylan S "Tamoxifen-associated ovarian cysts may be endometriomas." Am J Obstet Gynecol 175 (1996): 752

• Liver Diseases

  Moderate

  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.

  6 sources

  1. Loomus GN, Aneja P, Bota RA "A case of peliosis hepatis in association with tamoxifen therapy." Am J Clin Pathol 80 (1983): 881-3
  2. Agrawal BL, Zelkowitz L "Bone 'flare,' hypercalcemia, and jaundice after tamoxifen therapy ." Arch Intern Med 141 (1981): 1240
  3. Blackburn AM, Amiel SA, Millis RR, Rubens RD "Tamoxifen and liver damage." Br Med J (Clin Res Ed) 289 (1984): 288
  4. Ching CK, Smith PG, Long RG "Tamoxifen-associated hepatocellular damage and agranulocytosis ." Lancet 339 (1992): 940
  5. "Product Information. Nolvadex (tamoxifen)." Astra-Zeneca Pharmaceuticals (2001):
  6. Van Hoof M, Rahier J, Horsmans Y "Tamoxifen-induced steatohepatitis." Ann Intern Med 124 (1996): 855-6

• Vision Disorders

  Moderate

  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.

  8 sources

  1. Griffiths MF "Tamoxifen retinopathy at low dosage." Am J Ophthalmol 104 (1987): 185-6
  2. Bentley CR, Davies G, Aclimandos WA "Tamoxifen retinopathy: a rare but serious complication." BMJ 304 (1992): 495-6
  3. Pavlidis NA, Petris C, Briassoulis E, Klouvas G, Psilas C, Rempapis J, Petroutsos G "Clear evidence that long-term, low-dose tamoxifen treatment can induce ocular toxicity. A prospective study of 63 patients." Cancer 69 (1992): 2961-4
  4. Pugesgaard T, Von Eyben FE "Bilateral optic neuritis evolved during tamoxifen treatment." Cancer 58 (1986): 383-6
  5. "Product Information. Nolvadex (tamoxifen)." Astra-Zeneca Pharmaceuticals (2001):
  6. Heier JS, Dragoo RA, Enzenauer RW, Waterhouse WJ "Screening for ocular toxicity in asymptomatic patients treated with tamoxifen." Am J Ophthalmol 117 (1994): 772-5
  7. Mihm LM, Barton TL "Tamoxifen-induced ocular toxicity." Ann Pharmacother 28 (1994): 740-2
  8. Jaiyesimi IA, Buzdar AU, Decker DA, Hortobagyi GN "Use of tamoxifen for breast cancer: twenty-eight years later." J Clin Oncol 13 (1995): 513-29

Therapeutic duplication

Drug classes that overlap with Tamoxifen Citrate, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• antineoplastic hormones

  The recommended maximum number of medicines in the 'antineoplastic hormones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antineoplastic hormones' category.

  Example product in the source data (US market): Letrozole/ribociclib