Tamoxifen course of treatment. Tamoxifen: why it is prescribed for men. What are the benefits of tamoxifen

Tamoxifen is an antiestrogenic drug with anti-inflammatory effects. Used to treat cancer, especially during menopause. Dispensed by prescription. Before starting treatment, consultation with a specialist is required.

Composition of Tamoxifen

The drug is available in the form of convex tablets from 10 to 40 mg. The main component is tamoxifen citrate. Additional components: lactose, cellulose, starch, magnesium stearate, colloidal silicon dioxide. One package contains 30 tablets.

Terms of use

To be treated with Tamoxifen, a woman should undergo appropriate examination. A strong drug can slow down the development of cancer cells, relieve inflammation, and help reduce tumors. The use of Tamoxifen is advisable for cancer:

  • on the ovaries;
  • endometrium;
  • mammary gland;
  • kidney;
  • for melanoma;
  • soft tissue sarcoma.

The duration of treatment with Tamoxifen depends on the diagnosis, the severity of the disease, and the dynamics of development.

Rules of application

The daily dose of the drug is 20–40 mg. Swallow the tablet whole. Take it with liquid. Do this once a day or divide it into 2 doses. The course of treatment is long. Determined by the attending physician. The use of Tamoxifen is complex. At the same time, other anti-cancer medications are prescribed. If the disease progresses, treatment is stopped and another drug is prescribed.

Contraindications

Treatment is carried out under the supervision of a doctor. A direct contraindication is individual intolerance to the components. The reaction may be unpredictable. Prescribe with caution, with dose adjustment, for:

  • problems with kidneys, liver;
  • with the presence of eye pathologies;
  • for diabetes mellitus;
  • severe thrombosis;
  • problems with blood clotting.

Side effects

During treatment, undesirable manifestations associated with the antiestrogenic effect of Tamoxifen can be observed.

  • tides;
  • nausea;
  • weight gain;
  • itching of the genitals;
  • bleeding from the vagina.

Appears much less frequently:


At the beginning of Tamoxifen therapy, an increase in tumor size is observed. Severe erythema appears in the affected areas. Symptoms disappear within 2 weeks after starting Tamoxifen. During long-term treatment, liver functions are impaired and the level of liver enzymes increases. The drug provokes amenorrhea and irregular menstrual cycle. Promotes the development of cystic tumors on the ovaries, uterine fibroids, polyps, and endometrial cancer.

Cases of overdose do not occur, since the use of tablets is controlled by a doctor. An increased dose leads to increased side effects.

Drug interactions

Cancer therapy involves the parallel use of several medications. When prescribing medications, the following interactions should be taken into account:

  1. Antihistamines increase stomach acidity, which accelerates the solubility of Tamoxifen. This reduces its effectiveness. The interval between taking medications is 1–2 hours.
  2. Tamoxifen together with Warfarin increases the rate of blood clotting.
  3. Diuretics, when used together, slow down the removal of calcium from the body. The risk of hypercalcemia increases.
  4. Parallel use with Tegafur causes the development of liver cirrhosis and chronic hepatitis.
  5. Combined use with hormone-containing drugs weakens the effect of the first and second medications.

Special situations

Women undergo periodic examinations during treatment. In certain cases, the use of tablets is stopped.

  1. If vaginal bleeding occurs, Tamoxifen should be discontinued.
  2. Before starting therapy, you need to determine the level of calcium in the blood. If the indicator increases significantly in the first week of therapy, Tamoxifen should be stopped.
  3. Stop treatment if severe venous thrombosis or severe shortness of breath occurs.
  4. Tamoxifen restores hormonal levels and promotes ovulation. Women during therapy and for 3 months after its completion should use protection.
  5. You should be examined by an ophthalmologist and have your blood tested.
  6. Tamoxifen affects the reaction rate. During therapy, you should refrain from driving a car or performing precise work.

It is recommended to discuss any negative changes in well-being with your doctor.

Concentration, elimination period

The action of Tamoxifen is associated with the ability to influence estrogen receptors. The drug makes it difficult for cells to divide, which prevents the growth of a cancerous tumor. The highest concentration in the blood is observed 7 hours after administration. After 4 weeks of therapy, the active component in the blood is maintained at a constant level. It is produced in 2 stages. Initial elimination is observed 14 hours after taking the tablet. Then after 7 days. The main part comes out with feces, a small part with urine.

Tamoxifen analogs

Many countries around the world produce similar products. Among them are Germany, Russia, India, Finland. Price category from 50 rub. up to 2000 rub.

Analogues in composition:

  • Tamoxifen - Hexal;
  • Ferein;
  • Zitazonium;
  • Vero - tamoxifen;
  • Ebewe.

Analogues according to indications, method of use:


Analogues by code:

  • Arimidex;
  • Bilumid;
  • Calumid;
  • Flutamide;
  • Anastrozole;
  • Letrozole;
  • Biculid;
  • Zitiga;
  • Lezra;
  • Egistrazole;
  • Anaster;
  • Flutsin.

Tamoxifen cost

The price of the drug depends on the manufacturer and the location of the pharmacy.

  • 30 pcs. tablets with a dose of 20 mg, India - from 130 rubles;
  • Pharmacor production, Austria – from 230 rubles;
  • Orion Pharma, Poland – from 780 rubles;
  • Tablets 10 mg, 30 pcs., Russia – from 50 rubles;
  • Tamoxifen-Ebewe 20 mg, 30 pcs., Finland – from 1140 rub.

The drug has different price categories. The choice when purchasing is individual. Composition, active substance, side effects, the contraindications are identical. The difference is in the manufacturer and manufacturing technology. For obvious reasons, women prefer manufacturers with a proven reputation - Finland, Germany, the Netherlands, Austria.

Tamoxifen contains 15.2; 30.4 or 45.6 mg tamoxifen citrate , which is respectively equivalent to 10, 20 or 30 mg tamoxifen.

Tablets are packaged in blisters, containers or polyethylene bottles of 10, 20, 30, 40, 50, 60, 90, 100, 120, 150 or 300 pcs.

Release form

Pills.

pharmachologic effect

It has antiestrogenic and antitumor properties.

Pharmacodynamics and pharmacokinetics

Tamoxifen is nonsteroidal antitumor antiestrogenic drug , characterized by the ability to competitively inhibit peripheral estrogen receptors in target organs and tumors arising from them.

As a result, the complex “ tamoxifen receptor-transfer cofactor”, which, translocating into cell nucleus , prevents hypertrophy of estrogen-dependent cells.

Sports Wiki states that the substance was first synthesized in 1971 and became the first antiestrogenic agent among representatives of the class of selective estrogen receptor modulators (SREs).

Renders antigonadotropic effect and suppresses education prostaglandins in tumor tissue , slows down the development of the tumor process, which is stimulated.

After taking a single dose of the drug, the ability to block estrogens persists for several weeks.

Promotes release pituitary gonadotropic hormones , thereby causing ovulation in women in its absence. At oligospermia in men increases serum concentration estrogen , luteotropin And follitropin .

Tamoxifen and some of its metabolites exhibit the properties of powerful inhibitors (oxidases) with mixed functions (monooxygenases) of the liver cytochrome P450 system. However, how clinically significant these effects are is not known.

In some cases, Tamoxifen is effective in estrogen-independent tumors . The substance has a partial estrogen-like effect on the lipid spectrum, and bone tissue .

Absorption of Tamoxifen is high, TCmax is from 4 to 7 hours after oral administration of the tablet. Steady-state plasma concentrations are observed 4 weeks after the start of treatment using a dosage of 40 mg/day.

WITH blood plasma albumin the substance is 99% bound. Metabolization occurs in the liver through demethylation, hydroxylation and conjugation and with the participation of the CYP2C9 isoenzyme.

Metabolites are excreted mainly with the contents intestines and partly kidneys (small amount). Removal is carried out in two stages. The initial half-life of the main metabolite circulating in the systemic circulation ranges from 7 to 14 hours, the final slow half-life is 7 days.

Indications for use

The use of Tamoxifen is advisable for:

  • estrogen-sensitive tumors ;
  • malignant damage to breast tissue (especially during the period in women);
  • breast cancer , including in men after surgical removal of the genital organs;
  • ductal breast cancer (ductal carcinoma in situ);
  • endometrial cancer .

Fareston or Tamoxifen - which is more effective?

Fareston - This antitumor antiestrogenic nonsteroidal drug , the basis of which is the substance. Main features of the medicine:

  • the presence of a chlorine atom in its chemical structure (which makes the drug more stable compared to Tamoxifen);
  • absence oncogenic effect ;
  • ability to induce apoptosis;
  • effectiveness at ER-negative tumors .

According to clinical observations conducted over six months, it was found that when taking Fareston:

  • changes in hormonal homeostasis are an order of magnitude more favorable than when taking Tamoxifen;
  • changes that are less dangerous for the patient in terms of cancer risk develop;
  • Undesirable side effects occur an order of magnitude less often.

Research also led to the conclusion that the composition complex treatment influence Fareston on tumor process with progressive breast cancer more effective than the effect of its analogue: with its use, patients experienced complete remission much more often, and disease progression began 1.2 months later.

Besides, antitumor effect during treatment Fareston was observed in a larger number of patients.

This drug is widely known and has been working successfully for a very long time. Thanks to him, many women practically received a second life. A special feature of the drug is the recognition of tumor cells and bringing them to complete destruction.

Tamoxifen is most often prescribed to women diagnosed with breast cancer.

However, due to its ability to destroy cells with hormonal receptors susceptible to Tamoxifen, this drug is prescribed to patients with other forms of cancer, such as:

  • ovarian cancer;
  • endometrium;
  • for certain forms of skin, kidney and soft tissue cancer.

Naturally, such a serious drug requires prescription only by a doctor, after some consultation and examination.

How to take Tamoxifen?

Tamoxifen (Nopvadex, Tamoximed) is part of a group of hormonal drugs intended for oral administration in tablet form. Tamoxifen tablets are taken every day according to the regimen prescribed by your doctor.

The course is developed only by a doctor who looks at the general condition of the patient, treatment regimens, and tests. If a woman has a tumor of the breast, endometrium of the kidneys, then starting from 10 - 20 mg / day (1-2 times a day), the dose can be increased to 30 - 40 mg / day (2 times a day), and in some cases up to 60 mg/day (3 times a day). The course can be repeated only after 1-2 months. But the duration of the full course of treatment is most often 2-3 years.

Anovulatory conditions in women and oligospermia in men are treated according to a different scheme. A different dosage and corresponding course duration are also used. In case of anovulatory infertility, the initial dose is 10 mg 2 times a day. If necessary, you can use up to 40 mg 2 times a day. The course lasts only 4 days.

Tamoxifen cannot completely stop the aromatization of steroids. It can only stop the action of estrogen receptors for a certain period.

In this regard, after its use, a sharp jump in the level of estrogen in the blood may be observed. Aromatase inhibitors come to the rescue, which are taken along with a course of anti-estrogenic drugs. Proviron is considered the most effective, which prevents the aromatization of steroids against the background of the action of Tamoxifen, which deactivates estrogen receptors.

This combination of drugs, experts believe, is the most optimal and suitable for most patients. When using Tamoxifen during radiotherapy or cytostatic therapy, there is a risk of thrombosis. If this drug is taken simultaneously with Allopurinol, there is a possibility of liver dysfunction. Hormone-containing drugs, especially those containing estrogen, significantly reduce the effect of Tamoxifen.

Tamoxifen is very sensitive to sunlight. Its active substances are destroyed by direct rays. The most suitable place for storage is a cabinet or a dark place in the corner of the room.

Post-cycle therapy is a necessary condition, regardless of whether the course was difficult or easy. Tamoxifen is a drug that should be used for the prevention and hormonal disorders. Therefore, the usual dosage is 10-30 mg/day. In some cases, the dosage can be increased to 40 mg/day. Taking the drugs continues for two to three weeks.

Tamoxifen is strictly prohibited from being used after completing a course of steroids containing Trenbolones or Nandrolone. This period is characterized by an increase in estrogen levels in the blood, which provokes the development of side effects.

Contraindications of the drug

Tamoxifen is a rather aggressive drug. Its use is associated with a number of health complications observed in almost every patient. In addition, Tamoxifen has individual contraindications.

Most often, experts observe:

  • severe thrombocytopenia;
  • hypercalcemia:
  • leukopenia;
  • kidney diseases;
  • increased blood clotting;
  • diabetes;
  • disturbances at the hormonal level;
  • liver colic.

It is prohibited to use this drug during pregnancy or lactation period. The drug Tamoxifen affects many human vital systems. But in most cases, health disorders are transient and unstable.

In most cases, the menstrual cycle is disrupted and its regularity disappears. However, a clinical change in blood composition has never been observed.

After finishing taking the medication, most often the disorders listed above go away. But it is not recommended to stop taking Tamoxifen and you should not even change the regimen in which this drug is taken. However, there are cases when the use of the drug should be discontinued, for example:

  • vaginal bleeding;
  • changes in various blood samples and liver tests primarily.
  • increased blood clotting and, as a result, thrombophlebitis and thromboembolism, more common in women who smoke.

Tamoxifen is a drug that should be taken very carefully, as it can cause side effects. It is imperative to undergo a series of examinations from specialists and carry out the necessary tests.

Particular attention should be paid to patients with cardiovascular diseases, in particular thrombophlebia, and even if it has already passed. Another health point that needs to be taken into account is all kinds of ophthalmological disorders. The drug itself can cause changes in the conjunctiva and retina of the eyes and provoke retrobulbar neuritis.

Regarding the gastrointestinal tract, Tamoxifen causes nausea and even vomiting, decreased appetite, and constipation. The central nervous system manifests itself with headache, dizziness, depression, drowsiness, confusion of thoughts.

In many cases, while taking the drug, the skin becomes covered with a rash, redness, becomes dry, there is itching in the genital area, and hair loss occurs. In some cases, bleeding and enlargement of the ovaries are observed.

The positive thing about all these side effects is the fact that taken Thrombophlebitis does not cause them in every person. At the same time, for women suffering from cancer, the beneficial coefficient from taking the drug is enormous.

Everyone knows that drinking alcohol while taking medications is not beneficial. However, the ethanol contained in Tamoxifen allows the consumption of certain doses of alcohol. Of course, the patient must consult with the attending physician.

Instructions for use

Attention! The information is provided for informational purposes only. This instruction should not be used as a guide to self-medication. The need for prescription, methods and doses of the drug are determined exclusively by the attending physician.

general characteristics

international and chemical names: tamoxifen; ((Z)-2-ethyl dimethine citrate);

basic physical and chemical properties: white tablets;

compound: 1 tablet contains tamoxifen citrate 0.01530 g (equivalent to 0.01 g tamoxifen);

Excipients: potato or corn starch, milk sugar, calcium stearate, low molecular weight medical polyvinylpyrrolidone, aerosil.

Release form. Tablets for oral (Orally- route of administration of the drug through the mouth (per os)) applications.

Pharmacotherapeutic group

Antitumor drugs. Antiestrogenic agents. ATS L02B A01.

Pharmacological properties

Tamoxifen is an antitumor drug that exhibits an antiestrogenic effect. The action of tamoxifen is due to its ability to competitively bind to estrogen receptors (Receptor(Latin receptio - perception, English receptor): 1) specific sensitive formations in living organisms that perceive external and internal stimuli (extero- and interoreceptors, respectively) and transform the activity of the nervous system. Depending on the type of perceived irritation, there are mechanoreceptors, chemoreceptors, photoreceptors, electroreceptors, thermoreceptors\; 2) active groups of protein macromolecules with which mediators or hormones, as well as many drugs, specifically interact. A receptor is a conformationally mobile macromolecule or set of macromolecules, the binding of which by ligand(s) (agonist or antagonist) causes biological or pharmacological effects. A number of receptors exist in several subtypes. There are four main types of receptors: 1) membrane receptors associated with ion channels and consisting of several protein subunits that are located in the biological membranes of cells in a radial order, forming ion channels (for example, H-cholinergic receptors, GABA A receptors, glutamate receptors )\; 2) membrane receptors coupled to G-proteins, consisting of protein molecules that “stitch” biological membranes seven times\; the biological effect upon activation of these receptors develops with the participation of a system of secondary transmitters (Ca2+ ions, cAMP, inositol-1,4,5-triphosphate, diacylglycerol). Receptors of this type are available for a number of hormones and mediators (for example, M-cholinergic receptors, adrenergic receptors, etc.)\; 3) intracellular or nuclear receptors that regulate DNA transcription processes and, accordingly, protein synthesis by cells. They are cytosolic and nuclear proteins (eg, receptors for steroid and thyroid hormones)\; 4) membrane receptors that directly control the functions of the effector enzyme, associated with tyrosine kinase and regulating protein phosphorylation (for example, insulin receptors, a number of growth factors, etc.)) in target organs and prevent their interaction with endogenous (Endogenous(from endo... and...gene) - internal origin\; in medicine - originating from causes lying in the internal environment of the body) ligand (Ligand- in complex chemical compounds, molecules or ions directly associated with the central atom - the complexing agent. In biochemistry and pharmacology - an information-carrying molecule/signal substance)- 17--estradiol. This inhibits the development of the tumor process stimulated estrogens (Estrogen- pituitary hormone responsible for the maturation of eggs). The drug has no androgenic activity.

Pharmacokinetics. When taking tablets, tamoxifen is well absorbed from the digestive tract; the maximum concentration in the blood is observed approximately 3-7 hours after a single dose. Equilibrium concentration in the blood is established 4 weeks after the start of treatment. Metabolized in the liver by hydroxylation and demethylation. It is excreted slowly, mainly with feces, in the form of metabolites. Half-life (Half-life(T1/2, synonymous with half-elimination period) - the period of time during which the concentration of a drug in the blood plasma decreases by 50% from the initial level. Information about this pharmacokinetic indicator is necessary to prevent the creation of a toxic or, conversely, ineffective level (concentration) of the drug in the blood when determining the intervals between administrations) the main metabolite - N-desmethyltamoxifen - 14 days, unchanged tamoxifen - about 7 days.

Indications for use

Breast cancer, especially in women menopause (Menopause– age-related restructuring of the higher vegetative centers with subsequent disruption of the cyclic gonadotropic activity of the pituitary gland and the cyclic activity of the ovaries with the cessation of ovulation and the reproductive ability of the body), breast cancer in men, endometrial cancer and ovaries (Ovary- female reproductive gland, place of formation and maturation of eggs and production of estrogens and progesterone), kidney cancer, melanoma (Melanoma– a malignant tumor that develops from pigment-forming melanocyte cells. Most often, skin melanoma is observed; less often, the tumor occurs in the intestines, membranes of the brain and spinal cord, retina, vascular tract, ciliary body, iris)(containing estrogen receptors), prostate cancer with resistance (Resistance- body stability, immunity to any external factors. In particular, nonspecific resistance is called means of innate immunity. The term is more often used in relation to microorganisms (the emergence of mechanisms of immunity to antimicrobial drugs, antibiotics) or plants (to diseases). In relation to humans and animals, the term immunity is more often used) to other drugs, tumors pituitary gland (Pituitary- endocrine gland. The pituitary gland is located at the base of the brain and consists of an anterior (adenohypophysis) and posterior (neurohypophysis) lobe. The pituitary gland has a predominant influence on growth, development, metabolic processes, regulates the activity of other endocrine glands), soft tissue sarcoma, postoperative therapy (Therapy- 1. The field of medicine that studies internal diseases is one of the oldest and main medical specialties. 2. Part of a word or phrase used to indicate the type of treatment (oxygen therapy\; hemotherapy - treatment with blood products)) for the purpose of correcting hormonal status, as well as in cases where surgery or radiation therapy is not indicated, anovulatory infertility, oligospermia.

Directions for use and doses

The dosage regimen is set individually, depending on the indications, the patient’s condition and the antitumor therapy regimen used. Prescribed only to adults. For breast, endometrial, and kidney cancer, the initial dose of the drug is 10-20 mg (10 mg 1-2 times a day), then, if necessary, the dose can be increased to 30 mg, and after 7-10 days - to 40 mg per day (20 mg 2 times a day), per course - 2.4-9.6 g. If necessary and there are no side effects, the daily dose can be increased to 60 mg (3 times 20 mg). Treatment is carried out for a long time, usually 2.5-3 months, sometimes 2-3 years, until signs of regression of the process appear and over the next 1-2 months. Repeated courses are carried out after a 1-2 month break.
In patients with breast cancer after surgery, Tamoxifen is used in a dose of 20 mg (10 mg 2 times a day) to correct the hormonal status. For anovulatory infertility, take 10 mg 2 times a day, for 4 days in a row, starting from the 2nd day of menstruation; in subsequent 4-day cycles, you can increase the dose to 20-40 mg 2 times a day. For oligospermia - 10 mg 2 times a day.

Side effect

From the outside digestive system: loss of appetite, nausea, vomiting, gastrointestinal disorders, increased liver activity transaminases (transaminases- enzymes of the transferase class, the reactions they catalyze provide a connection between protein and carbohydrate metabolism); in some cases - fatty liver (Fatty liver- a condition in which more than 5% of the liver mass is fat, mainly triglycerides), cholestasis, hepatitis. From the outside central nervous system (central nervous system- the main part of the nervous system, represented by the spinal cord and brain. Functionally, the peripheral and central nervous systems represent a single whole. The most complex and specialized part of the central nervous system is the cerebral hemispheres): depression (Depression - mental disorder: sad, depressed mood with pessimism, monotony of ideas, decreased motivation, retardation of movements, various somatic disorders), dizziness, headache, with prolonged therapy with high doses - retinopathy, keratopathy, cataract (Cataract- clouding of the lens of the eye as a result of senile tissue malnutrition, diabetes, eye damage and other reasons. Sharply deteriorates vision), retrobulbar neuritis. From the hematopoietic system: rarely - thrombocytopenia (Thrombocytopenia- decrease in platelet count), leukopenia (Leukopenia- the content of leukocytes in the peripheral blood is less than 4000 in 1 μl, due to the influence of various damaging factors on the body), anemia (Anemia- a group of diseases characterized by a decrease in red blood cells or hemoglobin in the blood). From the endocrine system: in women - hyperplasia (Hyperplasia- an increase in the number of cells in any tissue (except tumor) or organ, resulting in an increase in the volume of a given anatomical formation or organ) endometrium, vaginal bleeding, hot flashes, suppression menstrual cycle (Menstrual cycle– regularly recurring uterine bleeding, during which a woman loses an average of 50–100 ml of blood. The coagulability of menstrual blood is reduced, so bleeding continues for 3–5 days. The duration of the menstrual cycle is 28 days, it can be less (up to 21 days) or more (up to 30–35 days)), weight gain; in men - impotence, decreased libido (Libido- sexual desire). From the cardiovascular system: swelling (Edema– tissue swelling as a result of a pathological increase in the volume of interstitial fluid), thromboembolism, phlebitis. Dermatological reactions: rarely - mild skin rashes on the face, neck, chest, itching (Itching- a modified feeling of pain caused by irritation of the nerve endings of pain receptors), alopecia (Alopecia– increased hair loss and insufficient new growth). Other: hypercalcemia, bone pain, increased body temperature.

Contraindications

Individual intolerance, thrombophlebitis (Thrombophlebitis- a venous disease characterized by inflammation of the venous wall and thrombosis. The occurrence of thrombophlebitis is preceded by inflammation of the vein - phlebitis and periphlebitis), severe thrombocytopenia, leukopenia, hypercalcemia, pregnancy.

Interaction with other drugs

Combination with radio- and cytostatic therapy is allowed, but it should be taken into account that combined use with cytostatics (cytostatics- drugs that inhibit cell division\; used mainly for the treatment of malignant tumors) increases the risk of thrombosis. With the simultaneous use of Tamoxifen and allopurinol, liver dysfunction may occur. It is not recommended to combine it with hormonal drugs, especially with estrogens, because the latter reduce the therapeutic effect of Tamoxifen.

Overdose

Manifests itself in increased side effects. Treatment is symptomatic.

Features of application

Before starting treatment, female patients must undergo a thorough gynecological (to exclude pregnancy) and therapeutic examination; Women of childbearing age should use reliable contraceptives (Contraceptives (not oral), and contraception (Contraception- Preventing pregnancy with contraceptives) should continue for 3 months after completion of the course. During treatment it is necessary to control the number leukocytes (Leukocytes- colorless blood cells of humans and animals that absorb bacteria and dead cells and produce antibodies. Includes granulocytes, lymphocytes and monocytes), platelets (Platelets- blood cells involved in the blood clotting process. With a decrease in their number - thrombocytopenia - there is a tendency to bleeding), calcium levels, indicators of the blood coagulation system. Particular caution and close monitoring are required when treating patients with renal pathology, diabetes mellitus, ophthalmic diseases and thromboembolic disorders in medical history (Anamnesis- a set of information about the development of the disease, living conditions, previous diseases, etc., collected for the purpose of use for diagnosis, prognosis, treatment, prevention). Tamoxifen is ineffective for treating patients with liver metastases. If necessary, use the drug during the period lactation (Lactation- secretion of milk from the mammary gland) need to stop breast-feeding. With the development of vaginal bleeding, metrorrhagia (Metrorrhagia- uterine bleeding that recurs at irregular intervals and is not associated with the menstrual cycle) and swelling of the legs, the dose of Tamoxifen should be reduced.
When taking Tamoxifen, it is recommended to refrain from activities that require increased concentration or rapid mental reactions.

General Product Information

Conditions and shelf life. Store in a dry place, protected from light and out of reach of children, at a temperature not exceeding 25 °C.
Shelf life - 2 years.

Vacation conditions. On prescription.

Package. 20 or 30 tablets in a blister pack or 60 tablets in a container.

Manufacturer.LLC "Pharmaceutical company "Zdorovye".

Location. 61013, Ukraine, Kharkov, st. Shevchenko, 22.

Website. www.zt.com.ua

This material is presented in free form on the basis of the official instructions for medical use of the drug.

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    • How exactly does this medication work?
    Experts were able to establish that the cells of malignant neoplasms quite often contain protein substances that tend to interact with female sex hormones, thereby provoking increased growth of the tumor cell. Using tamoxifen, it is possible to block these protein components, and, consequently, stop the further spread of the malignant neoplasm.

    How can sensitivity to this drug be determined?
    To determine sensitivity to the components of this pharmaceutical product, it is recommended to undergo a special analysis of a malignant neoplasm, which will determine receptors for both progesterone and estrogen.

    What is a reaction called a "flare"?
    During the first course of therapy with this medication, it is quite possible that “signs of exacerbation of the pathology” may occur. Such signs include hot flashes and general weakness, as well as pain in the bones or in the chest area. It is this phenomenon that is called “flare”. In most cases, the severity of these signs gradually disappears. A very large number of patients perceive this phenomenon as a very strong side reaction of the body to the drug, which in turn pushes them to abandon its use. You shouldn't make hasty conclusions. First, get advice from a specialist who can confirm or refute your suspicions.

    How should I take this drug?
    Tamoxifen can be taken before, during, or after meals, while washing down the tablets of this medication with a small amount of liquid.

    Is it possible to replace this medication with any drug with fewer complications?
    In fact, such a drug exists - it is toremifene. It is a second generation medication and has fewer adverse reactions. If a woman completely misses menstruation, then she can use the help of medications from the group of aromatase inhibitors. This type of medicine can be classified as femaru, so extraza, Arimidex and some other medicines. In the case of a menstrual cycle, experts opt for medications such as buserelin, zoladex, goserelin and some others.

    What are the benefits of this medication?
    Its most important advantage is considered to be that this drug is truly highly effective against breast cancer. Moreover, it is also accessible to large masses of the population.

    What are its disadvantages?
    Its most important disadvantage is considered to be a large number of side effects.

    There are many reasons for the development of gynecomastia. The most common of them include a violation of the ratio of testosterone and estrogen, as well as various metabolic diseases, cirrhosis of the liver, inflammatory processes in the ovarian region, HIV infection, tumors of the stomach, lungs, and the like. To identify this pathology, the patient should first consult a specialist. He will examine the patient and also prescribe a number of necessary examinations.

    As for the direct treatment of this disease, in this case everything depends on the form of this pathology. If gynecomastia is the result of excessive levels of estrogen in the patient’s body, then doctors prescribe special hormonal medications. One such medication is tamoxifen. Tamoxifen tends to suppress the overall level of estrogen, thereby restoring the natural appearance of the male mammary glands. We note right away that treatment with tamoxifen in all cases is very long-term. Since this drug tends to provoke the development of various side effects, during the course of treatment it is very important that men monitor any changes in their body as closely as possible.

    In most cases, experts prescribe Tamoxifen Ebeve in the amount of twenty milligrams per day. If there is any common form of malignant neoplasm on the face, then it is quite possible to increase the daily dosage to thirty to forty milligrams. The maximum daily dose of this drug is considered to be forty milligrams. The therapeutic effect of such treatment is most often observed after four to ten weeks of therapy. If there are already metastases in the patient’s bones, then the necessary healing effect will have to wait for months.

    If your doctor has prescribed you more than one tablet of this medication per day, then you can easily divide the total amount into two doses, that is, drink half in the morning and the other half in the evening. The duration of tamoxifen therapy directly depends on both the severity of the existing pathology and its course. In most cases, the course of therapy is very long, and all because the tablets of this drug are recommended to be taken until remission occurs.

    Even if a person has any impairment of the normal functioning of the liver or kidneys, this is not a reason to adjust the dose of this medication. The dosage, as well as treatment regimens for children with this drug, have not yet been established by specialists. The most effective therapeutic effect can be achieved in the fight directly against estrogen receptor-positive malignant neoplasms that make themselves felt during the postmenopausal period.

    It should also be noted that Tamoxifen Ebeve can be safely used along with both radiation therapy and chemotherapy. It is also important to say that if you have diabetes, eye diseases or thromboembolic disease, this pharmaceutical should be prescribed with extreme caution.

    Since this drug has an estrogenic effect, it can be used to treat both cancer and polyps, as well as hyperplasia. If before this the patient had to use the help of this medication, then before starting a course of treatment for a cancer tumor, various therapeutic and gynecological examinations should be regularly carried out for six months, or even more. If a woman develops vaginal discharge, vaginal bleeding or pain in the pelvic area during the course of therapy, then it is very important that the doctor determines the true cause of the development of this type of phenomenon as quickly as possible.

    If a woman uses tamoxifen ebeve to prevent breast cancer, then she needs to be checked for endometrial hyperplasia at least once a month. If atypical hyperplasia occurs, treatment with this medication will need to be stopped immediately. Since some people experience the development of certain visual impairments while using this drug, experts advise periodically visiting patients with breast cancer, which can occur during menopause. In addition, this drug has found its wide use in the fight against breast cancer in men, malignant neoplasms in the ovaries, kidneys or endometrium. It is also used in the case of melanoma or soft tissue sarcoma, which contain estrogen receptors. You cannot do without the help of this medication in the case of prostate cancer. When this pathological condition occurs, this drug is prescribed to patients only if other drugs fail to provide the necessary therapeutic effect.

    Let us immediately draw the attention of readers to the fact that this medication also has some contraindications for use, so it is not prescribed to all patients. So, for example, if a person has experienced increased sensitivity to any of its components, then it is best to refuse the help of this remedy. Under no circumstances should tamoxifen be used by pregnant women or breastfeeding mothers. This drug is prescribed with extreme caution to those citizens who have severe thrombophlebitis, thrombocytopenia, one or another eye pathology, thromboembolic disease, leukopenia or hyperlipidemia.

    It is also important to note the fact that while taking this drug, a wide variety of side effects can become apparent. In fact, there are quite a lot of them. The most common side effects include vomiting, thrombophlebitis, pain in the affected areas, nausea, leukopenia, dizziness, diarrhea, and loss of appetite. In case of an overdose, the patient also experiences far from pleasant symptoms. There is no antidote for this drug, so treatment is symptomatic.

    As for dosages, in this case everything depends on the existing pathology. So, for example, in the fight against breast cancer, women are most often prescribed tamoxifen in the amount of twenty to forty milligrams in the morning and evening. For endometrial cancer, this medication is prescribed twenty to thirty milligrams one to two times a day. It should be noted that tablets of this drug must be taken without prior chewing. They should be taken with a small amount of water.

    Since this medication is quite strong, before using it it is very important to first get specialist advice, as well as undergo a full examination of all organs and systems.

    It has long been known that exactly Clomid is the most popular drug for athletes. Tamoxifen is used by them only in the most extreme cases.
    What explains this? Does Clomid really deserve the most recognition?
    Right now we will try to find answers to these questions.

    Let's start with the fact that in fact these drugs are almost identical. Considering the structure of the molecules of these two medications, one can immediately note the fact that they are very similar to one another. Moreover, both of these drugs belong to the category triphenylethylenes. With all this, Clomid is considered to be much weaker, and its effect is immediately several times weaker. If the daily dosage of Clomid is fifty to one hundred milligrams, then tamoxifen is prescribed in doses of twenty to forty milligrams. Considering these facts, it becomes clear that using Clomid makes no sense in the fight against breast cancer.

    The advantage of tamoxifen is, of course, good, but only if we are talking about cancer. If we talk about athletes, then in this case the leading position is occupied by Clomid. In fact, it is common for both medications to interact with estradiol receptors, since both of them have a weakly expressed estrogenic effect. The thing is that Clomid does not tend to have a very strong negative effect on the liver, while tamoxifen causes extremely serious side effects on this organ. They make themselves felt especially often during a long course of therapy with this drug.

    With all this, tamoxifen also has some advantages, and there are many of them. Its first advantage is considered to be that this medication tends to increase the amount of very high-density cholesterol in the patient’s blood. This is very important, since this is the type of cholesterol that is classified as “good”. If the level of “good” cholesterol in the human body dominates over the level of “bad” cholesterol, this makes it possible to prevent the development of a number of disorders of the cardiovascular system. Surely, you know that this type of violation is observed among competitive level athletes very often.

    Another advantage of this drug is that it is a mild estrogen. And finally, this medication is considered to be much safer than Clomid. In the course of numerous studies, experts were able to establish that long-term therapy with Clomid leads to irreversible impairments in the quality and acuity of vision. In general, there have been and will continue to be debates regarding which of these drugs is the best. This is not surprising, since both of these medications have both positive and negative qualities.