The majority of these reports have shown reduced levels of total cholesterol with five years of tamoxifen treatment resulting in a decreased number of heart attacks. These alterations may improve heart health. Tamoxifen acts primarily as estrogen on the liver and has favorable effects on serum cholesterol, most notably, in post-menopausal women. No adverse affect on blood cholesterol use has been noted. However, other trials have reported a decrease in the incidence of cardiac events in women taking tamoxifen.
Ocular toxicity is uncommon with the dose and duration of therapy used in current clinical practice.
In the past, ocular toxicity has been reported as a possible complication of tamoxifen therapy, mostly in women treated with a higher dosage of the drug. No reports have been made of ocular toxicity in any of the major adjuvant breast cancer studies of tamoxifen. The patients receiving tamoxifen treatment had no differences in activities of daily vision, visual acuity measurements, or other tests of visual function except for color screening. Retinopathy and corneal changes are infrequent and probably dose-related as well. Women should have a baseline ophthalmic evaluation during the first year of tamoxifen therapy and receive follow-up evaluations as necessary.