Tamoxifen (Nolvadex)

==General information==
Class/mechanism: SERM (selective estrogen receptor modulator), with estrogen agonist/antagonist properties depending on tissue type. Tamoxifen has estrogen antagonist properties in breast tissue. It has estrogen agonist properties in bone, helping to decrease bone resorption, but in contrast to Raloxifene (Evista), it also has agonist properties in uterine tissue.Tamoxifen (Nolvadex) package insert Tamoxifen (Nolvadex) package insert (locally hosted backup)
Route: PO
Extravasation: n/a
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, or the prescribing information. 
==Diseases for which it is used==
*Breast cancer
**ER+ breast cancer
**ER+/HER2+ breast cancer
*Endometrial cancer
*Hereditary hemorrhagic telangiectasia
*Low-grade serous ovarian cancer
==Diseases for which it was used==
*Hepatocellular carcinoma
*Melanoma
*Ovarian cancer
==Patient drug information==
*Tamoxifen (Nolvadex) package insert PDF pages 32-37
*Tamoxifen (Nolvadex) patient drug information (Chemocare)Tamoxifen (Nolvadex) patient drug information (Chemocare)
*Tamoxifen (Nolvadex) patient drug information (UpToDate)Tamoxifen (Nolvadex) patient drug information (UpToDate)
==History of changes in FDA indication==
* 1977-12-30: Initial FDA approval
* Uncertain date: Approved for the treatment of node-positive breast cancer in postmenopausal women following total mastectomy or segmental mastectomy, axillary dissection, and breast irradiation. (Based on ECOG 1178, Hubay et al. 1980, NATO, NCIC-CTG MA.4, NSABP B-09, NSABP B-14)
* Uncertain date: Approved for the treatment of metastatic breast cancer in women and men. Available evidence indicates that patients whose tumors are estrogen receptor positive are more likely to benefit from NOLVADEX therapy. (Based on Crump et al. 1997) 
* 1989-03-16: Approved for use in premenopausal women with metastatic breast cancer as an alternative to oophorectomy or ovarian radiation. (Based on Buchanan et al. 1986, Crump et al. 1997, Ingle et al. 1986a)
* 1998-10-29: Approved to reduce the occurrence of contralateral breast cancer in patients receiving adjuvant Nolvadex therapy for breast cancer.
* 1998-10-29: Approved to reduce the incidence of breast cancer in women at high risk for breast cancer.
==History of changes in EMA indication==
*1974-04-29: EURD
==Also known as==
*Code name: ICI-46474
*Generic names: TAM, tamoxifen citrate, TMX
*Brand names: Istubal, Nolvadex, Soltamox, Valodex
==References==
Category:Drugs
Category:Oral medications
Category:Protein expression-specific medications
Category:Selective estrogen receptor modulators
Category:Breast cancer medications
Category:Endometrial cancer medications
Category:Hereditary hemorrhagic telangiectasia medications
Category:Low-grade serous ovarian cancer medications
Category:Hepatocellular carcinoma medications (historic)
Category:Melanoma medications (historic)
Category:Ovarian cancer medications (historic)
Category:FDA approved in 1977
Category:EMA approved in 1974
Category:WHO Essential Cancer Medicine