Tamoxifen is a hormonal therapy drug used
- to treat breast cancer
- to treat womb cancer
- to reduce the risk of breast cancer coming back and to protect the other breast.
Tamoxifen is also used to:
- treat other types of cancer
- treat or prevent breast tenderness and swelling (gynaecomastia) – this can be a side effect of some hormonal therapies used for prostate cancer
- prevent breast cancer in women who have a family history of cancer.
Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.
Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made or how they work in the body.
Many breast cancers rely on the hormone oestrogen to grow. This type of breast cancer is called oestrogen receptor-positive (ER-positive) breast cancer. Tamoxifen blocks oestrogen from reaching the cancer cells.
Taking tamoxifen tablets
Tamoxifen comes as tablets or syrup you can take at home. Your nurse or doctor will talk to you about your treatment plan.
Always take the tablets or syrup exactly as explained. This is important to make sure it works as well as possible for you. Make sure you take it at the same time every day.
If you forget to take the tablets or syrup, take it as soon as you remember. But if it is almost time for your next dose, do not take a double dose. Just take the next dose at your usual time.
Other things to remember about your tablets or syrup:
- Keep them in the original package and at room temperature, away from heat and direct sunlight.
- Keep them safe and out of sight and reach of children.
- Get a new prescription before you run out of tablets or syrup, and make sure you have plenty for holidays.
- If your treatment is stopped, return any unused tablets or syrup to the pharmacist.
Your nurse or pharmacist may also give you other medicines to take home. Take all your medicines exactly as they have been explained to you. Do not stop taking any of your medicines unless your doctor tells you to.
We explain the most common side effects of this treatment here. We also include some less common side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
Hot flushes and sweats
Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm and look red. Flushes may last from a few seconds up to 10 minutes. You may have sweats and then feel cold and clammy. Some people feel anxious or irritable during a hot flush.
There are things you can do to try to reduce flushes:
- Wear clothes made from natural fabrics, such as cotton.
- Wear layers of clothes that you can remove if you feel hot.
- Use cotton bed sheets and have layers of bedding that you can remove if you feel hot.
- Keep room temperatures cool or use a fan.
- Have cold drinks rather than hot ones. Try to avoid drinks with caffeine in them.
You may have fewer hot flushes and sweats as your body adjusts to hormonal treatment. Or your doctor can prescribe drugs to help. Flushes and sweats usually stop a few months after treatment finishes, but some people continue to have them.
You can read more about coping with hot flushes in our information about managing menopausal symptoms.
You may have vaginal discharge, bleeding, itching, or dryness during this treatment. If you have any vaginal bleeding, tell your doctor or nurse.
You can use non-hormonal creams, gels, or lubricants to help with vaginal dryness and any discomfort during sex. You can buy these from a chemist, or your doctor can give you them.
Change in periods
If you are still having periods, you may find they become irregular, lighter, or sometimes stop altogether during this treatment. This does not always mean you are unable to get pregnant. Even if your periods stop or are irregular when taking this treatment, you still need to use contraception to prevent a pregnancy. Your doctor or nurse can tell you more about this.
Loss of sex drive
Your sex drive may be lower while taking this treatment. Talk to your doctor or nurse for advice. We have more information about coping with the effects of treatment on your sex life.
Any sickness usually improves after a few weeks. Try taking tamoxifen with food or at night.
Let your doctor or nurse know if you continue to feel sick. They can give you advice or drugs to help.
Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
This treatment may affect your skin. It may cause a rash, which might be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Always tell your doctor or nurse about any changes to your skin. They can give you advice and may prescribe creams or medicines to help. Skin changes usually improve when treatment finishes.
It is very important to contact your doctor straight away if you get a severe skin rash.
Fluid build-up (oedema)
You may find your ankles or fingers become swollen when taking this drug. This is caused by a build-up of fluid, which is called oedema. It is usually mild. If you notice any swelling or puffiness, ask your nurse or doctor for advice.
This treatment may cause cataracts (clouding of the lens of the eye) or other eye problems. If you get blurry vision or notice any change in your vision, always tell your doctor or nurse.
If you have headaches, let your doctor or nurse know. They can usually be controlled with mild painkillers.
Effects on the nervous system
This treatment can affect the nervous system. You may have pins and needles, or feel tingling in your arms and legs. You may also feel dizzy or unsteady, or have taste changes. Tell your doctor or nurse if you notice any of these symptoms.
It is important not to drive or operate machinery if you feel dizzy.
Leg cramps and muscle pain
If you have leg cramps and muscle pain, walking may stretch the muscles and help with this. Let your doctor or nurse know if leg cramps or muscle pains are a problem.
Your hair may become thinner when you are taking this treatment. This is usually mild. Ask your nurse for advice if you are worried about this.
Blood clot risk
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
- pain, redness or swelling in a leg or arm
- chest pain.
If you have any of these symptoms, contact a doctor straight away.
A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.
Effects on the womb
This treatment can cause changes to the lining of the womb that may cause vaginal bleeding. Rarely, tamoxifen can cause womb cancer.
The benefits of taking tamoxifen usually outweigh the risk of womb cancer. Always tell your doctor if you have irregular or unexpected bleeding from the vagina. They will arrange tests if needed to check for changes to the lining of the womb.
You should also tell them if you have any pain or pressure in the lower tummy (pelvis). This can be an early sign of womb cancer, although it is usually caused by other conditions. If womb cancer is found early, treatment can be very successful.
If you have ongoing side effects
Most of the time side effects can be controlled or managed. But for a few people, they can be more troubling. If this happens, make sure you talk to your doctor or nurse. They can usually suggest ways to improve your side effects. If things don’t improve, go back to your doctor or nurse. They may suggest you try something else.
It is important not to stop taking tamoxifen without telling your doctor, as this may affect the success of your treatment. If side effects can’t be managed, your doctor may suggest you take a different type of hormonal therapy.
Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.
Women are advised not to breastfeed while having this treatment. This is because the drugs could be passed to the baby through breast milk.
Some medicines can affect the hormonal treatment or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.
Tamoxifen syrup contains alcohol. Tell your doctor, nurse, or pharmacist if this is a problem for you. This may affect your ability to drive or operate machinery.
Glycerol and sorbitol
Tamoxifen syrup contains sugars called glycerol and sorbitol. If you have been told by a doctor that you cannot digest some sugars, talk to your doctor before taking this drug.
Problems with lactose
These tablets contain a type of sugar called lactose. If you have been told by a doctor that you cannot digest lactose (lactose intolerant) or other sugars, talk to your doctor before taking this drug.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.