Tamoxifen Citrate 20 mg

Tamoxifen is a tablet that blocks the effect of oestrogen, a sex hormone, in some parts of the body, while acting a little like oestrogen in others. Because of this it is used in conditions where oestrogen affects how tissue grows. Your doctor has prescribed this medicine for you after considering your own situation, and may want to see you regularly while you take it. It is prescription-only and must not be given to anyone else.

Some conditions make this medicine unsuitable, and some need extra checks, so tell your doctor about your full medical history before you start.

Warnings and precautions

• +Talk to your doctor before using tamoxifen if you have ever had a blood clot, or if clots run in your family, because this medicine makes clots more likely. The risk is higher if you are not moving about, for example after an operation or on a long journey. Tell any surgeon or dentist that you take tamoxifen.
• +Talk to your doctor before using tamoxifen if you have any problem with the lining of your womb, or have had one. Report any unusual bleeding from the vagina, spotting between periods, or a change in discharge, straight away, even if it seems small.
• +Talk to your doctor before using tamoxifen if you have liver problems, as your doctor may want to check your liver with blood tests.
• +Talk to your doctor before using tamoxifen if you have cataracts or any other eye problem, or if your sight changes while you are taking it.
• +Talk to your doctor before using tamoxifen if you have been told your blood fats (triglycerides) are high, or if you have had inflammation of the pancreas.
• +Talk to your doctor before using tamoxifen if you have a low number of white blood cells or platelets, or if you bruise or bleed easily.
• +Talk to your doctor if you are having a general anaesthetic or a long flight, so that steps can be taken to lower the risk of a clot.

Other medicines and Tamoxifen Citrate

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including ones bought without a prescription, herbal remedies and supplements. It is especially important to mention blood thinners such as warfarin (medicines that stop the blood clotting so easily), because tamoxifen can make their effect much stronger and cause bleeding; certain antidepressants, particularly paroxetine and fluoxetine, which can stop tamoxifen working properly; rifampicin, and medicines for epilepsy; anagrelide; and anastrozole or similar hormone medicines. Do not take St John's wort (a herbal remedy for low mood) with tamoxifen. If you are unsure, show the pack to your pharmacist.

Pregnancy, breastfeeding and fertility

Do not take tamoxifen if you are pregnant, think you may be pregnant, or are planning to become pregnant, as it may harm an unborn baby. Do not breastfeed while taking it. If you could become pregnant, use a reliable non-hormonal method of contraception, such as condoms or a copper coil, during treatment and for the period your doctor advises afterwards; hormonal contraceptives may not be suitable. Tell your doctor straight away if you become pregnant. Tamoxifen may change your periods or stop them for a time, but this does not mean you cannot become pregnant. It may also affect fertility; discuss this with your doctor if you plan to have children.

Driving and using machines

Tamoxifen may make you feel tired, dizzy or light-headed, and some people notice changes in their sight. If you are affected, do not drive, cycle or use tools or machines until you feel normal again. If your sight changes in any way, stop driving and tell your doctor.

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. It is a tablet that you swallow whole with a drink of water. You can take it with or without food, and it helps to take it at about the same time each day. Your doctor decides the amount and how long you should take it, sometimes for several years, so do not change or stop treatment yourself even if you feel well. If you forget a tablet, take the next one at the usual time; do not take a double amount to make up for a forgotten one. If you take more tablets than your doctor told you to, contact your doctor straight away or go to the nearest hospital, and take the pack with you.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Other possible side effects

• +Hot flushes and sweating, including at night
• +Feeling sick, or discomfort in the stomach
• +Fluid build-up, so that your ankles, feet or hands swell
• +Vaginal dryness, itching or discharge
• +Irregular periods, or periods stopping
• +Headache or dizziness
• +Feeling tired or weak
• +Muscle cramps, or aching joints and bones
• +Thinning of the hair
• +Skin rash, or a change in the skin
• +Changes in mood, or feeling low

Keep this medicine out of the sight and reach of children. Store below 30 degrees Celsius in the original pack, protected from light and moisture. Do not use this medicine after the expiry date printed on the carton and the blister foil; the expiry date refers to the last day of that month. Do not use the tablets if the blister is torn or the tablets look damaged or discoloured. Do not throw medicines away in your household waste or down the toilet. Take medicines you no longer need back to your pharmacy for safe disposal. This helps protect the environment.

Each tablet contains tamoxifen (as tamoxifen citrate) as the active substance. The other ingredients are the fillers, binder, lubricant and film coat that form the tablet; the full list is printed on the carton. The tablets are film-coated and are supplied in blister strips inside a cardboard carton, in packs of 10 to 100 tablets. Not all pack sizes may be available in your country. Every carton carries a printed square barcode (a GS1 DataMatrix) and a verification code that you can enter at ergopharm.net to check the pack is genuine. Manufactured under GMP conditions by Ergopharm, Vadodara, Gujarat, India.