Available as:
Indications
Cytotam 10 Tablet is used for:
Breast cancer
Adult Dose
Oral
Breast Cancer Treatment
20 mg daily as a single or in 2 divided doses. Max: 40 mg daily.
Continue with adjuvant therapy for at least 5 years
For women with ER-positive disease, continuing tamoxifen to 10 years rather than stopping at 5 years produces a further reduction in recurrence and mortality, particularly after year 10
Breast Cancer Prevention
Indicated to reduce the incidence of breast cancer in women at high risk for breast cancer; high risk is defined as women aged >35 years with a 5-year predicted risk of breast cancer >1.67% (calculated by the Gail Model)
Adult: 20 mg daily for 5 yr.
Data are limited for use >5 yr in the risk-reduction setting
Anovulatory infertility
Adult: 20 mg daily on days 2-5 of the menstrual cycle, increase if necessary in subsequent cycles. Max: 80 mg daily. Women w/ irregular menstruation: Initial course may begin on any day and a 2nd course may start 45 days later.
Child Dose
Renal Dose
Administration
May be taken with or without food.
Contra Indications
History of DVT or pulmonary embolism. Pregnancy and lactation. Concomitant coumarin-type anticoagulant therapy.
Precautions
Patient w/ leucopenia and thrombocytopenia, hyperlipidaemias. Monitoring Parameters Perform periodic CBC (e.g. platelet counts) and LFTs. Routine gynaecological monitoring and any abnormal symptoms (e.g. abnormal vag bleeding or discharge, pelvic pain, menstrual irregularities).
Lactation: not known if excreted in breast milk, do not nurse
Pregnancy-Lactation
Interactions
Increases dopaminergic effect of bromocriptine. Increased risk of thromboembolic events w/ cytotoxic drugs. Increased risk of bleeding w/ platelet aggregation inhibitors. May mutually reduce effects w/ hormone preparations particularly oestrogens (e.g. OCs). Reduced plasma levels w/ CYP3A4 inducers (e.g rifampicin) and CYP2D6 inhibitors. Increased plasma levels w/ CYP3A4 inhibitors.
Potentially Fatal: Significant increase in anticoagulant effect w/ coumarin-type anticoagulants (e.g. warfarin).
Adverse Effects
Side effects of Tamoxifen :
>10%
Hot flashes (64%),Vaginal discharge (30%),Amenorrhea (16%),Menstrual changes (13%)
1-10%
Oligomenorrhea (9%),Cataracts (8%),Bone pain (6%),Nausea (5%),Cough (4%),Edema (4%),Fatigue (4%),Musculoskeletal pain (3%),Ovarian cyst (3%),Depression (2%),Abdominal cramps (1%),Anorexia (1%)
<1%
Angioedema,Corneal changes,Loss of libido,Endometrial cancer,Pancreatitis,Retinal vein thrombosis,Stroke,Uterine fibroids
Potentially Fatal: Blood dyscrasias, cholestasis, hepatitis, hypercalcaemia in patients with bone metastasis, thromboembolic events. Increased risk of endometrial cancer and uterine sarcoma.
Mechanism of Action
Tamoxifen, a triphenylethylene derivative, produces a nuclear complex by competitively binding to oestrogen receptors on tumours and other tissue targets thus, decreasing DNA synthesis and inhibiting oestrogen effect. It is only cytostatic rather than cytotoxic due to accumulation of cell in G0 and G1 phases.
Note
Cytotam 10 10mg Tablet manufactured by Cipla Ltd.. Its generic name is Tamoxifen. Cytotam 10 is availble in Nepal.
Farmaco Nepal drug index information on Cytotam 10 Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.