Tamoxifen

Common name: Tamoxifen citrate

Trade name: Tamoxifen

All names: Tamoxifen citrate, Tamoxifen, Tamoxifen, Nolvadex, Tamofen, (Z)-2-[4-(1,2-diphenyl-1-butene)phenoxy]-N,N- Dimethylethylamine, Oncomox, Soltamox, Crisafeno, tamoxifen, Tamofen

Indications:

For the treatment of advanced breast and ovarian cancer.

Usage and dosage:

Breast cancer: It has a better effect on patients with estrogen receptor-positive breast cancer. Orally take 10 to 20 mg each time, 2 times a day.

Endometrial cancer: This product can increase the level of progesterone receptors. Those with low progesterone receptor levels can first use this product to increase the receptor level, and then use progesterone treatment, or both can be used at the same time to improve the efficacy. The general dosage is 10 to 20 mg orally each time, twice a day.

Adverse reactions:

Gastrointestinal reactions: loss of appetite, nausea, vomiting, diarrhea.

Secondary anti-estrogen effects: facial flushing, vulvar itching, menstrual disorders, amenorrhea, increased leucorrhea, vaginal bleeding, etc.

Neuropsychiatric symptoms: headache, dizziness, depression, etc.

Long-term use of large doses can cause visual impairment, such as cataracts.

Myelosuppression: A few patients may have transient leukopenia and thrombocytopenia.

Others: rash, hair loss, weight gain, abnormal liver function, etc.

Taboos:

Contraindicated for those with fundus diseases.

People with abnormal liver function should use it with caution. If there is bone metastasis, blood calcium needs to be checked regularly in the early stages of treatment.

It has effects on the fetus and is contraindicated for pregnant and lactating women.

Notes:

Use with caution if you have visual impairment or liver and kidney dysfunction before taking the medication.

For patients who take this product for a long time and are at risk of thromboembolism, their blood pictures should be checked regularly during treatment. If there is bone metastasis, blood calcium needs to be checked regularly in the early stages of treatment. During long-term treatment with this product for more than 2 years, liver function should be tested regularly.

When abnormal vaginal bleeding occurs, you should see a doctor immediately and conduct a comprehensive examination. The drug should be discontinued in case of heavy vaginal bleeding.

Patients treated with this product are at increased risk of endometrial cancer and should undergo careful gynecological examination.

Using this product may cause sudden functional ovarian cysts, menorrhagia and irregular uterine bleeding. Therefore, if this drug must be used before menopause, antigonadotropin drugs should be taken at the same time.

Storage:

Shield, seal, and store in a dry place.

Mechanism of action:

Tamoxifen is a synthetic anti-estrogen drug. Its structure is similar to estrogen, and it can compete with estradiol for the estrogen receptor, form a stable complex with the estrogen receptor, and transport it into the nucleus to prevent the opening of chromosomal genes, thereby inhibiting the growth and development of cancer cells.

Safety and efficacy:

Tamoxifen is the most commonly used non-steroidal anti-estrogen endocrine drug in clinical treatment of breast cancer. Unlike chemotherapy, it can predict the treatment effect and has fewer serious side effects. The effective rate is 60% to 70% for those who are both ER and PR positive, and the effective rate is 30% to 40% for those who are ER or PR positive. The effective rate is less than 10% for those who are both ER negative. Adjuvant tamoxifen therapy is considered the “standard” treatment for postmenopausal lymph node-positive, ER-positive patients. At the same time, it can reduce the incidence of contralateral breast cancer. Studies show that taking medication for 5 years is better than 2 years.

Research shows that tamoxifen treatment can significantly reduce the recurrence rate and mortality; TAM has the best effect on ER-positive patients, and is also effective on patients with unknown ER or ER-negative but PR-positive patients; adding tamoxifen after adjuvant chemotherapy can further improve the efficacy.