Oncotamox tablets

Oncotamox

  • Active Ingredient: Tamoxifen
  • 20 mg
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What is Oncotamox?

The active ingredient of Oncotamox brand is tamoxifen. Tamoxifen blocks the actions of estrogen, a female hormone. Certain types of breast cancer require estrogen to grow.

Used for

Oncotamox is used to treat diseases such as: Breast Cancer, Breast Cancer, Adjuvant, Breast Cancer, Male, Breast Cancer, Metastatic, Breast Cancer, Palliative, Breast Cancer, Prevention, McCune-Albright Syndrome, Precocious Puberty.

Side Effect

Possible side effects of Oncotamox include: dizziness; pain or feeling of pressure in the pelvis; pain in the stomach or side, possibly radiating to the back; change in vaginal discharge; cough; white or brownish vaginal discharge.

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Mechanism of Injury

The acute form of liver injury attributed to Oncotamox use is probably due to an idiosyncratic reaction to a metabolite of the medication rather than its estrogenic effects. In contrast, the induction of fatty liver and triggering of porphyria cutanea tarda are likely due to estrogenic effects on the liver in the setting of a genetic predisposition to fatty liver disease or porphyria cutanea tarda.

How it works

Oncotamox belongs to a group of drugs called antiestrogens. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Antiestrogens work by blocking the effects of the hormone estrogen in the body. Estrogen may cause the growth of some types of breast tumors. Oncotamox may block the growth of tumors that respond to estrogen.

Oncotamox oral tablet doesn’t cause drowsiness, but it can cause other side effects.

What is Oncotamox?

Oncotamox (Nolvadex®) is a medication in pill form that has been used for more than 25 years to treat breast cancer in women and men. Oncotamox is one of the most common endocrine therapy drugs. It has been shown to decrease the chance of recurrence in some early-stage breast cancers and to prevent the development of cancer in the opposite breast. Oncotamox can also slow or stop the growth of cancer cells present in the body.

There are an estimated 29 million women at increased risk for breast cancer in this country, and Oncotamox may offer another alternative to watchful waiting or prophylactic (preventative) mastectomy.

Oncotamox can reduce the risk of a breast cancer recurrence, but many women complain of side effects like hot flashes and weight gain.

In this week’s issue of People, former Victoria’s Secret model Jill Goodacre opens up about her five-year battle with breast cancer and the medication she’s been on to keep the disease at bay. Goodacre, who’s married to singer and actor Harry Connick Jr., went through surgery and radiation in 2012 after a tumor was detected via sonogram, and has taken the drug Oncotamox ever since.

As she approaches her five-year cancer-free mark, Goodacre says she’s looking forward to stopping Oncotamox. The medication can cause side effects, including weight gain, which Goodacre admits she’s struggled with.

“I’ve always been a pretty fit person, and so to be just rounder and heavier and not to really be able to do much about it—that’s been hard,” she told People. “It’s taken a lot out of my self-confidence.”

That’s a common problem among breast cancer survivors, says Nikita Shah, MD, medical director of the Cancer Risk Evaluation Program at Orlando Health UF Health Cancer Center. (Dr. Shah has not treated Goodacre, but does prescribe Oncotamox to many of her own patients.)

Still, Oncotamox can be lifesaving, says Dr. Shah, and for many women, its benefits outweigh its potential side effects. Here’s what else breast cancer patients and their loved ones should know about the pros and cons of this treatment.

How does Oncotamox affect breast cancer?

Oncotamox is classified as a selective estrogen receptor modulator (SERM) and works as an anti-estrogen: While the hormone estrogen promotes the growth of breast cancer cells, Oncotamox works by blocking estrogen from attaching to estrogen receptors on these cells. By blocking the estrogen receptors, it is believed that the growth of the breast cancer cells will be halted.

Chemical name: Oncotamox

Pill brand names: Nolvadex, Apo-Tamox, Tamofen, Tamone

Liquid brand name: Soltamox

Class: SERM (selective estrogen receptor modulator) hormonal therapy. Evista and Fareston are other SERMs.

How it works: SERMs block the effects of estrogen in the breast tissue by attaching to the estrogen receptors in breast cells.

Uses: Oncotamox, used to treat men and both premenopausal and postmenopausal women, typically is used to:

  • reduce the risk of early-stage, hormone-receptor-positive breast cancer coming back after surgery and other treatments
  • shrink large, hormone-receptor-positive breast cancers before surgery
  • treat advanced-stage, hormone-receptor-positive breast cancer, including metastatic breast cancer
  • reduce breast cancer risk in undiagnosed women at higher-than-average risk of developing breast cancer

Oncotamox usually is taken for 5 to 10 years, depending on a woman’s menopausal status. The American Society of Clinical Oncology recommends that:

  • newly diagnosed premenopausal and perimenopausal women take 5 years of Oncotamox as their first hormonal therapy; after this first 5 years is done, the hormonal therapy taken for the second 5 years (for a total of 10 years of hormonal therapy) would be determined by the woman’s menopausal status:
    • postmenopausal women could take another 5 years of Oncotamox or switch to an aromatase inhibitor for 5 years
    • pre- and perimenopausal women would take another 5 years of Oncotamox
  • take Oncotamox for 10 years
  • take an aromatase inhibitor for 5 years; right now there isn’t enough evidence to recommend taking an aromatase inhibitor for 10 years
  • take Oncotamox for 5 years, then switch to an aromatase inhibitor for another 5 years (for a total of 10 years of hormonal therapy)
  • take Oncotamox for 2 to 3 years, then switch to an aromatase inhibitor for another 5 years (for a total of 7 to 8 years of hormonal therapy)
  • postmenopausal women who started taking an aromatase inhibitor but didn’t finish 5 years of treatment can switch to Oncotamox to complete 5 years of hormonal therapy
  • postmenopausal women who started taking Oncotamox but didn’t finish 5 years of treatment can switch to an aromatase inhibitor and take it for 5 years (for a total of 7 to 8 years of hormonal therapy)
  • How it's given: Oncotamox is taken orally as a pill or as a liquid.

    Additional information: About 10% of people have an abnormal CYP2D6 gene that makes a version of the CYP2D6 enzyme that doesn’t function as well as it should. Having a low-functioning CYP2D6 enzyme might keep a person from getting the full benefit of Oncotamox. In 2018, the Clinical Pharmacogenetics Implementation Consortium, an international group of scientists that issues guidelines on the effects of genetic factors on reactions to drugs, issued a guideline on using CYP2D6 genotype information to make decisions about prescribing Oncotamox after surgery to treat hormone-receptor-positive breast cancer. The guideline strongly recommends that people with an abnormal CYP2D6 genotype that makes them less able to metabolize Oncotamox be treated with a different type of hormonal therapy, such as an aromatase inhibitor. You may want to ask your doctor about being tested for this genetic abnormality if you are considering taking Oncotamox.

    Also, certain medications can block the activity of the CYP2D6 enzyme, including antidepressants known as SSRIs and SNRIs, as well as Benadryl (chemical name: diphenhydramine) and Tagamet (chemical name: cimetidine). Make sure you tell your doctor about ALL other medicines you're taking if you're considering taking Oncotamox to make sure you get the full benefit of treatment.

    Interactions

    Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

    Some products that may interact with this drug are: anastrozole, "blood thinners" (e.g., warfarin), estrogens, letrozole, hormonal forms of birth control (e.g., birth control pills, patches, implants), ribociclib.

    Other medications can affect the removal of Oncotamox from your body, which may affect how Oncotamox works. Examples include cimetidine, rifamycins (e.g., rifampin), SSRI antidepressants (e.g., fluoxetine, paroxetine), St. John's wort, drugs used to treat seizures (e.g., carbamazepine, phenobarbital, phenytoin, primidone), among others.

    This medication may interfere with certain laboratory tests (including thyroid tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

    How long do I take Oncotamox?

    The American Society of Clinical Oncology recommends that:

    • newly diagnosed premenopausal and perimenopausal women take 5 years of Oncotamox as their first hormonal therapy; after this first 5 years is done, the hormonal therapy taken for the second 5 years (for a total of 10 years of hormonal therapy) would be determined by the woman’s menopausal status:
      • postmenopausal women could take another 5 years of Oncotamox or switch to an aromatase inhibitor for 5 years
      • pre- and perimenopausal women would take another 5 years of Oncotamox
    • take Oncotamox for 10 years
    • take an aromatase inhibitor for 5 years; right now there isn’t enough evidence to recommend taking an aromatase inhibitor for 10 years
    • take Oncotamox for 5 years, then switch to an aromatase inhibitor for another 5 years (for a total of 10 years of hormonal therapy)
    • take Oncotamox for 2 to 3 years, then switch to an aromatase inhibitor for another 5 years (for a total of 7 to 8 years of hormonal therapy)
  • postmenopausal women who started taking an aromatase inhibitor but didn’t finish 5 years of treatment can switch to Oncotamox to complete 5 years of hormonal therapy
  • postmenopausal women who started taking Oncotamox but didn’t finish 5 years of treatment can switch to an aromatase inhibitor and take it for 5 years (for a total of 7 to 8 years of hormonal therapy)
  • Oncotamox Overdose

    Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

    Tuberculosis drugs

    Taking Oncotamox with certain tuberculosis drugs can decrease the amount of Oncotamox in your body. If you need to take these drugs together, your doctor may increase your Oncotamox dosage. Examples of these drugs include:

    Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

    This drug comes with several warnings.

    It can be a treatment or a prevention

    Oncotamox is in a class of drugs known as selective estrogen receptor modulators, or SERMs. These drugs work by attaching to estrogen receptors in breast cells, blocking estrogen’s ability to cause cell mutations that lead to cancer.

    The drug—taken as a pill or a liquid—is often prescribed to pre-menopausal women after surgery for early-stage breast cancer. Because surgeons can’t always be sure they removed all of the cancer cells, Oncotamox can reduce the risk that those leftover cells will continue to multiply and the cancer will return.

    It can also be prescribed to women, pre- or post-menopause who have not been diagnosed with breast cancer, if they have a high risk (1.67% or higher) of developing it over the next five years. These women are usually 35 or older, and have risk factors such as a family history of cancer or a history of abnormal biopsies.

    FDA warning: Serious s >
    • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
    • Oncotamox can increase the risk of serious and life-threatening events, including uterine cancer, blood clots, and stroke. These events can be fatal. You should discuss the potential benefits and risks of this drug with your doctor.

    Q: I'm taking Oncotamox and have been given conflicting information. Do I need to avoid foods that contain phytoestrogens?

    A: Your question regards avoiding phytoestrogen foods while taking Oncotamox (Nolvadex) //www.everydayhealth.com/drugs/Oncotamox. Phytoestrogen foods are foods that are structurally similar to estrogen. Oncotamox works by binding to estrogen receptors in the breast and other tissues to decrease the effects of estrogen. After performing an extensive search and review of clinical studies concerning phytoestrogens and Oncotamox, it is discovered that there is limited data and appears that additional studies need to be performed to fully understand if this combination is safe. A journal article from 2007 referenced on the American Cancer Society's Web site states that there are animal studies indicating that a specific phytoestrogen could interfere with the effects of Oncotamox on breast cancer cells. Please talk with your health care provider, preferably your oncologist for additional information regarding eating phytoestrogen foods while taking Oncotamox. Jennyfer Marsico, RPh

    Reasons some people may not get the full benefit of Oncotamox

    The body uses an enzyme called CYP2D6 to convert Oncotamox into its active form. Two things can interfere with the body’s ability to make this happen: a flaw in the CYP2D6 enzyme and certain medications that block the effectiveness of this enzyme.

    • Abnormal CYP2D6 enzyme: About 10% of people have a CYP2D6 enzyme that doesn’t function as well as it should. Having an abnormal CYP2D6 enzyme might keep a person from getting the full benefit of Oncotamox. You may want to ask your doctor about being tested for this enzyme abnormality if you are considering taking Oncotamox. Still, CYP2D6 testing is controversial because several large studies found that an abnormal CYP2D6 enzyme didn’t affect Oncotamox’s effectiveness. Together, you and your doctor can decide if CYP2D6 testing makes sense for your unique situation.
    • Medications that can interfere with CYP2D6: There are medications that can block the activity of CYP2D6 to varying degrees (usually stated as “strong” or “moderate” inhibitors of CYP2D6). These medications include some of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). There are also other types of commonly prescribed medications, such as Cardioquin (chemical name: quinidine), Benadryl (chemical name: diphenhydramine), and Tagamet (chemical name: cimetidine), that can block CYP2D6. Blocking the activity of CYP2D6 can interfere with the activation of Oncotamox — reducing its effectiveness as an anti-cancer treatment. Most doctors recommend that you avoid taking strong and moderate inhibitors of CYP2D6 while you’re on Oncotamox.

    If you have already finished Oncotamox and you were taking other medications at the same time, make an appointment to talk with your doctor about whether any of your other medications may have interfered with CYP2D6 and the potential benefit you received from Oncotamox. Your doctor may recommend no additional therapy or extended hormonal therapy (with Oncotamox or an aromatase inhibitor) depending on your risk of recurrence, your overall medical condition, and your preferences.

    If you were taking Oncotamox because you are at high risk but have never been diagnosed, and you were also taking a CYP2D6 inhibitor, your doctor may now recommend additional anti-estrogen therapy with Oncotamox or raloxifene (brand name: Evista), depending on your menopausal status. Talk to your doctor about what’s best for your situation.

    If you had progression of breast cancer while on both Oncotamox and a strong or moderate CYP2D6 inhibitor, you can’t assume that Oncotamox failed to work. Rather, it’s possible that Oncotamox never had a fair chance at getting the cancer under control because its action was blocked by the other medicine. Moving forward, Oncotamox, without a CYP2D6 inhibitor, may still provide significant benefit.

    Q: Are there any side efects of taking Oncotamox over a five year period?

    A: Oncotamox is a medication that is used to treat or prevent breast cancer. Oncotamox is in the group of medications called selective estrogen receptor modulator or SERMs. Oncotamox interferes with the activity of estrogen, that may promote the growth of breast cancer. Some breast cancers are classified as estrogen receptor positive which means they have a protein that estrogen binds to. These breast cancers depend on estrogen to grow and Oncotamox works against the effects of estrogen on these cells. The prescribing information on Oncotamox lists the following as the most common side effects of the medication: hot flashes, headaches, fatigue, nausea/vomiting, vaginal dryness, and skin rash. The side effects are similar to those experienced during menopause. The prescribing information on Oncotamox states that depending on your type of breast cancer the treatment length will vary. Patients with metastatic breast cancer may take Oncotamox for long periods of time depending on the cancer's response to the medication. When used in patients with early stage breast cancer, Oncotamox is generally prescribed for 5 years. Oncotamox has been linked to endometrial cancer is some women, and the length of time taking the medication increases the risk. Patients who do not have a uterus are not at risk. This is one of the main reasons that Oncotamox is not taken for longer than 5 years. Cataracts are a common eye issue as we age, but it is found that Oncotamox can increase the risk of developing this condition. If you are taking chemotherapy medications while taking Oncotamox, there is a small increase in the risk for developing blood clots. The total number of women who experienced this side effect was very small. The risk is similar to taking estrogen hormone replacement therapy. Lori Poulin, PharmD

    COMMON BRAND(S): Nolvadex, Soltamox

    GENERIC NAME(S): Oncotamox

    OTHER NAME(S): Oncotamox Tablet

    Oncotamox has rarely caused very serious (possibly fatal) strokes, blood clots in the lungs/legs, and cancer of the uterus. If you are taking Oncotamox to reduce the risk of breast cancer, or if your cancer is limited to the milk ducts (ductal carcinoma in situ-DCIS), then discuss the benefits and risks of taking this medication with your doctor. However, if you are taking Oncotamox to treat breast cancer, then the benefits of taking Oncotamox are greater than the risks of side effects.

    Get medical help right away if you develop symptoms of a stroke or blood clots in the lungs/legs, such as weakness on one side of the body, slurred speech, sudden vision changes, confusion, shortness of breath, chest pain, or calf pain/swelling.

    Tell your doctor right away if you develop symptoms of cancer of the uterus, such as unusual changes in your monthly period (e.g., amount or timing of bleeding), unusual vaginal discharge, or pain/pressure below your "belly button" (navel).

    Oncotamox is used to treat breast cancer. It is also used to reduce the chances of breast cancer in high-risk patients.

    This medication can block the growth of breast cancer. It works by interfering with the effects of estrogen in the breast tissue.


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