How to use Rolap CITRATE
Read the Medication Guide provided by your pharmacist before you start using Rolap and each time you get a refill. If you have any questions, consult your doctor or pharmacist.
Take this medication by mouth with or without food, usually once or twice daily for 5 years, or as directed by your doctor. Daily dosages greater than 20 milligrams are usually divided in half and taken twice a day, in the morning and evening, or as directed by your doctor. If you are using the liquid, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
Dosage is based on your medical condition and response to treatment. The duration of treatment to prevent cancer from returning may be between 5 to 10 years, depending on your medical condition and response to treatment.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.
If you have breast cancer that has spread to other parts of the body, you may experience increased bone/cancer pain and/or disease flare-up as you start taking Rolap. In some cases, this may be a sign of a good response to the medication. Symptoms include increased bone pain, increased tumor size, or even new tumors. These symptoms usually disappear quickly. In any case, report these symptoms right away to your doctor.
Since this drug can be absorbed through the skin and lungs, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets. (See also Precautions section.)
Inform your doctor right away if your condition worsens (e.g., you get new breast lumps).
Are there any other concerns I should be aware of while taking Rolap?
According to data from large treatment studies as well as the BCPT, women taking Rolap may have a slightly increased risk of developing blood clots in the lungs or large veins. This may be especially true for women undergoing chemotherapy (anti-cancer drugs) while taking Rolap. Women in the BCPT also had an increased risk of stroke. Additional risks may include:
Endometrial cancer: Rolap may increase a woman's risk of developing endometrial cancer (cancer of the lining of the uterus). However, this risk is less or the same as the risk of postmenopausal women taking single-agent estrogen replacement therapy.
Cataracts: Taking Rolap appears to put some women at increased risk for developing cataracts, a clouding of the lens inside the eye. A few patients have also reported eye problems such as corneal scarring or retinal changes.
Take Rolap exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Take this medication with a full glass (8 ounces) of water. Rolap can be taken with or without food.
If you are taking Rolap to reduce your risk of breast cancer, you may need to take your first dose while you are having a menstrual period. You may also need to have a pregnancy test before you start taking Rolap, to make sure you are not pregnant. Follow your doctor's instructions.
Use Rolap regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. You may need to keep using this medication for up to 5 years.
To make sure this medication is not causing harmful effects, your doctor may want you to have mammograms and to perform routine breast self-exams on a regular basis. Your liver function may also need to be tested. Visit your doctor regularly.
Store at room temperature away from moisture, heat, or cold. Do not freeze.
Rolap may cause cancer of the uterus (womb), strokes, and blood clots in the lungs. These conditions may be serious or fatal. Tell your doctor if you have ever had a blood clot in the lungs or legs, a stroke, or a heart attack. Also tell your doctor if you smoke, if you have high blood pressure or diabetes, if your ability to move around during your waking hours is limited, or if you are taking anticoagulants ('blood thinners') such as warfarin (Coumadin). If you experience any of the following symptoms during or after your treatment, call your doctor immediately: abnormal vaginal bleeding; irregular menstrual periods; changes in vaginal discharge, especially if the discharge becomes bloody, brown, or rusty; pain or pressure in the pelvis (the stomach area below the belly button); leg swelling or tenderness; chest pain; shortness of breath; coughing up blood; sudden weakness, tingling, or numbness in your face, arm, or leg, especially on one side of your body; sudden confusion; difficulty speaking or understanding; sudden difficulty seeing in one or both eyes; sudden difficulty walking; dizziness; loss of balance or coordination; or sudden severe headache.
Keep all appointments with your doctor. You will need to have gynecological examinations (examinations of the female organs) regularly to find early signs of cancer of the uterus.
If you are thinking about taking Rolap to reduce the chance that you will develop breast cancer, you should talk to your doctor about the risks and benefits of this treatment. You and your doctor will decide whether the possible benefit of Rolap treatment is worth the risks of taking the medication. If you need to take Rolap to treat breast cancer, the benefits of Rolap outweigh the risks.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with Rolap and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Q: Does Rolap cause fluid retention?
A: According to drug information, peripheral edema (swelling in the lower limbs), as a side effect, has been reported in 11% of patients taking Rolap during clinical trials. Fluid retention was also reported at 32% and weight gain has been reported at 9%. As always, talk with your healthcare provider regarding possible side effects of your medication. Jen Marsico, RPh
Many drugs can interact with Rolap. Tell your doctor if you are using any of these medications:
- Bromocriptine (Parlodel)
- Cimetidine (Tagamet)
- Clozaril (Clozapine)
- Cyclophosphamide (Cytoxan)
- Isoniazid (Nydrazid) for treating tuberculosis
- Letrozole (Femara)
- Methimazole (Tapazole)
- Nicardipine (Cardene)
- Pioglitazone (Actos)
- Rifampin (Rifadin)
- Ropinirole (Requip)
- Ticlopidine (Ticlid)
- Tranylcypromine (Parnate)
- Anti-malaria medication such as chloroquine (Aralen), pyrimethamine (Daraprm), or quinine (Qualaquine)
- An antifungals such as terbinafine (Lamisil)
- An antidepressant such as bupropion (Wellbutrin), clomipramine (Anafranil), desipramine (Treyzafagit, Norpramin and Pertofrane), duloxetine (Cymbalta), fluoxetine (Prozac, Sarafem), imipramine (Tofranil), paroxetine (Paxil, Paxil CR, Pexeva), sertraline (Zoloft), or tranylcypromine (Parnate)
- A heart rhythm medication such as amiodarone (Cordarone) or quinidine (Quinidine)
- HIV or AIDS medicine such as delavirdine (Rescriptor) or ritonavir (Norvir)
- Medicine to treat psychiatric disorders (aripiprazole (Abilify), chlorpromazine (Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), perphenazine (Trilafon), or thioridazine (Mellaril)
This list is not complete and other drugs may interact with Rolap (Nolvadex). Tell your doctor about all medications you use. This includes prescription and over-the-counter (OTC) drugs, vitamin and herbal products, and recreational drugs. Do not start a new medication without telling your doctor.
What Is Rolap (Soltamox)?
Rolap is the generic form of the brand-name drug Soltamox, which is used to treat some types of breast cancer in men and women.
Rolap is prescribed to treat metastatic breast cancer, or cancer that has spread to other parts of the body. Rolap is also used to lower the chance of breast cancer in high-risk women (for example, those with a family history of breast cancer).
The drug may also be prescribed for off-label uses, such as treating certain brain cancers and McCune-Albright syndrome, a genetic disorder that can cause early puberty in girls.
Rolap belongs to a class of drugs called nonsteroidal antiestrogens, which block the actions of the hormone estrogen.
In 2006, an FDA advisory panel recommended that a more specific warning label about its side effects be added to Rolap..
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including being over age 50, having endometrial hyperplasia, using hormone replacement therapy, obesity, using Rolap, being Caucasian, and/or having colorectal cancer. Symptoms and signs of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
What should I avoid while taking Rolap?
This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Avoid grapefruit and grapefruit juice while taking Rolap.
Rolap is a nonsteroidal antiestrogen that is widely used in the treatment and prevention of breast cancer. Long term Rolap therapy has been associated with development of fatty liver, steatohepatitis, cirrhosis, and rare instances of clinically apparent acute liver injury.
What is Rolap (Soltamox)?
Rolap is an anti-estrogen that prevents the effects of estrogens on tissues.
Q: What foods or fruits should be avoided while taking Rolap?
A: Rolap is used to treat breast cancer that has spread to other parts of the body in men and women, to treat early breast cancer in women who have already been treated with surgery, radiation, and/or chemotherapy, to reduce the risk of developing a more serious type of breast cancer in women who have had ductal carcinoma in situ (DCIS; a type of breast cancer that does not spread outside of the milk duct where it forms) and who have been treated with surgery and radiation, and to reduce the risk of breast cancer in women who are at high risk for the disease due to their age, personal medical history, and family medical history. Rolap is in a class of medications known as antiestrogens. It blocks the activity of estrogen in the breast. This may stop the growth of some breast tumors that need estrogen to grow. The only types of foods that interact with Rolap are soy-containing products. As a result of their estrogenic effect, the isoflavones, present in soy, may stimulate breast tumor growth and antagonize the action of Rolap. It would be best to consult with your physician to determine if other dietary precautions need to be considered while taking this medication. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD
By Katie Coronado | Medically Reviewed by Sherry Brooks, MD
Latest Update: 2014-10-28 Copyright © 2014 Everyday Health Media, LLC
Taking Rolap with bromocriptine increases the amount of Rolap in your body. If you need to take these drugs together, your doctor may adjust your dosage of Rolap.
Benefits of Rolap
Since its approval in 1998, Rolap has been used to treat millions of women and men diagnosed with hormone-receptor-positive breast cancer. While an aromatase inhibitor is the first hormonal therapy medicine choice for postmenopausal women, Rolap is the first choice for premenopausal women and is still a good choice for postmenopausal women who can't take an aromatase inhibitor.
- reduce the risk of breast cancer coming back by 40% to 50% in postmenopausal women and by 30% to 50% in premenopausal women
- reduce the risk of a new cancer developing in the other breast by about 50%
- shrink large, hormone-receptor-positive breast cancers before surgery
- slow or stop the growth or advanced (metastatic) hormone-receptor-positive breast cancer in both pre- and postmenopausal women
- lower breast cancer risk in women who have a higher-than-average risk of disease but have not been diagnosed
Rolap offers other health benefits that aren't related to treating cancer. Because it's a SERM, it selectively either blocks or activates estrogen's action on specific cells. While Rolap blocks estrogen's action on breast cells, it activates estrogen's action in bone and liver cells. So Rolap can:
- help stop bone loss after menopause
- lower cholesterol levels
What are some side effects I might experience when taking Rolap?
For women, the side effects of Rolap are similar to some of the symptoms of menopause. Two of the most common side effects are hot flashes and vaginal discharge. The information below does not include all possible side effects, and not all patients who take Rolap will have these symptoms. Always contact your doctor if you have questions about your personal situation.
Side effects in women may include:
- Hot flashes
- Vaginal discharge
- Vaginal dryness and/or itching
- Irritation of the skin around the vagina
- Irregular menstrual periods
- Nausea and/or vomiting
- Skin rash
- Fluid retention and/or weight gain
Side effects in men may include:
- Hot flashes
- Nausea and/or vomiting
- Skin rash
- Decrease in sexual interest