Nolvadex is a non-steroid anti-estrogen which competitively inhibits estrogen receptors in the target organs and tumors in them. Nolvadex is used to treat breast cancer in women and in men (especially after castration) and also when it has spread to other parts of the body, kidney cancer, melanomas and sarcomas of the soft tissues with estrogen receptors, cancer of the ovary. The effect of the medication can last several weeks after a single dose. Nolvadex is able to cause ovulation in women, stimulation production of gonadotropic hormones of hypophysis. In men with oligospermia it increases concentration of luteinizing hormone and follicle-stimulating hormone, testosterone and estrogen in the blood serum.

Dosage and direction
Take it exactly as recommended by your physician as the dosage depends on your condition. Long treatment (about 2 years) is advised. Take this medication with food and a big glass of water as a single dose or divide it in two (taken in the morning and the evening), do not chew or crush them.

Precautions
This medication may increase the possibility of developing endometrial cancer. Patients who are treated with Nolvadex should be monitored for any abnormal vaginal bleeding, changes in menstrual periods, change in vaginal discharge, or pelvic pain or pressure.

Contraindications
Nolvadex is contradicted in patients with hypersensitivity to this medication and also in women who are threated by coumarin-type anticoagulant therapy or in women with deep vein thrombosis or pulmonary embolus in history, pregnant or breastfeeding women.
Cautiousness should be exercised in patients with eye diseases (including cataracts), hyperlipidemia, leukopenia, thrombocytopenia, hypercalcemia, severe thrombophlebitis, thromboembolism (also in history).

Possible side effect
Usual side effects caused by Nolvadex are: hot flashes, nausea, vomiting, weight gain, abnormal menstrual periods. If they change from minor to severe you should immediately inform your doctor about it.
Nolvadex is able to cause abnormalities in liver and blood tests, so regular monitoring of side effects caused by Nolvadex is required. If such signs as jaundice and bleeding appear a patient should immediately seek for immediate medical help.

Drug interaction
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins), also if you are taking any of these drugs: Anastrozole, letrozole, or warfarin, Carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin, or St. John's wort.

Missed dose

If you forgot to take your dose in time, please do it as soon as you remember. But do not take if it is too late or almost time for your next dose. Do not take double or extra doses. Take your usually dose next day in the same regularly time.

Overdose

In patients with metastatic cancer treated with the maximally tolerated doses of Nolvadex side acute neurotoxicity manifested by tremor, hyperreflexia, unsteady gait and dizziness were observed. If you supposes that took too much of this medication look for immediate medical help and contact your doctor.

Storage

Store at room temperature between 20-25 C (68-77 F), protect from heat and light. Keep all drugs out of the reach of children and pets.