Nolvadex

Do not take Nolvadex if you are sensitive to it or have ever had an allergic reaction to it.

If you are taking the blood-thinning drug warfarin or have had problems with clots in your veins or your lungs, you should not take Nolvadex to reduce the risk of breast cancer, and when taking it to treat an actual case of the disease, you should use it with caution.

Special warnings about Nolvadex

In addition to increasing the risk of uterine cancer, Nolvadex also raises the odds of developing endometriosis (the spread of endometrial tissue outside the uterus), uterine fibroids, uterine polyps, and ovarian cysts. Women who take Nolvadex also face a greater risk of stroke and blood clots lodging in their lungs. The risk increases further when Nolvadex is combined with toxic cancer drugs. Nolvadex can also cause liver damage, and should be used with caution if you already have liver problems.

If you experience visual problems while taking Nolvadex, notify your doctor immediately.

In a few women Nolvadex may raise the level of cholesterol and other fats in the blood. Your doctor may periodically do blood tests to check your cholesterol and triglyceride levels.

Nolvadex may produce an abnormally high level of calcium in the blood. Symptoms include muscle pain and weakness, loss of appetite, and, if severe, kidney failure. If you experience any of these symptoms, notify your doctor as soon as possible.

If tests show that your blood contains too few white blood cells or platelets while you are taking Nolvadex, your doctor should monitor you with special care. These problems have sometimes been found in women taking Nolvadex; whether the drug caused the blood-cell abnormalities is uncertain.

Possible food and drug interactions when taking Nolvadex

If Nolvadex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Nolvadex with the following:

• Aminoglutethimide
• Blood-thinning drugs such as warfarin
• Bromocriptine
• Cancer drugs such as cyclophosphamide
• Letrozole
• Phenobarbital
• Rifampin