Nolvadol Tablets (Generic Tamoxifen Citrate Tablets)

1. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) © The Swiss Pharmacy

2. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol (Generic Tamoxifen Citrate Tablets) a nonsteroidal antiestrogen, is used for the treatment of breast cancer and the treatment of anovulatory infertility. Nolvadol which is indicated for the treatment of breast cancer has a response which is similar to that seen with either estrogens or androgens but Tamoxifen (Nolvadol Tablets) appears to produce less marked side-effects and to be more acceptable to the patient. © The Swiss Pharmacy

3. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol Tablets are manufactured by Phoenix Remedies Limited, India in the strength of 20 mg. © The Swiss Pharmacy

4. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Chemical Structure © The Swiss Pharmacy

5. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) The active ingredient contained in Nolvadol tablets is Tamoxifen Citrate. Each Nolvadol tablet contains 30.4 mg Tamoxifen Citrate, an amount equivalent to 20 mg of Tamoxifen. © The Swiss Pharmacy

6. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Uses of Nolvadol 20 mg Tablets: Tamoxifen belongs to a group of medicines called anti- oestrogens. Anti-oestrogens block the effects of a hormone called oestrogen in your body. Nolvadol (Generic Tamoxifen Citrate Tablets) is used in the treatment of breast cancer and to stimulate ovulation (the production of an egg) in women who suffer from a condition called anovulatory infertility. This is when you may have regular, or irregular, menstruation (periods) but you do not ovulate (release an egg). URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

7. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Uses of Nolvadol 20 mg Tablets: Nolvadol can also reduce the risk of breast cancer occurring in those women who have an increased likelihood of developing breast cancer (your risk). It is important that your healthcare professional calculates your risk of developing breast cancer and discusses the result with you before commencing treatment. There are a number of specific tools available to calculate breast cancer risk, based on information such as your age, family history, genetics, reproductive factors and a history of breast disease. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

8. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Recommended Adult Dosage Breast cancer: The dosage range of Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) for adults (including the elderly) is 20 to 40 mg daily given either in divided doses twice daily or as a single dose once daily. Dosages greater than 20 mg per day should be given in divided doses (morning and evening). In early disease, it is currently recommended that treatment is given for not less than 5 years. The optimal duration of Tamoxifen therapy remains to be determined. Nolvadol Tablets Breast cancer: URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

9. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Recommended Adult Dosage Ductal Carcinoma in Situ (DCIS): Ductal Carcinoma in Situ (DCIS): The recommended dose is Nolvadol tablets 20 mg daily for 5 years. Reduction in Breast Cancer Incidence in High Risk Women: The recommended dose is Nolvadol tablets 20 mg daily for 5 years. There are no data to support the use of Tamoxifen other than for 5 years. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

10. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Recommended Adult Dosage Anovulatory Infertility: Anovulatory Infertility: Prior to starting any course of treatment with Nolvadol, whether initial or subsequent, the possibility of pregnancy must be excluded. In women who are menstruating regularly, but with anovular cycles, the initial course of treatment consists of 20 mg given daily on the second, third, fourth and fifth days of the menstrual cycle. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

11. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Contraindications ➔Nolvadol is contraindicated in patients with a known hypersensitivity to Tamoxifen Citrate or any component of the tablet. ➔In patients who require concomitant warfarin therapy or have a history of deep vein thrombosis or pulmonary embolus, if the indication for treatment is either reduction of breast cancer incidence in high-risk patients or risk reduction of invasive breast cancer after treatment of DCIS. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

12. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Storage Instructions Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) have to be stored at controlled room temperature i.e. from 20°C to 25°C (68°F to 77°F) with excursions permitted between 15° to 30°C (59° to 86°F). Keep this as well as all other medicines away from children and pets. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

13. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Warnings Uterine malignancies: Promptly evaluate abnormal vaginal bleeding in a woman with current or past Tamoxifen use. Thromboembolic events: Risk increases with coadministered chemotherapy. For treatment of breast cancer, consider risks and benefits in patients with a history of thromboembolic events. Embryo-fetal toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

14. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Warnings Effects on the liver: Liver cancer and liver abnormalities, some fatal, have occurred. Perform periodic liver function testing. A number of second primary tumors, occurring at sites other than the endometrium, have been reported following the treatment of breast cancer with tamoxifen in clinical trials. Ocular disturbances, including corneal changes, decrement in color vision perception, retinal vein thrombosis, and retinopathy have been reported in patients receiving Tamoxifen. An increased incidence of cataracts and the need for cataract surgery have been reported in patients receiving Tamoxifen. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

15. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol Tablets and Alcohol Alcohol can raise the risk of side effects with Tamoxifen (Nolvadol Tablets), some of which can be serious. Alcohol makes it harder for Tamoxifen to work properly and should be limited or avoided while you're taking this medication. Alcohol can raise your risk of developing breast cancer. Alcohol consumption is a modifiable behavior that is linked to increased breast cancer risks and is associated with the development of hormone-dependent breast cancers as well as disease progression and recurrence following endocrine treatment. Alcohol also largely blocks a dose of Tamoxifen after 72 hours of treatment, suggesting a role for alcohol in breast cancer insensitivity to Selective estrogen receptor modulators (SERMs). URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

16. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Possible Side Effects Most common Nolvadol (Generic Tamoxifen Tablets) side effects include hot flashes, mood disturbances, vaginal discharge, vaginal bleeding, nausea, and fluid retention. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

17. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol Tablets Overdosage Acute overdosage in humans has not been reported. In a study of advanced metastatic cancer patients which specifically determined the maximum tolerated dose of Tamoxifen in evaluating the use of very high doses to reverse multidrug resistance, acute neurotoxicity manifested by tremor, hyperreflexia, unsteady gait and dizziness were noted. These symptoms occurred within 3 to 5 days of beginning tamoxifen and cleared within 2 to 5 days after stopping therapy. No permanent neurologic toxicity was noted. One patient experienced a seizure several days after tamoxifen was discontinued and neurotoxic symptoms had resolved. The causal relationship of the seizure to tamoxifen therapy is unknown. No specific treatment for Tamoxifen overdosage is known; treatment must be symptomatic. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

18. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol Tablets During Pregnancy Tamoxifen Citrate (Nolvadol tablets) has been classified by the US FDA as Pregnancy Category D. Tamoxifen may cause fetal harm when administered to a pregnant woman. Women should be advised not to become pregnant while taking Tamoxifen or within 2 months of discontinuing Tamoxifen and should use barrier or nonhormonal contraceptive measures if sexually active. Tamoxifen does not cause infertility, even in the presence of menstrual irregularity. Effects on reproductive functions are expected from the antiestrogenic properties of the drug. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

19. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol Tablets During Nursing There is no information regarding the presence of Tamoxifen (Nolvadol tablets) or its metabolites in human milk or its effects on the breastfed infant. Additional information from juvenile animal studies suggests a potential for serious long-term adverse effects for breastfed infants exposed to tamoxifen through breast milk. Because of the potential for serious adverse reactions in breastfed infants from Tamoxifen, advise a woman not to breastfeed during treatment with Nolvadol tablets and for 3 months following the last dose. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy

20. Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) Nolvadol Tablets Nolvadol Tablets (Generic Tamoxifen Citrate Tablets) are manufactured by Phoenix Remedies Private Limited, India. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9956_Nolvadol-Tablets.html © The Swiss Pharmacy