Prescription onlyNo lower cost generic available



  • Pill
  • Liquid
  • Breast cancer (treatment and prevention)
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Lowers risk of and treats breast cancer.

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Prescription onlyNo lower cost generic available

Our pharmacists’ bottom line

Nolvadex (Tamoxifen) is an effective, first-line option for certain types of breast cancers, but it has many severe side effects and needs a lot of monitoring.

  • In studies, postmenopausal women who were at high risk for breast cancer took Nolvadex (Tamoxifen) for 5 years and lowered their risk by about 50%.
  • Nolvadex (Tamoxifen) is the only medicine approved to lower risk of breast cancer regardless of menopausal status. Other medicines are approved only for postmenopausal women.
  • Effective in treating metastatic breast cancer in men and women.
  • Available in both tablets and a sugar-free solution.
  • If you're taking Nolvadex (Tamoxifen) to lower your risk for breast cancer, it can raise your risk of having a stroke or getting a blood clot, especially if you have a history of blood clots or you're currently taking a blood thinner, like warfarin. Tell your doctor about any health conditions before you start taking Nolvadex (Tamoxifen).
  • Can raise the risk of fractures in premenopausal women.
  • There are many drug interactions, including antidepressants and other chemotherapy (anti-cancer) medicines. Talk to your doctor or pharmacist before making any changes.
  • Requires regular blood tests and doctor exams to monitor for side effects.
  • Not the best choice if you have eye or liver problems.

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Side effects for Nolvadex (Tamoxifen)

From clinical trials of Nolvadex / Breast cancer  ( 2859)

  • Hot flashesHot flashes65% for Tamoxifen vs.48% for placebo
  • FlushFlush33% for Tamoxifen vs.0% for placebo
  • Holding waterHolding water32% for Tamoxifen vs.30% for placebo
  • Vaginal dischargeVaginal discharge30% for Tamoxifen vs.15% for placebo
  • NauseaNausea26% for Tamoxifen vs.24% for placebo
  • Irregular mensesIrregular menses25% for Tamoxifen vs.19% for placebo
  • Weight loss (>5%)Weight loss (>5%)23% for Tamoxifen vs.18% for placebo
  • Skin changesSkin changes19% for Tamoxifen vs.15% for placebo
  • No periodsNo periods16% for Tamoxifen vs.0% for placebo
  • Altered mensesAltered menses13% for Tamoxifen vs.0% for placebo

What to expect when you take Nolvadex (Tamoxifen)

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Tips from our pharmacists
  • Nolvadex (Tamoxifen) can raise your risk of getting uterine or endometrial cancer. Talk to your doctor if you have abnormal vaginal bleeding or an irregular menstrual cycle.
  • Common side effects include hot flashes, vaginal discharge, nausea, and vomiting.
  • Take Nolvadex (Tamoxifen) once a day with a full glass of water. It can be taken with or without food.
  • If you're taking the solution, make sure to keep it at room temperature and protect it from light. Throw it away after 3 months, even if you haven't finished all of it.
  • Drinking grapefruit juice with Nolvadex (Tamoxifen) can raise your risk of side effects.

Risks and Warnings for Nolvadex (Tamoxifen)

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  • If you're at high risk for breast cancer or are a women with Ductal Carcinoma in Situ (DCIS), taking Nolvadex (Tamoxifen) has been associated with uterine cancer, stroke, and blood clots of the lung. Talk to your doctor about the risks before taking Nolvadex (Tamoxifen).

    This is a black box warning. The FDA requires this warning when there is a significant risk of serious or life-threatening effects that anyone taking the drug should consider.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Nolvadex (Tamoxifen)

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The FDA category for this medication is D. It is advised that you: Weigh risks vs. benefits
  • Tips from our pharmacists
  • Take Nolvadex (Tamoxifen) once a day with a full glass of water. It can be taken with or without food.