Patient/caregiver was educated on precautions to be exercised while taking Tamoxifen as follows:
- Warfarin and tamoxifen are metabolized by the same enzyme systems in the liver and so, compete mutually for the enzymes. Taken concurrently, tamoxifen can take over all the enzyme for metabolism, thus slowing down metabolism of warfarin. Warfarin could remain active in the blood for unduly long time, thus increasing risk for prolonged anticoagulation. Individuals taking these two drugs together can present with hemorrhage at slightest injury and episodes of internal bleeding with bleeding per rectum and blood in the urine. If you are on blood thinners, simultaneous intake of tamoxifen could be dangerous. Check with your physician regarding your safety with these medications and an appropriate change in the plan of care.
- Tamoxifen intake can result in increased risk for elevated blood pressure. Taking tamoxifen along with medications like ergotamine, that also stand a chance of increasing the blood pressure can result in complementation of their individual actions on blood pressure and lead to dangerously elevated blood pressure numbers. Acutely elevated blood pressure in these individuals can significantly increase the risk for development of stroke. Individuals presenting with stroke can demonstrate symptoms such as, numbness or weakness, especially in one half of the body, poor balance, problems with speech and/or vision, severe headache, and confusion. Report to your physician regarding any symptoms of elevated blood pressure and stroke development, for further investigation and necessary changes in the plan of care. Also, avoid taking tamoxifen along with any other medications that stand a chance of increasing the blood pressure.
- Patients newly started on tamoxifen, in the initial stages of tamoxifen intake, could present with side-effects, such as, increase in the size of the tumor, growth of new masses in the breast tissue, exacerbation of pain, worsening lymphedema and swelling, which settle over a period of time. In an established case of tamoxifen intake, these findings could also indicate poor response to tamoxifen and metastatic progression of tumor to involve other sites.
