Last update June 10, 2018

Tamoxifen Citrate

Incompatible

Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Commentary.

Non-steroidal anti-estrogen with an estrogen antagonist action by binding to the estrogen receptor. Similar action to clomiphene.
Indicated in breast cancer after remission in order to prevent recurrence.
Oral administration once or twice a day for 5 years.
It has also been used in combination with clomiphene to induce ovulation (Suginami 1993).

Since the last update date we have not found published data on its excretion in breastmilk.

Its high binding to plasma proteins would hinder transfer to breastmilk, but high pKa and its long half-life make its transfer to breastmilk likely.

It inhibits breastfeeding in the immediate postpartum (Masala 1978, Shaaban 1975), possibly due to decreased prolactin levels (Jordan 1991).

Until there is more data about this product in relation to breastfeeding, scientific associations and expert authors strongly advise against breastfeeding while taking tamoxifen because of the risk of interfering with the infant's estrogen balance (Hale 2017 p.906, Pistilli 2013, WHO 2002, Helewa 2002).


See below the information of this related product:

  • Clomifene Citrate (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Alternatives

We do not have alternatives for Tamoxifen Citrate.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Tamoxifen Citrate in other languages or writings:

Group

Tamoxifen Citrate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Tamoxifen Citrate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 564 daltons
Protein Binding 99 %
pKa 8.76 -
Tmax 4 - 7 hours
T½ 120 - 336 hours

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. AEMPS. Tamoxifeno. Ficha técnica. 2013 Full text (in our servers)
  3. Pistilli B, Bellettini G, Giovannetti E, Codacci-Pisanelli G, Azim HA Jr, Benedetti G, Sarno MA, Peccatori FA. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: how should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013 May;39(3):207-11. Abstract
  4. Astra Zeneka. Tamoxifen. Drug Summary. 2004 Full text (in our servers)
  5. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  6. Helewa M, Lévesque P, Provencher D, Lea RH, Rosolowich V, Shapiro HM; Breast Disease Committee and Executive Committeee and Council, Society of Obstetricians and Gynaecologists of Canada.. Breast cancer, pregnancy, and breastfeeding. J Obstet Gynaecol Can. 2002 Abstract
  7. Suginami H, Kitagawa H, Nakahashi N, Yano K, Matsubara K. A clomiphene citrate and tamoxifen citrate combination therapy: a novel therapy for ovulation induction. Fertil Steril. 1993 Abstract
  8. Jordan VC, Fritz NF, Langan-Fahey S, Thompson M, Tormey DC. Alteration of endocrine parameters in premenopausal women with breast cancer during long-term adjuvant therapy with tamoxifen as the single agent. J Natl Cancer Inst. 1991 Abstract
  9. Masala A, Delitala G, Lo Dico G, Stoppelli I, Alagna S, Devilla L. Inhibition of lactation and inhibition of prolactin release after mechanical breast stimulation in puerperal women given tamoxifen or placebo. Br J Obstet Gynaecol. 1978 Abstract
  10. Shaaban MM. Suppression of lactation by an antiestrogen, tamoxifen. Eur J Obstet Gynecol Reprod Biol. 1975 Abstract

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