Before you start to use it

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You must tell your doctor if:

1. you have any allergies to:

• tamoxifen, the active ingredient in NOLVADEX
• any of the other ingredients in NOLVADEX listed at the end of this leaflet
• other anti-oestrogen medicines
• any other medicines
• any other substances, such as foods, preservatives or dyes.

If you have an allergic reaction, you may experience a skin rash, hay fever, difficulty breathing or feel faint.

2. you have or have ever had any of these medical conditions:

• any unexplained vaginal bleeding
• problems with your blood
• liver problems
• deep vein thrombosis (DVT – blood clots in veins of your leg) or pulmonary embolus (blood clots in your lungs).

It may not be safe for you to take NOLVADEX if you have any of these conditions.

Taking other medicines

Tell your doctor if you are taking any other medicines, including:

• oral contraceptives (‘the pill’)
• hormone replacement therapy
• medicines used to thin your blood e.g. warfarin
• rifampicin
• chemotherapy
• any medicines that you buy at the chemist, supermarket or health food shop.

NOLVADEX should not be taken with aromatase inhibitors such as anastrozole, letrozole or exemestane.

These medicines may affect the way NOLVADEX works or may not work as well. They could also cause side effects if you take them with NOLVADEX.

Your doctor or pharmacist can tell you what to do if you are taking any of these medicines.

If you have not told your doctor about any of these things, tell them before you take any NOLVADEX.

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Taking NOLVADEX

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.

Your doctor or pharmacist will tell you how many tablets you will need to take each day.

If you do not understand the instructions on the box, ask your doctor or pharmacist for help.

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How much to take

Your doctor will decide how much NOLVADEX you need to take.

The usual dose is 20 mg of NOLVADEX each day.

This is two 10 mg Nolvadex tablets taken together or one 20 mg Nolvadex-D tablet taken once a day.

Some people need to take 40 mg once a day. Your doctor will tell you if this is necessary.

Swallow your NOLVADEX whole, with a full glass of water. Do not chew or crush the tablets.

When to take it

Take NOLVADEX at about the same time each day.

It does not matter if you take NOLVADEX before, with or after food.

How long to take it

Continue taking NOLVADEX for as long as your doctor or pharmacist tells you to.

When you forget to take it

Should you miss a dose, take it as soon as you remember, as long as it is 12 hours before the next dose is due.

If it is less than 12 hours to the next dose, do not take the dose you have missed.

Do not double the dose to make up for the dose that you missed.

When you are not sure what to do, ask your doctor or pharmacist.

Having trouble remembering to take your medicine, ask your pharmacist for some hints.

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Immediately telephone your doctor or pharmacist or the Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at your nearest hospital immediately if you think that you or anyone else may have taken too much NOLVADEX. Do this even if there are no signs of discomfort or poisoning.

If you take too much NOLVADEX you may experience problems with the rhythm of your heart.

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While you are using it

Things you must do

Be sure to keep all your appointments with your doctor so your progress can be checked.

Tell any other doctors, dentists and pharmacists who are treating you that you are taking NOLVADEX.

If you are about to be started on any new medicine, tell your doctor, dentist or pharmacist that you are taking NOLVADEX.

If you go into hospital, please let the medical staff know that you are taking NOLVADEX.

Things you must not do

Don’t get pregnant while you are taking NOLVADEX and for nine months after you stop taking NOLVADEX. Ask your doctor about reliable methods of contraception.

Shoul not breastfeed while you are taking NOLVADEX.

Must not take NOLVADEX to treat any other complaints unless your doctor tells you to.

Never not stop taking NOLVADEX, or lower the dosage, unless you have discussed this with your doctor.

Things to be careful of

Be careful driving or operating machinery until you know how NOLVADEX affects you. Some patients may experience dizziness, fatigue or light headedness.

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Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking NOLVADEX.

NOLVADEX helps most people with breast cancer, but it may have unwanted side effects in a few people.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor or pharmacist to answer any questions you may have.