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Vascular disordersRespiratory, thoracic andmediastinal disordersGastrointestinal disordersHepatobiliary disordersSkin and subcutaneoustissue disordersMusculoskeletal andconnective tissuedisordersReproductive system andbreast disordersVery CommonCommonUncommonVery commonCommonUncommonCommonUncommonRareVery commonCommonRareVery rareCommonVery commonCommonHot flushesThromboembolic events(including deep veinthrombosis, microvascularthrombosis and pulmonaryembolism)Interstitial pneumonitisNauseaVomitingDiarrhoeaConstipationPancreatitisChanges in liver enzymesFatty liverCirrhosis of the liverHepatitisCholestasis aHepatic failure aHepatocellular injury aHepatic necrosis aSkin RashAlopeciaAngioedemaSteven-Johnsonssyndrome aCutaneous vasculitis aBullous pemphigoid aErythema multiforme aCutaneous lupuserythematosus bLeg crampMyalgiaVaginal bleedingVaginal dischargePruritus valvaeEndometrial changes(including hyperplasia andpolyps)
Congenital, familial andgenetic disordersGeneral disorders andadministration siteconditionsRareVery rareVery commonEndometriosis aCystic ovarian swelling aVaginal polypsPorphyria cutanea tarda bFatigueInvestigations Common Elevated triglyceridesInjury, poisoning andprocedural complicationsVery rareRadiation Recall ba This adverse drug reaction was not reported in the tamoxifen arm (n=3094) of theabove study; however, it has been reported in other trials or from other sources. Thefrequency has been calculated using the upper limit of the 95% confidence intervalfor the point estimate (based on 3/X, where X represents the total sample size e.g.3094). This is calculated as 3/3094 which equates to a frequency category of ‘rare’.b The event was not observed in other major clinical studies. The frequency has beencalculated using the upper limit of the 95% confidence interval for the point estimate(based on 3/X, where X represents the total sample size of 13,357 patients in themajor clinical studies). This is calculated as 3/13,357 which equates to a frequencycategory of ‘very rare’.Side effects can be classified as either due to the pharmacological action of themedicine, e.g. hot flushes, vaginal bleeding, vaginal discharge, pruritus vulvae andtumour flare, or as more general side effects, e.g. gastrointestinal intolerance,headache, light-headedness and occasionally, fluid retention and alopecia.When side effects are severe, it may be possible to control them by a simple reductionof dosage (to not less than 20 mg/day) without loss of control of the disease. If sideeffects do not respond to this measure, it may be necessary to stop the treatment.Skin rashes (including isolated reports of erythema multiforme, Stevens Johnsonsyndrome and bullous pemphigoid) and commonly hypersensitivity reactionsincluding angioedema have been reported.Uncommonly, patients with bony metastases have developed hypercalcaemia oninitiation of therapy.Cases of visual disturbances including rare reports of corneal changes, and commonreports of retinopathy have been described, in patients receiving tamoxifen therapy.Cataracts have been reported commonly in association with the administration oftamoxifen.Cases of optic neuropathy and optic neuritis have been reported in patients receivingtamoxifen and, in a small number of cases, blindness has occurred.
Page 1 and 2: SUMMARY OF PRODUCT CHARACTERISTICS1
Page 3 and 4: • Hypersensitivity to the active
Page 5 and 6: Concomitant medications that inhibi
Page 7: Unless specified, the following fre
Page 11 and 12: Porphyria cutanea tarda has been ob
Page 13 and 14: to tamoxifen. The poor metaboliser
Page 15 and 16: breast cancerNon-invasivecancers77(
Page 17 and 18: No age-related effects of tamoxifen
Page 19 and 20: 6.5 Nature and contents of containe

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