Tamoxifen 20 mg Tablets

  • Name:

    Tamoxifen 20 mg Tablets

  • Company:
    info
  • Active Ingredients:

    Tamoxifen Citrate

  • Legal Category:

    Product subject to medical prescription which may be renewed (B)

Patient Information Leaflet Patient Information Leaflet last updated on medicines.ie: 23/01/19

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Summary of Product Characteristics last updated on medicines.ie: 23/1/2019

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Gerard Laboratories

Gerard Laboratories

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Medicine Name Brabio 40mg/ml solution for injection, pre-filled syringe Active Ingredients Glatiramer Acetate
Medicine Name Cifloxager 250 mg Film-coated Tablets Active Ingredients Ciprofloxacin hydrochloride
Medicine Name Cifloxager 500 mg Film-coated Tablets Active Ingredients Ciprofloxacin hydrochloride
Medicine Name Ciprager 10mg & 20mg Film Coated Tablets Active Ingredients citalopram hydrobromide
Medicine Name Ciprager 40mg Film Coated Tablets Active Ingredients citalopram hydrobromide
Medicine Name Ciprofloxacin Mylan 2mg/1ml solution for infusion Active Ingredients Ciprofloxacin
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1 - 0 of 117 items.Total: Infinity pages

When a pharmaceutical company changes any document, a new version is published on medicines.ie. For each version, we show the dates it was published on medicines.ie and the reasons for change.

Updated on 23 January 2019 PIL

Reasons for updating

  • Change to section 6 - marketing authorisation holder
  • Change to section 6 - date of revision

Updated on 23 January 2019 SmPC

Reasons for updating

  • Change to section 7 - Marketing authorisation holder
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Updated on 28 November 2017 SmPC

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  • New SmPC for new product

Legal category: Product subject to medical prescription which may be renewed (B)

Updated on 28 November 2017 SmPC

Reasons for updating

  • Change to section 4.1 - Therapeutic indications
  • Change to section 4.2 - Posology and method of administration
  • Change to section 4.4 - Special warnings and precautions for use
  • Change to section 4.8 - Undesirable effects
  • Change to section 6.3 - Shelf life
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

4. CLINICAL PARTICULARS

4.1 Therapeutic indications


Tamoxifen is indicated iIn the treatment of breast cancer.

4.2 Posology and method of administration

Posology

Breast cancer: Adults (including the elderlyolder people): The dosage range is 20 to 40 mg daily, given either in divided doses twice daily or as a single dose once daily. In early disease, it is currently recommended that treatment is given for not less than 5 years. The optimal duration of tamoxifen therapy remains to be determined.

Paediatric population
In an uncontrolled trial in 28 girls aged 2–10 years with McCune Albright Syndrome (MAS), who received 20 mg tamoxifen once a day for up to 12 months duration, mean uterine volume increased after 6 months of treatment and doubled at the end of the one-year study. While this finding is in line with the pharmacodynamic properties of tamoxifen, a causal relationship has not been established (see section 5.1).

4.8 Undesirable effects
Font has been changed in Table 1.

6.3 Shelf life

5Five years

10. DATE OF REVISION OF THE TEXT

AugustFebruary 20176

Updated on 24 November 2017 PIL

Reasons for updating

  • New PIL for new product

Updated on 24 November 2017 PIL

Reasons for updating

  • Change to Section 1 - what the product is
  • Change to section 2 - what you need to know - warnings and precautions
  • Change to section 2 - interactions with other medicines, food or drink
  • Change to section 2 - pregnancy, breast feeding and fertility
  • Change to section 2 - driving and using machines
  • Change to section 3 - overdose, missed or forgotten doses
  • Change to section 4 - possible side effects
  • Change to section 6 - date of revision

Updated on 2 December 2016 PIL

Reasons for updating

  • Change to section 6 - manufacturer
  • Change to section 6 - date of revision
  • Discontinuation of one or more strengths

Updated on 24 May 2016 SmPC

Reasons for updating

  • Change to separate SPCs covering individual presentations

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

20 mg Presentation Only.

Updated on 23 March 2016 PIL

Reasons for updating

  • Change of manufacturer
  • Change to date of revision

Updated on 26 February 2016 SmPC

Reasons for updating

  • Change to section 4.2 - Posology and method of administration
  • Change to section 4.3 - Contraindications
  • Change to section 4.4 - Special warnings and precautions for use
  • Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
  • Change to section 4.6 - Pregnancy and lactation
  • Change to section 4.7 - Effects on ability to drive and use machines
  • Change to section 4.8 - Undesirable effects
  • Change to section 4.9 - Overdose
  • Change to section 6.1 - List of excipients
  • Change to section 7 - Marketing authorisation holder
  • Change to section 8 - MA number
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

 

4.2 Posology and method of administration

 

Posology

 

Breast cancer: Adults (including older peopleelderly): The dosage range is 20 to 40 mg daily, given either in divided doses twice daily or as a single dose once daily.
In early disease, it is currently recommended that treatment is given for not less than 5 years. The optimal duration of tamoxifen therapy remains to be determined.

 

Method of administration

For administration by the oral routeuse.

 

4.3 Contraindications

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

Tamoxifen should not be used in the following:

  • Tamoxifen must not be administered during pregnancy. There have been a small number of reports of spontaneous abortions, birth defects and foetal deaths after women have taken tamoxifen, although no causal         relationship has been established (see also section 4.6).
  •  hypersensitivity to the active substance, or to any of the excipients listed in section 6.1.

    4.4 Special warnings and precautions for use

    Paediatric population

    In an uncontrolled trial in 28 girls aged 2–10 years with McCune Albright Syndrome (MAS), who received 20 mg tamoxifen once a day for up to 12 months duration, mean uterine volume increased after 6 months of treatment and doubled at the end of the one-year study. While this finding is in line with the pharmacodynamic properties of tamoxifen, a causal relationship has not been established (see section 5.1).

    In the literature it has been shown that CYP2D6 poor metabolisers have a lowered plasma level of endoxifen, one of the most important active metabolites of tamoxifen (see section 5.2).

    Concomitant medications that inhibit CYP2D6 may lead to reduced concentrations of the active metabolite endoxifen. Therefore, potent inhibitors of CYP2D6 (e.g. paroxetine, fluoxetine, quinidine, cinacalcet or bupropion) should whenever possible be avoided during tamoxifen treatment (see sections 4.5 and 5.2).

    Paediatric population

    In an uncontrolled trial in 28 girls aged 2–10 years with McCune Albright Syndrome (MAS), who received 20 mg tamoxifen once a day for up to 12 months duration, mean uterine volume increased after 6 months of treatment and doubled at the end of the one-year study. While this finding is in line with the pharmacodynamic properties of tamoxifen, a causal relationship has not been established (see section 5.1).

    Venous thromboembolism

    A 2-3-fold increase in the risk for VTE has been demonstrated in healthy tamoxifen-treated women (see section 4.8).

    In patients with breast cancer, prescribers should obtain careful histories with respect to the patient’s personal and family history of VTE. If suggestive of a prothrombotic risk, patients should be screened for thrombophilic factors. Patients who test positive should be counselled regarding their thrombotic risk. The decision to use Tamoxifen in these patients should be based on the overall risk to the patient. In selected patients, the use of Tamoxifen with prophylactic anticoagulation may be justified (reference section 4.5).

    The risk of VTE is further increased by severe obesity, increasing age and all other risk factors for VTE. The risks and benefits should be carefully considered for all patients before treatment with Tamoxifen. In patients with breast cancer, this risk is also increased by concomitant chemotherapy (see section 4.5). Long-

    term anticoagulant prophylaxis may be justified for some patients with breast cancer who have multiple risk factors for VTE.

    Surgery and immobility:

    Tamoxifen treatment should only be stopped if the risk of Tamoxifen-induced thrombosis clearly outweighs the risks associated with interrupting treatment. All patients should receive appropriate thrombosis prophylactic measures

    and should include graduated compression stockings for the period of hospitalisation, early ambulation, if possible, and anti-coagulant treatment.

    If any patients with VTE, tamoxifen should be stopped immediately and appropriate anti-thrombosis measures initiated. Tamoxifen should not be restarted unless there is a compelling alternative explanation for their

    thrombotic event. In patients receiving tamoxifen for breast cancer, the decision to re-start tamoxifen should be made with respect to the overall risk for the patient. In selected patients with breast cancer, the continued use of

    Tamoxifen with prophylactic anticoagulation may be justified. All patients should be advised to contact their doctors immediately if they become aware of any symptoms of VTE.

    4.5 Interaction with other medicinal products and other forms of interaction

    When tamoxifen is used in combination with coumarin type anticoagulants, such as warfarin, a significant increase in anticoagulant effect may occur. Where such co-administration is initiated, careful monitoring of the patient is recommended.

    When tamoxifen is used in combination with cytotoxic agents, there is increased risk of thromboembolic event occurring (see also section 4.8).

    The use of tamoxifen in combination with anastrozole as adjuvant therapy has not shown improved efficacy compared with tamoxifen alone.

    The known principal pathway for tamoxifen metabolism in humans is demethylation, catalysed by CYP3A4 enzymes. Pharmacokinetic interaction with the CYP3A4 inducing agent rifampicin, showing a reduction in tamoxifen plasma levels has been reported in the literature. The relevance of this finding is not known.

    Pharmacokinetic interaction with CYP2D6 inhibitors, showing a reduction in plasma level of an active tamoxifen metabolite, 4-hydroxy-N-desmethyltamoxifen (endoxifen), has been reported in the literature.


    4.6 Fertility, pregnancy and lactation

    Pregnancy

    Tamoxifen must not be administered during pregnancy. There have been a small number of

     

    reports of spontaneous abortions, birth defects and foetal deaths after women have taken tamoxifen, although no causal relationship has been established.

     

    Reproductive toxicology studies in rats, rabbits and monkeys have shown no teratogenic potential.

    Tamoxifen was not mutagenic in a range of in vitro and in vivo mutagenicity tests. Investigations in different in vitro system and in vivo tests in rodents, have shown that tamoxifen has a genotoxic potential following hepatic activation.

    In rodent models of foetal reproductive tract development, tamoxifen was associated with changes similar to those caused by oestradiol, ethynyloestradiol, clomiphene and diethylstilboestrol (DES). Although the clinical relevance of these changes is unknown, some of them, especially vaginal adenosis, are similar to those seen in young women who were exposed to DES in utero and who ha

     

    ved a 1 in 1000 risk of developing clear-cell carcinoma of the vagina or cervix. Only a small number of pregnant women have been exposed to tamoxifen. Such exposure has not been reported to cause subsequent vaginal adenosis or clear-cell carcinoma of the vagina or cervix in young women exposed in utero to tamoxifen

     

    Such exposure has not been reported to cause subsequent vaginal adenosis or clear-cell carcinoma of the vagina or cervix in young women exposed in utero to tamoxifen

     

     

    .

     

    Breast-feeding

    It is not known if tamoxifen is excreted in human milk and therefore, the drug is not recommended during

     

    breast-feedinglactation. The decision either to discontinue nursing or discontinue tamoxifen should take into account the importance of the drug to the mother.

     

    4.7 Effects on ability to drive and use machines

    Tamoxifen is unlikely to impair the ability of patients to drive or

     

    useoperate machinery. However, fatigue has been reported with the use of tamoxifen and caution should be observed when driving or operating machinery while such symptoms persist.

     

    4.8 Undesirable effects

    Unless specified, the following frequency categories were calculated from the number of adverse events reported in a large phase III study conducted in 9366 postmenopausal women patients with operable breast cancer treated for 5 years and unless specified, no account was taken of the frequency within the comparative treatment group or whether the investigator considered it to be related to study medication.

    Adverse drug reactions (ADRs) can be classified as either due to the pharmacological

     

    (anti-oestrogenic) action of the drug e.g. hot flushes, vaginal bleeding, vaginal discharge and pruritus vulvae, or as more general ADRs e.g. nausea, fluid retention and skin rashes. When such side effects are severe, it may be possible to control them by simple reduction of dosage (within the recommended dose range) without loss of control of the disease.

     

    When such side effects are severe, it may be possible to control them by simple reduction of dosage (within the recommended dose range) without loss of control of the disease

     

     

    .

     

    Vaginal discharge

     

    hyperplasia and polyps)

     

    Vaginal polyps

     

    Congenital, familial and genetic disorders

     

    Porphyria cutanea tarda

    b

    Injury, poisoning and procedural complications

     

     

    Radiation Recall

     

    b

    General disorders and administration site conditions

     

    Fatigue

     

    Investigations

     

    Elevated

     

    Increase of serum triglyceridesj

    (including paraesthesia and dysgeusia)

     

    Eye disorders

     

    Cataracts

    Retinopathy

     

    Visual disturbance

     

    Corneal changes

    Optic neuropathy

    a d

    Vascular disorders

     

    Hot flushes

     

    Thromboembolic events (including deep vein thrombosis and microvascular thrombosis)

     

    h

    Multiple SOC Terms

     

     

    Thromboembolic events (including deep vein thrombosis, microvascular thrombosis and pulmonary embolism)

     

     

    Respiratory thoracic and mediastinal disorders

     

    Thromboembolic events (including pulmonary embolism)

     

    h

    Interstitial pneumonitis

     

    Gastrointestinal disorders

     

    Nausea

     

    Vomiting

    Diarrhoea

    Constipation

     

    Pancreatitis

    j

    Hepatobiliary disorders

     

    Changes in liver enzymes

    i

     

    Fatty liver

    i

    Cirrhosis of the liver

    i

    Cholestasis

    a i

     

    Hepatitis

    i

     

    Hepatic failure

    a i

     

    Hepatocellular injury

    a i

     

    Hepatic necrosis

    a i

    Skin and subcutaneous tissue disorders

     

    Skin rash

     

    Alopecia

     

    Angioedema

    Stevens-Johnson syndrome

    a

     

    Cutaneous vasculitis

    a

     

    Bullous pemphigoid

    a

     

    Erythema multiforme

    a

    Cutaneous lupus erythematosus

    b

    Musculoskeletal and connective tissue disorders

     

    Leg cramp

    Myalgia

     

    Reproductive system and breast disorders

     

    Vaginal bleeding

     

    Pruritus vulvae

    Endometrial changes (including

     

    Endometriosisa

    Cystic ovarian swelling

    a


    c

     

    Uncommonly, patients with bony metastases have developed hypercalcaemia on initiation of therapy.

     

    d

     

    Cases of optic neuropathy and optic neuritis have been reported in patients receiving tamoxifen and, in a small number of cases, blindness has occurred.

     

    e

     

    Falls in platelet count, usually only to 80,000 – 90,000 per cu mm but occasionally lower, have been reported in patients taking tamoxifen, for breast cancer.

     

    f

     

    Leukopenia has been observed following the administration of tamoxifen sometimes in association with anaemia and/or thrombocytopenia.

     

    g

     

    Neutropenia has been reported on rare occasions; this can sometimes be severe.

     

    h

     

    When tamoxifen is used in combination with cytotoxic agents there is increased risk of thromboembolic events occurring.

     

    i

     

    Tamoxifen has been associated with changes in liver enzyme levels and with a spectrum of more severe liver abnormalities which in some cases were fatal.

     

    j

     

    Elevation of serum triglyceride levels,

     

    4.9 Overdose

    Signs and symptoms

    On theoretical grounds, overdosage would be expected to cause enhancement of the anti-oestrogenic side effects mentioned above. Observations in animals show that extreme overdosage (100-200 times recommended daily dose) may produce oestrogenic effects.

    An overdose would theoretically enhance the anti-oestrogenic effects of tamoxifen. However, an oestrogenic effect has been seen in animals that have received between 100-200 times the recommended daily dose.

    There have been reports in the literature that tamoxifen given at several times the standard dose may be associated with prolongation of the QT interval of the ECG.

    Management

    There is no specific antidote to overdosage and treatment must be symptomatic.

     

     

    Treatment of overdose must be symptomatic as there is no antidote.

     


    6. PHARMACEUTICAL PARTICULARS

    6.1 List of excipients

    Mannitol (E421)

    Maize

     

    Sstarch

     

    Croscarmellose

     

    Ssodium

     

    Magnesium Stearate



    7. MARKETING AUTHORISATION HOLDER

    Generics (UK) Limited

    Station Close

    Potters Bar

    Hertfordshire

    EN6 1TL

    U

     

    nited KingdomK

     

    8. MARKETING AUTHORISATION NUMBERS

    PA

     

    0405/001/001

     

    PA

     

    0405/001/002

     













    Updated on 26 February 2016 PIL

    Reasons for updating

    • Change to warnings or special precautions for use
    • Change of contraindications
    • Change to date of revision
    • Change to dosage and administration

    Updated on 23 February 2015 SmPC

    Reasons for updating

    • Change to section 1 - Name of medicinal product
    • Change to section 2 - Qualitative and quantitative composition
    • Change to section 4.2 - Posology and method of administration
    • Change to section 4.3 - Contraindications
    • Change to section 4.4 - Special warnings and precautions for use
    • Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
    • Change to section 4.6 - Pregnancy and lactation
    • Change to section 4.7 - Effects on ability to drive and use machines
    • Change to section 4.8 - Undesirable effects
    • Change to Section 4.8 – Undesirable effects - how to report a side effect
    • Change to section 4.9 - Overdose
    • Change to section 5.1 - Pharmacodynamic properties
    • Change to section 5.2 - Pharmacokinetic properties
    • Change to section 6.4 - Special precautions for storage
    • Change to section 6.6 - Special precautions for disposal and other handling
    • Change to section 10 - Date of revision of the text

    Legal category: Product subject to medical prescription which may be renewed (B)

    Free text change information supplied by the pharmaceutical company

    section 1 & 2
    name amended (BP removed)

    section 4.2
    In early disease, it is currently recommended that treatment is given for not less than 5 years. The optimal duration of tamoxifen therapy remains to be determined.

     

    Paediatric population
    The use of tamoxifen is not recommended in children, as safety and efficacy have not been established (see sections 5.1 and 5.2)
    Method of administration

    For oral use.

    section 4.3
    Tamoxifen must not be administered during pregnancy.  There have been a small number of spontaneous abortions, birth defects and foetal deaths after women have taken tamoxifen, although no causal relationship has been established (see also section 4.6).

    section 4.4
    A small number of cases of endometrial hyperplasia, endometrial polyps and a n increased incidence of endometrial cancer and uterine sarcoma (mostly malignant mixed Mullerian tumours) have been reported in association with tamoxifen treatment.  The underlying mechanism is unknown, but may be related to the oestrogen-like effects of tamoxifen. 

    Any patients receiving or having previously received tamoxifen who report abnormal gynaecological symptoms, especially vaginal bleeding including menstrual irregularities, post-menopausal bleeding and vaginal discharge,  should be promptly investigated. 

    section  4.5

    section 4.4

    The use of tamoxifen in combination with anastrozole as adjuvant therapy has not shown improved efficacy compared with tamoxifen alone.

     

    The known principal pathway for tamoxifen metabolism in humans is demethylation, catalysed by CYP3A4 enzymes. Pharmacokinetic interaction with the CYP3A4 inducing agent rifampicin, showing a reduction in tamoxifen plasma levels has been reported in the literature. The relevance of this finding is not known.

    section  4.6
    Pregnancy

    Breast-feeding

    section 4.8
    table 4.8

    section 5.1

    Mechanism of action
    Paediatric populationAn uncontrolled trial was undertaken in a heterogeneous group of 28 girls aged 2 to 10 years with McCune Albright Syndrome (MAS), who received 20 mg tamoxifen once a day for up to 12 months duration.
    Among the patients who reported vaginal bleeding during the pre-study period, 62% (13 out of 21 patients) reported no bleeding for a 6 month period and 33% (7 out of 21) reported no vaginal bleeding for the duration of the trial. Mean uterine volume increased after 6 months of treatment and doubled at the end of the one-year study.
    While this finding is in line with the pharmacodynamic properties of tamoxifen, a causal relationship has not been established (see section 4.4). There are no long-term safety data in children. In particular, the long term effects of tamoxifen on growth, puberty, and general development have not been studied.


    section 5.2
    headers added

    section 6.4
    Blisters:
    Store in the original package.

    section  4.6

    section 4.4section  4.6

    Updated on 19 February 2015 PIL

    Reasons for updating

    • Change to warnings or special precautions for use
    • Change to storage instructions
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    • Change to product name
    • Correction of spelling/typing errors

    Updated on 4 February 2014 PIL

    Reasons for updating

    • Change to further information section
    • Change to date of revision
    • Addition of manufacturer

    Updated on 28 August 2012 SmPC

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    • Correction of spelling/typing errors

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    causal corrected to casual
    endrometrial correced to endometrial
    trigyceride corrected to triglyceride

    Updated on 16 February 2011 PIL

    Reasons for updating

    • Change to side-effects
    • Change due to user-testing of patient information

    Updated on 27 January 2011 SmPC

    Reasons for updating

    • Change to section 4.4 - Special warnings and precautions for use
    • Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
    • Change to section 5.1 - Pharmacodynamic properties
    • Change to section 5.2 - Pharmacokinetic properties

    Legal category: Product subject to medical prescription which may be renewed (B)

    Free text change information supplied by the pharmaceutical company

    section 4.4:added

    In the literature it has been shown that CYP2D6 poor metabolisers have a lowered plasma level of endoxifen, one of the most important active metabolites of tamoxifen (see section 5.2).

     

    Concomitant medications that inhibit CYP2D6 may lead to reduced concentrations of the active metabolite endoxifen.Therefore, potent inhibitors of CYP2D6 (e.g. paroxetine, fluoxetine, quinidine, cinacalcet or bupropion) should whenever possible be avoided during tamoxifen treatment (see section 4.5 and 5.2).


    section 4.5: added
    Pharmacokinetic interaction with CYP2D6 inhibitors, showing a 65-75% reduction in plasma levels of one of the more active forms of the drug, i.e. endoxifen, has been reported in the literature. Reduced efficacy of tamoxifen has been reported with concomitant usage of some SSRI antidepressants (e.g. paroxetine) in some studies. As a reduced effect of tamoxifen cannot be excluded, co-administration with potent CYP2D6 inhibitors (e.g. paroxetine, fluoxetine, quinidine, cinacalcet or bupropion) should whenever possible be avoided (see section 4.4 and 5.2).

    section 5.1:added

    CYP2D6 polymorphism status may be associated with variability in clinical response to tamoxifen.The poor metaboliser status may be associated with reduced response.The consequences of the findings for the treatment of CYP2D6 poor metabolisers have not been fully elucidated (see sections 4.4, 4.5 and 5.2)

     

    CYP2D6 genotype

    Available clinical data suggest that patients who are homozygote for non-functional CYP2D6 alleles, may experience reduced effect of tamoxifen in the treatment of breast cancer.

     

    The available studies have mainly been performed in postmenopausal women (see sections 4.4 and 5.2)


    section 5.2:added

    Tamoxifen is metabolised mainly via CYP3A4 to N-desmethyl-tamoxifen, which is further metabolised by CYP2D6 to another active metabolite endoxifen. In patients who lack the enzyme CYP2D6 endoxifen concentrations are approximately 75% lower than in patients with normal CYP2D6 activity. Administration of strong CYP2D6 inhibitors reduces endoxifen circulating levels to a similar extent.



    Updated on 26 January 2011 PIL

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    Updated on 29 April 2010 SmPC

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    • Change to section 3 - Pharmaceutical form
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    Section 3 Pharmaceutical Form,tablet description updated for the 10mg & 20mg tablets.
    Section 10 Date of Revision of text updated

    Updated on 20 November 2009 PIL

    Reasons for updating

    • Change to date of revision
    • Addition of manufacturer

    Updated on 11 February 2008 SmPC

    Reasons for updating

    • Change to section 9 - Date of renewal of authorisation

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    Section 9: Date of last renewal corrected from 14th March 2001 to 14th March 2006

    Updated on 7 March 2007 SmPC

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    • Correction of spelling/typing errors
    • Addition of joint SPC covering all presentations

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    Section 1, 2 , 3 and 8: Addition of 20mg strength details - i.e. now a combined SPC

    Updated on 15 January 2007 PIL

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    • Change to date of revision
    • Correction of spelling/typing errors

    Updated on 11 December 2006 SmPC

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    • Change to section 3 - Pharmaceutical form
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    Following the approval of Type II variation, change to section 3 - marking description changed from 'TM' to 'TN', and the date of revision of text changed to November 2006.

    Updated on 17 October 2006 PIL

    Reasons for updating

    • Change to side-effects
    • Change to date of revision
    • Removal/change of distributor

    Updated on 9 October 2006 SmPC

    Reasons for updating

    • Change to section 2 - Qualitative and quantitative composition
    • Change to section 3 - Pharmaceutical form
    • Change to section 6.1 - List of excipients
    • Change to section 6.4 - Special precautions for storage
    • Change to section 10 - Date of revision of the text

    Legal category: Product subject to medical prescription which may be renewed (B)

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     Section 2: BP removed.
     Section 3: The term 'tablets' included.
     Section 6.1: Mannitol updated to Mannitol (E421).
     Section 6.4: Storage statement updated.

    Updated on 23 August 2006 SmPC

    Reasons for updating

    • New SPC for medicines.ie

    Legal category: Product subject to medical prescription which may be renewed (B)

    Updated on 22 September 2004 PIL

    Reasons for updating

    • New PIL for medicines.ie