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Nolvadex To Treat Gynecomastia

nolvadex to treat gynecomastia              

Why is tamoxifen (Soltamox) prescribed to patients?

Tamoxifen is used for the treatment of invasive breast cancer in men and women, the most common type of breast cancer, following surgery and/or radiation and for preventing invasive breast cancer in women at high risk for developing it.

Tamoxifen also is used for the treatment of women following surgery and radiation for a less common type of breast cancer called ductal carcinoma in situ (DCIS or intraductal carcinoma). Women who have had DCIS are at high risk for developing invasive breast cancer at a later date, and tamoxifen prevents development of the invasive cancer in almost half of the women during the first five years of treatment.

Occasionally, tamoxifen is used to stimulate ovulation.

How does tamoxifen (Soltamox) work?

The precise mechanism of its action is unknown, but one possibility is that it binds and blocks estrogen receptors on the surface of cells, preventing estrogens from binding and activating the cell. It is used in patients for treating and preventing breast cancer.

Evaluation of a patient with gynecomastia

Initial steps in the clinical evaluation of a patient presenting with enlarged breast tissue are to differentiate true gynecomastia from pseudogynecomastia and rule out male breast carcinoma. Pseudo-gynecomastia is characterized by increased subareolar fat without enlargement of the glandular component of breast. By contrast, a palpable button of firm or rubbery breast tissue concentric with the nipple–areolar complex is felt in patients with true gynecomastia. Breast carcinoma is usually hard and located outside of the nipple–areolar complex, and may be associated with skin dimpling, nipple retraction, bleeding or discharge, and lymphadenopathy. It is also more likely to be unilateral as compared with gynecomastia, which frequently affects breast tissue of both sides.


Anti-androgen therapy for prostate cancer results in high incidence of gynecomastia. Tamoxifen has been shown to prevent much of the gynecomastia in such patients in randomized double-blind placebo-controlled trials. The incidence of gynecomastia in men receiving bicalcutamide therapy for prostate cancer was found to be 10, 50 and 73% in those receiving prophylactic tamoxifen, anastrozole and placebo, respectively . In a similar trial, the combined incidence of gynecomastia and mastalgia was 12% in those who received 3 months therapy with tamoxifen as compared with 64% with anastrozole and 70% with placebo . Tamoxifen has also been demonstrated to be superior to prophylactic breast radiation therapy in the prevention of bicalcutamide-induced gynecomastia .

What is the dosage for tamoxifen (Soltamox)?

The dose for metastatic breast cancer treatment, DCIS, and prevention of breast cancer is 10 mg twice daily or 20 mg once daily for 5 years.

The dose for stimulation of ovulation is 5-40 mg twice daily for 4 days.

Tamoxifen can be taken with food.

Is tamoxifen (Soltamox) safe to use during pregnancy or while breastfeeding?

Tamoxifen should not be used during pregnancy because it can harm the fetus.

It is not known whether tamoxifen is excreted in breast milk. Tamoxifen causes a reduction in milk production. Women taking tamoxifen should not breastfeeding.


Store Nolvadex between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed, light-resistant container. Store away from moisture, heat, and light. Do not store in the bathroom. Do not take tablets after the expiration date printed on the label. Keep Nolvadex out of the reach of children and away from pets.

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