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Tomoxifen

fuzzytrouble's picture
fuzzytrouble
Posts: 210
Joined: Feb 2009

Hello everyone, I am updating on my latest ct scan. It came back good and nothing new showing, except my power port needs the catheter to be repositioned. I was doing the Taxol alone every 3 weeks with one week off. I stopped doing it on my 9th round because the neuropathy was getting really bad and other issues. The Taxol did keep my lung nodules from growing and other seem to get smaller, but I just couldn't take it any more. Well now the doctor has put me on Tamoxifen which is pill form once a day. Has anyone else done this tratment? I am also on Warafin and I was just concerned if there were any bad side effects with it. I am going to have a good summer and plan on going to Boston in September to be with our daughter while she has her second child. I will be chasing the two year old around. I can't wait. Well I hope everyone is having a good day. I want to help by telling my experiences with the newer sisters, and what I have gone through so far and what was done for treatments.
Hugs from Oregon
Sharon

california_artist
Posts: 850
Joined: Jan 2009

As to the question, when I googled the drug combo I got these results:

Seems they give it together to lower the clot risk, but you should be closely monitored. And I would also tell your doc if you are eating foods that have a blood thinning factor like garlic, turmeric etc.

Live long and prosper.

Love ya, as always, your friend,

Claudia

http://www.ncbi.nlm.nih.gov/pubmed/19843839

Ann Pharmacother. 2009 Nov;43(11):1867-71. Epub 2009 Oct 20.
Safety of concomitant tamoxifen and warfarin.
Givens CB, Bullock LN, Franks AS.
Source
University of Tennessee Medical Center, Knoxville, TN, USA.
Abstract
OBJECTIVE:
To review the literature regarding the potential interaction between tamoxifen and warfarin.
DATA SOURCES:
A search of MEDLINE from 1948 to August 20, 2009, was performed using the search terms tamoxifen, warfarin, drug interactions, and cytochrome P450 2C9. EMBASE was searched (1980-week 33, 2009), using the search terms tamoxifen and warfarin, for articles limited to use in humans and published in English, then further narrowed to drug interactions. Bibliographic review was conducted but did not reveal any additional references.
STUDY SELECTION AND DATA EXTRACTION:
All sources evaluated were published in English and included original case reports, letters, and medical record or database reviews that described an interaction between warfarin and tamoxifen.
DATA SYNTHESIS:
Since tamoxifen therapy and cancer increase the risk of venous thromboembolism, warfarin may be prescribed to these patients. However, product information, primary literature, and tertiary literature describe concomitant use of tamoxifen and warfarin as a contraindication since this may increase the level of anticoagulation and the risk of bleeding complications. Although the exact mechanism of the interaction is unknown, one theory is that tamoxifen inhibits CYP2C9, which metabolizes the S-isomer of warfarin. Five publications were identified including 2 letters, 2 individual case reports, and 2 retrospective reviews (1 of the case reports was included in a medical record review). Collectively, these articles described a total of 31 patients taking warfarin and tamoxifen concomitantly, with 8 patients experiencing bleeding complications.
CONCLUSIONS:
Although concomitant use of warfarin and tamoxifen is deemed a contraindication, evidence regarding this potential interaction is limited. Therefore, safety of concomitant use of tamoxifen and warfarin may be similar to that of other drugs that interact with warfarin, requiring consistent and careful monitoring. However, more evidence is needed to warrant the routine use of this combination.
PMID:
19843839
[PubMed - indexed for MEDLINE]

You might want to go on line or have someone there go online. There were numberous references to the combo.

fuzzytrouble's picture
fuzzytrouble
Posts: 210
Joined: Feb 2009

Thanks Claudia. I have been on Warfarin for over a year so I have been watching the blood thinning foods, but the pharmacist would not hand it over to me until she talk to the doctor and the nurse who watches my INR. The clinic I go to is very good and keeps a good eye on my blood draws. I will be getting the medication tomorrow after all. I did look online to see about research on this and found all but what you found. : )
I will keep posting to let others know how it goes. I hope you are having a good night and a good day tomorrow. Thanks again for the info.
Hugs to you,
Sharon

Kaleena's picture
Kaleena
Posts: 1020
Joined: Nov 2009

Great news, Sharon. I can't help you with regard to the tamoxifen pill form, but I wish you a great trip to Boston in September.

My best to you!

Kathy

fuzzytrouble's picture
fuzzytrouble
Posts: 210
Joined: Feb 2009

I get to have a vacation from chemo which I need so badly. I know you have all probably been there so you know what I mean. Since I have been on this Taxol every week I have gained about 12lbs. I am so upset because I have tried not to gain any but the fluid retention is a problem, so hopefully it will get better while I am off Taxol. Well thank you for your comment and here's hoping the best for you too. I have been kind of out of not posting but I promise to keep up now.
Hugs from Oregon,
Sharon

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

Even though my cancer is ER- and PR-, there was a study that showed that for some reason they cannot explain, a combination of tamoxifen & megace was shown to hold even ER- / PR- women stable about 23% of the time. That's not a high percentage, but it seemed worth a shot to me since I have active cancer and need to be off all chemo to do these 2 radioembolism treatments. (You CAN get chemo simultaneously with radioembolism, but I can't because chemo brings my platelets down too low for the surgery.) The percentage of success for women that are ER+/PR+ is much higher. & taking the pills is so EASY!

Today marks the 9th week I've been on this combo: both in pill form. I can't see/feel any side effects at all. I do wake up thirsty, so that may be a side effect, but it's nothing a glass of water doesn't fix. I posted that study somewhere here long ago, and can look for it if you want to read it. You may want to ask your oncologist about combining the tamoxifen with megace, as they seem to balance each other out. They say megace increases appetite, but if you are aware of that, it shouldn't be a problem. I haven't gained any weight.

I take TWO 20 mg tamoxifen tablets daily. Then EVERY OTHER WEEK, I add FIVE 40 mg megace tablets to my daily pill count. That was the dosage cited in the study, and when I showed the study to my oncologist, he said "okay" and made that my regime. It's been effortless, Sharon. This truly IS a complete chemo break! ENJOY!

california_artist
Posts: 850
Joined: Jan 2009

Thank you so much for always taking the time to share what you know, when you think it might help someone. I love your compassion.

It is very exciting to hear that that synergistic combo works in a way to override the usual lack of chemo's effectiveness on the ER/PR- cancer cells. Giving hope and options is what life is all about.

Enjoy what your are doing and add to that the joy of knowing that you have made others' lives more enjoyable too.

Your cyber bud,

Claudia

fuzzytrouble's picture
fuzzytrouble
Posts: 210
Joined: Feb 2009

Claudia, you to are a great person with doing research for all of us and I just think you and Linda and many more here are giving us all a lot to think about. I love your profile picture, I am a cat lover.
Hugs from Oregon,
Sharon

fuzzytrouble's picture
fuzzytrouble
Posts: 210
Joined: Feb 2009

I have to wait to take the tamoxifen because of my fluid retention. I went to my PCP today to see what she thought about it and she put me on a fluid pill for 5 days to see if it will help. I also went into the hospital yesterday to have my power port catheter repositioned. I was so scared about the whole thing. It went so smooth I was so happy. My catheter migrated up into my jugular vein so it had to be fixed fast, and they did it going through my groin. It's always something. ha, ha
I will see what my doc says about the megace, I have to see him at the end of Aug. I will be enjoying the chemo break as soon as I get finished with all this other stuff. I am happy that you are feeling good Linda and enjoying life. How's the pool?
Hugs from Oregon,
Sharon

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