Tomoxifen

california_artist said:

Hi, Sharon. Great news
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.

lindaprocopio said:

I just started my 9th week on tamoxifen/megace.
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!