More information on Tamoxifen and certain anti-depressants

Another article just came out on this issue. There seems to be quite a bit of evidence now that certain anti-depressants interfere with Tamoxifen effectiveness...

"News release
Popular Breast Cancer Drug Used with Certain Antidepressants Puts New Jersey Women at Risk
FRANKLIN LAKES, N.J., July 30 /PRNewswire-FirstCall/ -- A new analysis finds that women in New Jersey who take the breast cancer drug tamoxifen in conjunction with certain popular antidepressants may be at a higher risk for a breast cancer recurrence.

In May, Medco Health Solutions, Inc. (NYSE: MHS) and Indiana University School of Medicine released a study revealing that women using tamoxifen to prevent a recurrence of breast cancer who also use certain selective serotonin reuptake inhibitors (SSRI), for example Prozac (fluoxetine), Paxil (paroxetine) and Zoloft (sertraline), have up to twice the chance of having a recurrence of the disease.

In a separate New Jersey-specific analysis, Medco found that among nearly 2,000 tamoxifen patients in the state during 2008, 12 percent were also taking SSRIs, including those that could put them in the at-risk population.

"We've been aware that certain antidepressants, known as CYP2D6 inhibitor drugs, block the activation of tamoxifen chemically, but this evidence shows that these drugs are putting women in New Jersey and across the nation at a much higher risk for recurrent breast cancer," said Dr. Milayna Subar, National Practice Leader for Medco's Oncology Therapeutic Resource Center located at Medco's Willingboro, N. J. pharmacy. "Women taking tamoxifen along with an SSRI should speak with their doctor immediately to discuss modifications to their medication regimen to ensure they are getting the full benefit of their tamoxifen therapy."

Approximately 500,000 women take tamoxifen in the U.S., with 80,000 new patients starting on the treatment annually. Nearly 30 percent of women taking tamoxifen also use an antidepressant. Based on estimates from the Centers for Disease Control and Prevention, New Jersey is among the states with the highest breast cancer incidence and death rate in the country.

The study by Medco and Indiana University School of Medicine that was presented at the 2009 Annual Meeting of the American Society of Clinical Oncology (ASCO). It was the largest study to-date looking at how these drugs impact breast cancer recurrence rates when taken with tamoxifen.

Antidepressants are often prescribed when women receiving tamoxifen are depressed, or to treat hot flashes -- a common side effect of the breast cancer drug. Paxil, Prozac and Zoloft are among a group of antidepressant drugs known as CYP2D6 inhibitors. These drugs prevent the CYP2D6 enzyme from working properly, and cause less of the active form of tamoxifen, called endoxifen, from being produced, making the drug less effective at preventing breast cancer. Women taking tamoxifen along with certain SSRIs have a 2-fold increased risk of breast cancer recurrence compared to women not taking these drugs together.

Tamoxifen

Tamoxifen is one of the oldest and most widely used treatments for reducing the risk of breast cancer recurrence among women with estrogen-dependent tumors. The drug works by blocking the estrogen receptors in the breast cells and can reduce the risk of a breast cancer recurrence by up to 50 percent. It's the only anti-estrogen available for prevention of breast cancer recurrence in pre-menopausal women and is one of several anti-estrogens used to treat post-menopausal breast cancer patients.

Medco Therapeutic Resource Center in Willingboro, N.J.

Willingboro, New Jersey is home to the world's largest automated pharmacy and is the current site of the Medco Therapeutic Resource Center (TRC) for oncology patients. Medco's TRCs focus on the specialized treatment of patients with chronic and complex conditions, including centers for cardiovascular diseases, diabetes, immunologic and pulmonary conditions. Nearly half of the company's 2,600 pharmacists are specialists deployed across the TRCs where they provide disease-specific therapy management for those patients who account for 96 percent of pharmacy spending and 75 percent of this country's medical costs.

About Medco

Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most advanced pharmacy and its clinical research and innovations are part of Medco making medicine smarter™ for more than 60 million Americans.

With more than 20,000 employees dedicated to improving patient health and reducing costs for a wide range of public and private sector clients, and 2008 revenue exceeding $51 billion, Medco ranks 45th on the Fortune 500 list and is named among the world's most innovative, most admired and most trustworthy companies.

For more information, go to http://www.medcohealth.com.

This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission.

SOURCE Medco Health Solutions, Inc.

CONTACT: Jennifer Luddy of Medco, +1-201-269-6402, jennifer_luddy@medco.com; or Erin Drelick of Coyne Public Relations, +1-973-316-1665, edrelick@coynepr.com