Tamona 20

Indications

Tamona is prescribed for managing breast cancer and treating infertility.

Pharmacology

Tamoxifen, the active ingredient in Tamona, is a non-steroidal, triphenylene-based compound with a complex profile of estrogen antagonist and agonist effects across different tissues. In breast cancer treatment, Tamoxifen primarily functions as an anti-estrogen, blocking estrogen from binding to its receptor at the tumor site. Additionally, Tamoxifen may help preserve bone mineral density in post-menopausal women.

Dosage & Administration

• Breast Cancer: Take 20 mg daily.
• Anovulatory Infertility: Start with 20 mg daily on the 2nd, 3rd, 4th, and 5th days of the menstrual cycle. If necessary, the dosage may be increased to 40 mg and then 80 mg for subsequent cycles. For irregular cycles, begin the initial course on any day, with subsequent courses starting 45 days later or on the 2nd day of the cycle if menstruation occurs.

Always follow your physician’s guidance for medication.

Interactions

When Tamona is combined with coumarin-type anticoagulants, there may be a significant increase in anticoagulant effects. Monitor the patient carefully. Using Tamona with cytotoxic agents can increase the risk of thromboembolic events.

Contraindications

Tamona should not be used during pregnancy. Avoid administering Tamona to individuals who have had a hypersensitivity reaction to this medication or any of its components.

Side Effects

Potential side effects include:

• Pharmacological Effects: Hot flashes, vaginal bleeding or discharge, pruritus vulvae, and tumor flare-ups.
• General Effects: Gastrointestinal discomfort, headaches, dizziness, fluid retention, and hair loss. In some cases, adjusting the dose within the recommended range may alleviate these effects without compromising disease control.
• Serious Reactions: Rarely, skin rashes such as erythema multiforme, Stevens-Johnson syndrome, and bullous pemphigoid, as well as hypersensitivity reactions like angioedema, have been reported. Hypercalcemia can occur in patients with bony metastases at the start of treatment.
• Hematological Effects: Reduced platelet count, with values occasionally dropping below 80,000/mm³, has been noted. Leucopenia and, on rare occasions, severe neutropenia have also been reported.
• Visual and Endocrine Effects: Visual disturbances, including corneal changes and retinopathy, as well as increased cataract incidence, have been observed. Uterine fibroids, endometrial changes, and cystic ovarian swellings in premenopausal women may also occur.
• Liver Effects: Tamona can affect liver enzyme levels and, in rare cases, cause severe liver issues such as fatty liver, cholestasis, and hepatitis. Elevated serum triglycerides, sometimes with pancreatitis, have also been reported.

Pregnancy & Lactation

• Pregnancy: Tamoxifen is contraindicated during pregnancy due to potential risks. Although no direct causal relationship has been proven, there have been instances of spontaneous abortions and birth defects. Women should avoid becoming pregnant while on Tamoxifen and use non-hormonal contraceptive methods. Premenopausal women should be tested for pregnancy before starting Tamoxifen. Discuss potential risks with your physician if considering pregnancy during or shortly after treatment.
• Lactation: The presence of Tamoxifen in breast milk is unknown. Therefore, it is not recommended for breastfeeding mothers unless absolutely necessary.

Precautions & Warnings

Tamona may suppress menstruation in premenopausal women and has been linked to an increased incidence of endometrial cancer. Any abnormal gynecological symptoms, particularly vaginal bleeding, should be promptly investigated. There have also been reports of secondary tumors at sites other than the endometrium or opposite breast. While no causal link has been established, these observations warrant caution.

Therapeutic Class

Hormonal Chemotherapy

Storage Conditions

Store between 20-25°C, away from light.