Type of medicine Anti-oestrogen
Used for Treatment of breast cancer
Infertility
Also called Nolvadex-D
Soltamox
Available as Tablets
Oral solution

Many breast cancers need the hormone oestrogen to grow. Some of these breast cancers are 'oestrogen receptor positive' which means the cancer cells contain oestrogen receptors. Nolvadex works by preventing oestrogen from binding to these receptors. This blocks the action of oestrogen on cancer cells which may in turn cause some breast cancer tumours to shrink.

Nolvadex is also sometimes used to treat infertility, by encouraging the release of an egg.

Why is this drug prescribed?

Nolvadex D tablets contain the active ingredient Nolvadex citrate, which is a type of drug known as an 'anti-oestrogen'. Nolvadex is also available without a brand name, ie as the generic drug. Nolvadex is mainly used to treat women with breast cancers that respond to the female sex hormone, oestrogen. Most breast cancers are sensitive to oestrogen, and their growth is increased in the presence of this hormone. Oestrogen binds to oestrogen receptors on the breast cancer cells and causes changes within the cells that result in faster growth of the cancer. Breast cancers that are sensitive to oestrogen are called oestrogen receptor positive cancers. Nolvadex works by blocking the oestrogen receptors, thereby blocking the effect of oestrogen on the cancer. This starves the breast cancer cells and stops them from growing. Nolvadex helps prevent breast cancer from spreading to other areas of the body and also reduces risk of developing cancer in the other breast. Nolvadex is also used in the treatment of female infertility that is caused by problems with ovulation. Again, it acts by blocking oestrogen receptors, this time in a part of the brain called the hypothalamus. The effect of this is an increase in the levels of the hormones that control the development and release of an egg. These hormones are released from the pituitary gland and are known as follicle stimulating hormone and luteinising hormone. FSH stimulates the ovaries and LH causes the release of an egg from the ovaries. In the normal menstrual cycle, oestrogen acts on receptors in the hypothalamus after ovulation. This causes the pituitary gland to stop releasing FSH and LH. As Nolvadex blocks the oestrogen receptors in the hypothalamus, it prevents this action of oestrogen. FSH and LH levels therefore increase, which increases the chances of egg development and ovulation.

Treatments

* Breast cancer * Infertility in women caused by failure of ovulation

What side effects can this drug cause?

* Hot flushes * Vaginal bleeding or discharge * Itching of the external female genitalia * Suppression of menstrual periods in pre-menopausal women receiving Nolvadex for breast cancer * Stimulation of tumour growth * Headache * Light-headedness * Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain * Fluid retention * Hair loss * Blood disorders * Visual disturbances * Liver disorders * Increased risk of abnormal blood clots within the blood vessels * The presence of tissue similar to the lining of the uterus at other sites in the pelvis * Cancerous changes in the endometrium * Fibroids in the womb * Severe blistering skin reaction affecting the tissues of the eyes, mouth, throat and genitals * Severe swelling of lips, face or tongue