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Buy Tamoxifen Online: A Guide to Generic Nolvadex 20 mg
Thinking of buying tamoxifen? Learn what generic Nolvadex is prescribed for, the usual 20 mg dose, side effects, interactions and how to order safely with a prescription.
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If you have been prescribed tamoxifen and want to buy tamoxifen at a lower cost, a generic version is usually the simplest option. Generic tamoxifen contains the same active ingredient as the original brand, Nolvadex, and has been used for decades in the treatment of hormone receptor-positive breast cancer. Because treatment often lasts five years or more, the price of each pack makes a real difference.
This guide explains what tamoxifen is prescribed for, how it works, the usual dose, possible side effects and interactions, and what to check before you order generic Nolvadex online with your prescription. It is general information for patients and carers. Your oncologist is the person to decide whether tamoxifen is right for you and how long you should take it.
Key takeaways
- Tamoxifen is a hormone therapy used for hormone receptor-positive breast cancer and, in some high-risk women, to lower the risk of breast cancer.
- The usual dose is tamoxifen 20 mg once daily, often for 5 to 10 years, as set by your oncologist.
- Report any abnormal vaginal bleeding, leg swelling or pain, chest pain or sudden breathlessness to your doctor promptly.
- Some antidepressants and warfarin can interact with tamoxifen, so your oncologist and pharmacist need a full list of your medicines.
- Before you buy tamoxifen online, make sure you have a valid prescription, which is required for every order.
Before you buy tamoxifen: what is it prescribed for?
Tamoxifen is one of the most widely used hormone therapies for breast cancer. Your oncologist may prescribe it in several situations:
- Early breast cancer: as adjuvant treatment after surgery, to lower the chance of the cancer coming back.
- Advanced or metastatic breast cancer: to slow the growth of hormone-sensitive cancer that has spread.
- Ductal carcinoma in situ (DCIS): in some women after surgery, to reduce the risk of further breast cancer.
- Risk reduction: in some women at high risk of breast cancer, for example because of a strong family history, tamoxifen may be offered to lower that risk.
Unlike aromatase inhibitors, tamoxifen can be used in women before and after the menopause. It is also used in men with hormone receptor-positive breast cancer. Whether it is suitable, and for which purpose, is always the oncologist’s decision.
How tamoxifen works
Tamoxifen belongs to a group of medicines called selective oestrogen receptor modulators, or SERMs. Many breast cancers have receptors for oestrogen (estrogen), and oestrogen attaching to these receptors can encourage the cancer cells to grow.
Tamoxifen attaches to the same receptors in breast tissue and blocks oestrogen from acting on them. This slows or stops the growth of hormone-sensitive cancer cells. It does not lower the overall level of oestrogen in the body. In some other tissues, such as bone and the lining of the womb, tamoxifen can act partly like oestrogen, which explains some of its side effects and why it tends to have less effect on bone density than aromatase inhibitors.
Tamoxifen is converted in the liver into active forms, mainly by an enzyme called CYP2D6. This is why certain medicines that block CYP2D6 matter, as explained in the interactions section below.
Tamoxifen 20 mg: usual dose and length of treatment
The usual dose of tamoxifen is 20 mg taken by mouth once a day. Swallow the tablet with water, with or without food, at around the same time each day. Some people are prescribed a different daily dose, so always follow the instructions on your prescription.
Treatment for breast cancer commonly lasts 5 years, and some people are advised to continue for up to 10 years, or to switch to an aromatase inhibitor after a few years. When tamoxifen is used for risk reduction, the course and dose may differ. Your oncologist will set the length of treatment based on your situation.
If you miss a dose, take it when you remember unless your next dose is nearly due. Do not take two doses at once to make up. Keep taking tamoxifen even if you feel well, and do not stop without speaking to your oncologist. The patient leaflet that comes with your medicine has full details.
Generic tamoxifen products
RxPillTab stocks two generic tamoxifen 20 mg products in our oncology medicines range:
| Product | Active ingredient | Strength | Equivalent to |
|---|---|---|---|
| Tamoxican 20 | Tamoxifen | 20 mg tablet | Nolvadex 20 mg |
| Tamoxol-20 | Tamoxifen citrate | 20 mg tablet | Nolvadex 20 mg |
Both contain tamoxifen at the standard 20 mg strength. The inactive ingredients, tablet appearance and packaging can vary between brands, but the active medicine is the same.
Side effects of tamoxifen
Not everyone gets side effects, and many ease after the first few months. Tell your doctor about any that are troubling you, as there are often ways to manage them.
Common side effects
- Hot flushes and night sweats
- Irregular or missed periods before the menopause
- Vaginal discharge, dryness or itching
- Nausea, tiredness and headaches
- Leg cramps, fluid retention or mild hair thinning
- Mood changes
Blood clots
Tamoxifen slightly increases the risk of blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), and there is a small increased risk of stroke. The risk is higher around surgery and during long periods without moving, such as long journeys. Get urgent medical help if you have pain, swelling or redness in one leg, sudden breathlessness, chest pain, or sudden weakness or numbness in the face, arm or leg. Your oncologist may advise pausing tamoxifen before planned surgery.
Changes in the womb lining
Tamoxifen can thicken the lining of the womb (endometrium). This can lead to polyps and, rarely, to womb (endometrial) cancer, mainly in women after the menopause. Report any abnormal vaginal bleeding, including bleeding after the menopause, spotting between periods, or a change in your usual periods, to your doctor promptly so it can be checked.
Other effects
Less commonly, tamoxifen can affect the eyes (for example cataracts) or the liver. Tell your doctor about any changes in your eyesight, yellowing of the skin or eyes, or unusual tiredness.
Interactions to discuss with your oncologist
Always give your oncologist and pharmacist a complete list of the medicines, supplements and herbal products you take. Key interactions include:
- Strong CYP2D6 inhibitors: some antidepressants, such as paroxetine, fluoxetine and bupropion, can reduce how well tamoxifen is converted to its active form and may make it less effective. If you need an antidepressant, for example for mood or hot flushes, your doctor can choose one that is less likely to interact.
- Warfarin and similar blood thinners: tamoxifen can increase the effect of warfarin and raise the risk of bleeding. Closer monitoring or a different approach may be needed.
- Aromatase inhibitors: tamoxifen is not taken at the same time as anastrozole or letrozole. They may be used one after the other, as planned by your oncologist.
- Oestrogen-containing products: hormone replacement therapy and hormonal contraceptives can work against tamoxifen and are generally avoided.
Pregnancy and contraception
Tamoxifen can harm an unborn baby. Women should not become pregnant while taking it, or for a period after stopping, as advised by the oncologist. Because hormonal contraceptives are usually avoided, a non-hormonal method such as condoms or a copper coil (IUD) is generally recommended. Tamoxifen can make periods irregular or stop them, but this does not mean you cannot become pregnant. Tamoxifen is not used during breastfeeding. Speak to your oncologist before starting treatment if you are planning a family.
Tamoxifen vs anastrozole and letrozole
Tamoxifen and aromatase inhibitors are the two main types of hormone therapy for breast cancer. Aromatase inhibitors lower oestrogen levels and are mainly used after the menopause, while tamoxifen blocks oestrogen’s effect and can be used at any age. Many women take one, then switch to the other during their treatment. Read our comparison of anastrozole vs letrozole to understand how these alternatives work.
Tamoxifen price: why people buy tamoxifen as a generic
Generic Nolvadex usually costs far less than the original brand, which adds up over a course of 5 to 10 years. The current tamoxifen price for each pack size is shown on the product pages. When comparing prices, make sure you compare the same strength (tamoxifen 20 mg) and the same number of tablets per pack.
How to buy generic tamoxifen online safely
If you buy medicine online for a long-term treatment like tamoxifen, these steps help you order safely:
- Have a valid prescription. A valid prescription is required for every order of a prescription medicine, including tamoxifen.
- Check the strength. Confirm that the product matches your prescription, usually tamoxifen 20 mg.
- Check the pack size. Order enough tablets to last until your next supply, allowing for delivery time, so you do not miss doses.
- Plan for delivery. Orders are shipped worldwide by EMS or registered mail in discreet packaging, delivered to the US, UK, Europe and Canada. Our how to order page explains the steps.
- Tell your doctor. Let your oncologist know which generic brand you are taking, and mention any new medicines you start.
For general tips on choosing a supplier, see our guide on how to buy generic medicines online safely.
Frequently asked questions
Do I need a prescription to buy tamoxifen online?
Yes. A valid prescription is required for every order of a prescription medicine. Tamoxifen should only be taken under the care of an oncologist or doctor managing your treatment.
Is generic Nolvadex as effective as the brand?
Generic Nolvadex contains the same active ingredient, tamoxifen, at the same strength as the original brand. The inactive ingredients and appearance of the tablet may differ.
How long will I need to take tamoxifen 20 mg?
Treatment for breast cancer commonly lasts 5 years and is sometimes extended to 10 years. Your oncologist decides the length of treatment.
What should I do if I have vaginal bleeding while taking tamoxifen?
Report any abnormal vaginal bleeding to your doctor promptly, especially if you have been through the menopause. It is usually not serious, but it should always be checked.
Can I take antidepressants with tamoxifen?
Some antidepressants can make tamoxifen less effective. Tell your doctor that you take tamoxifen so they can choose a medicine that is less likely to interact.
Can I switch between tamoxifen brands?
Generic brands contain the same active ingredient, but you should agree any change of brand or medicine with your oncologist so your records stay accurate.
The information on this page is for general guidance only and does not replace professional advice. Always consult your doctor or pharmacist before starting any medicine. Read our full medical disclaimer.
Medicines mentioned in this guide
All medicines are supplied only against a valid prescription. Prices shown are for the smallest pack.
About this guide
Written by the rxptteam8. We base our guides on official sources such as the NHS, the US FDA, the EMA and MedlinePlus, and we update them when guidance changes. Last updated .