Prior to treatment, women should undergo a thorough gynecological examination. Tamoxifen causes an ovulation that increases risk of pregnancy therefore women of reproductive age must use reliable methods of contraception (non-hormonal) during treatment and for 3 months after the end of treatment.
The drug should be discontinued upon appearance of a bloody vaginal discharge, or vaginal bleeding, signs of venous thrombosis of the lower limbs (leg pain or swelling), thromboembolism of pulmonary artery branches (dyspnea).
During treatment requires monitoring of indicators of blood coagulation, blood picture (leukocytes, platelets), indicators of liver function. Prior to and periodically during treatment it is recommended that an ophthalmic examination.
In patients with bone metastases periodically during the initial period of treatment to determine the concentration of calcium in serum (in the case of severe hypercalcemia receiving tamoxifen should be suspended). In patients with hyperlipidemia during treatment it is necessary to control the concentration of cholesterol and triglyceride in serum.
Ineffective in the treatment of patients with metastases (especially the liver).