How to use
Take Tamoxifen Citrate orally with a full glass of water and following the directions of your doctor exactly. You may take Tamoxifen Citrate with or without food. Do not increase the frequency or amount of your dosage without consulting a health care professional first.

It is important to take Tamoxifen Citrate regularly to achieve the best results. You may have to keep using this medication for up to 5 years.

Overdose

If you suspect you have taken too much of this medication, you should seek emergency medical attention straightaway. Possible symptoms of a Tamoxifen overdose include:

• Shakiness (tremor)
• Overactive reflexes
• Walking unsteadily
• Dizziness
• Irregular heart rhythm (arrhythmia)
• Seizures

An overdose of Tamoxifen Citrate is not expected to produce life-threatening symptoms.

Missed dose

If you miss a dose of Tamoxifen Citrate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not try to make up for a missed dose by doubling up.

Notes
While taking Tamoxifen Citrate, your physician may ask you to have your breasts and liver tested regularly to make this medication is not causing any harmful effects.

Do not share this medication with others, as they may have a problem that is not effectively treated by this drug.

Storage

Store Tamoxifen Citrate at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), away from heat and moisture. KEEP THIS AND ALL OTHER MEDICATION OUT OF REACH OF CHILDREN. 

Important note

The above information is intended to supplement, not substitute for, the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed that the taking of this medication is safe, appropriate or effective for you.

Precautions
Do not take this medication of you are allergic to Tamoxifen.

Before using Tamoxifen Citrate, make sure to inform your doctor if you suffer or have suffered from any of the following:

• Liver disease
• High levels of triglycerides (fatty acids) in your blood
• A history of stroke or blood clot
• A history of cataract
• While receiving chemotherapy or radiation treatment

If you suffer from any of the above, you may need additional tests or a dosage adjustment.

Tamoxifen Citrate is classed as FDA Pregnancy Category D, which means it can potentially harm an unborn baby. Inform your doctor immediately if you are pregnant or become pregnant during treatment with Tamoxifen Citrate . You should also use a non-hormonal form of birth control while you are using this medication and for 2 months after the end of the treatment.
Do not use Tamoxifen Citrate while breastfeeding. It is not yet known if Tamoxifen passes into breast milk or if it could harm an unborn baby. In addition, Tamoxifen Citrate slows down the production of breast milk.

Precautions
The below medications are known to cause unwanted interactions with Tamoxifen Citrate:

• Aminoglutethimide (Cytadren)
• Bromocriptine (Parlodel)
• Cimetidine (Tagamet)
• Clozapine (Clozaril, FazaClo)
• Isoniazid (for treating tuberculosis)
• Letrozole (Femara)
• Methimazole (Tapazole)
• Nicardipine (Cardene)
• Pioglitazone (Actos)
• Rifampin (Rifadin, Rifater, Rifamate, Rimactane)
• Ropinirole (Requip)
• Ticlopidine (Ticlid)
• A blood thinner (Warfarin, Coumadin)
• Anti-malaria medication such as Chloroquine (Arelan) or Pyrimethamine (Daraprim) or Quinine (Qualaquin)
• HIV or AIDS medicine such as delavirdine (Rescriptor) or ritonavir (Norvir)
• An antibiotic such as terbinafine (Lamisil)
• A heart rhythm medication such as amiodarone (Cordarone, Pacerone) or quinidine (Quinidex, Quin-Release Quin-G)
• Medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), or thioridazine (Mellaril)
• An antidepressant such as bupropion (Wellbutrin), clomipramine (Anafranil), desipramine (Norpramin), duloxetine (Cymbalta), fluoxetine (Prozac), imipramine (Tofranil), paroxetine (Paxil), sertraline (Zoloft) or tranylcypromine (Parnate)

This is only a partial list and other drugs may interact with Tamoxifen Citrate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Taking Tamoxifen Citrate may increase your risk of uterine cancer, stroke or a blood clot in the lung, which can be fatal.  Discuss the specific risks of taking Tamoxifen Citrate with your doctor.

Seek emergency medical attention if you have any of these signs of an allergic reaction to Tamoxifen Citrate:

• Hives
• Difficulty breathing
• Swelling of the face, lips, tongue or throat

If you experience any of the following serious side effects, you should stop using Tamoxifen Citrate and contact your doctor immediately:

• Sudden numbness or weakness, especially on one side of the body
• Sudden headache, confusion, problems with vision, speech, or balance
• Chest pain, shortness of breath, or coughing up blood
• Pain or swelling in one or both legs
• Unusual vaginal bleeding or discharge
• Irregular menstrual periods
• Pain or pressure in your pelvic area
• Fever, chills, body aches, flu symptoms
• Pale skin, easy bruising or bleeding
• New breast lumps
• Nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)

Less serious potential side effects of Tamoxifen Citrate include:

• Hot flashes, warmth or tingly feeling under your skin
• Bone, joint, or tumor pain
• Redness or skin changes
• Swelling in your hands or feet
• Vaginal itching or dryness
• Depressed mood, weakness
• Weight loss
• Nausea
• Cough, sore throat
• Decreased sex drive, impotence, or difficulty having an orgasm
• Headache, dizziness
• Thinning hair

The above is not a complete list of side effects. Notify your doctor immediately if any other side effects occur, especially if they are bothersome.