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Novadex tablet is available in Sydney Australia April 13, 2017

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The active substance group:

Tamoxifen (Tamoxifen), anti-tumor agent, an antiestrogen

 

Dosage Form:

tablets, coated tablets

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Contraindications:

Hypersensitivity, pregnancy , lactation. Eye diseases (including cataracts ), hyperlipidemia, leukopenia, thrombocytopenia, hypercalcemia, expressed thrombosis , thromboembolic disease (including history).

 

Dosage and administration:

Usually set individually depending on the evidence.
Inside, breast cancer, kidney – 20-40 mg 1-2 times a day (morning and evening), endometrial – 20-30 mg 1-2 times a day. On the course – 2.4-9.6, the treatment is carried out for a long time (until evidence of disease progression), as effect lasts only against the background of continuous use; if necessary, used in combination with radiation and cytostatic treatment.
Tablets should be taken with liquid, squeezed small amounts of liquid in one go in the morning or separating the required dose into 2 doses, morning and evening.

 

Pharmachologic effect:

The anti-tumor anti-estrogen agent. Competitively inhibits estrogen receptors in target organs and tumors derived from these organs. The result is a complex (drug-receptor-cofactor transport), novadex, after translocation into the nucleus of cells prevents hypertrophy, estrogen dependent regulation. Antigonadotropnym possesses properties Pg suppresses synthesis in tumor tissue. Inhibits the progression of tumor stimulated by estrogen.
The ability to block estrogen can persist for several weeks after a single dose.
Furthermore, tamoxifen can induce ovulation in women in its absence, stimulating the release of GnRH from the hypothalamus, stimulating release of pituitary gonadotropic hormones. In men with oligospermia it increases the concentration of LH and FSH, testosterone and estrogen in the blood serum. Tamoxifen and some of its metabolites (N-dezmetiltamoksifen, 4-hydroxytamoxifen) are potent inhibitors of the mixed function oxidases of the cytochrome P450 of the liver, but the clinical relevance of these effects is not defined.

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Side effects:

Ossalgia, pain in the lesions, fever; loss of appetite, nausea, vomiting, constipation or diarrhea, in rare cases – fatty liver, cholestasis, hepatitis; flushing of the skin with a sensation of heat; leukopenia, thrombocytopenia, thrombosis, thromboembolism, thrombophlebitis ; skin rash, skin dryness, increase in the size of soft tissue structures, sometimes accompanied by severe erythema affected areas and adjacent areas (usually resolves within 2 weeks); hypercalcemia, peripheral edema (fluid retention associated with), alopecia, increased body weight; depression, headache , dizziness , myasthenia gravis , fatigue, drowsiness, confusion; loss of visual acuity, corneal opacities, cataracts , retinopathy , optic neuritis .
Women – endometrial hyperplasia, a reversible development of cystic tumors, vaginal discharge, metrorrhagia, dysmenorrhea, genital itching, amenorrhoea .
The men – reduced potency and / or libido.Peredozirovka. Symptoms: increased side effects.
Treatment: symptomatic. No specific antidote.

 

Special instructions:

Before beginning treatment, women should undergo a thorough gynecological (with the exception of pregnancy) and physical examination.
Tamoxifen induces ovulation, which increases the risk of pregnancy, so women of childbearing age must use reliable methods of contraception (non-hormonal) during treatment and for 3 months after treatment.
During therapy is necessary to periodically monitor blood coagulation parameters, concentration Ca2 + in the blood, blood count (leucocytes, platelets), liver function tests, blood pressure, to inspect the oculist – every 3 months, gynecological examination (at occurrence of bleeding from the vagina or vaginal bleeding the drug should be discontinued).
In patients with bone metastases from time to time during the initial period of treatment should determine the concentration of Ca2 + in the blood serum (in the case of severe hypercalcemia receiving tamoxifen should be suspended). Is ineffective in the treatment of patients with metastatic disease (especially in liver).
If signs of thrombosis of the lower extremities (leg pain or swelling), thromboembolism, pulmonary artery branches (shortness of breath), the drug should be discontinued.
Patients with hyperlipidemia in the course of treatment is necessary to control the concentration of cholesterol and triglycerides in the blood serum.
During the period of treatment must be careful when driving and other lesson. Potentially hazardous activities that require high concentration and psychomotor speed reactions.

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Interaction:

Anti effect indirect action (requires careful monitoring for correcting dose anticoagulation).
Cytotoxic agents increase the risk of thrombosis.
Allopurinol promotes hepatotoxic effects.
The combined use of tamoxifen and tegafur can cause chronic active hepatitis and cirrhosis .
The simultaneous use of tamoxifen with others. Hormonal drugs (especially estrogensoderjath contraceptives) leads to a weakening of the specific actions of both drugs.
Drugs that reduce the excretion of Ca2 + (such as thiazide diuretics series), may increase the risk of hypercalcemia.
Antacids, H2-blockers of histamine receptors and dr.LS, reduces the acidity of gastric juice, can cause premature dissolution and loss of the protective effect of enteric tablets. The interval between doses of tamoxifen and these drugs should be 1-2 hours.
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