Matching articles for "Tamoxifen"
In Brief: A New Indication for Abemaciclib (Verzenio) (online only)
The Medical Letter on Drugs and Therapeutics • April 3, 2023; (Issue 1673)
The oral cyclin-dependent kinase (CDK) 4/6 inhibitor
abemaciclib (Verzenio – Lilly) has been approved by
the FDA for use in combination with endocrine therapy
(tamoxifen or an aromatase inhibitor) for...
The oral cyclin-dependent kinase (CDK) 4/6 inhibitor
abemaciclib (Verzenio – Lilly) has been approved by
the FDA for use in combination with endocrine therapy
(tamoxifen or an aromatase inhibitor) for adjuvant
treatment of patients with hormone receptor (HR)-positive, human epidermal growth factor receptor
2 (HER2)-negative, node-positive, early breast
cancer at high risk of recurrence.1It was previously
approved for the same indication, but patients were
also required to have a Ki-67 score ≥20%. About
70% of all breast cancers are HR-positive and HER2-negative. Ki-67 is a prognostic biomarker for tumor
proliferation; a score ≥20% is associated with early
recurrence and poor prognosis.
Elacestrant (Orserdu) for Advanced or Metastatic Breast Cancer
The Medical Letter on Drugs and Therapeutics • March 6, 2023; (Issue 1671)
The FDA has approved elacestrant (Orserdu –
Stemline), an oral estrogen receptor antagonist, for
treatment of estrogen receptor (ER)-positive, human
epidermal growth factor receptor 2...
The FDA has approved elacestrant (Orserdu –
Stemline), an oral estrogen receptor antagonist, for
treatment of estrogen receptor (ER)-positive, human
epidermal growth factor receptor 2 (HER2)-negative,
estrogen receptor 1 (ESR1)-mutated advanced or
metastatic breast cancer in postmenopausal women
or men who had disease progression following
endocrine therapy. Elacestrant is the first oral selective
estrogen receptor degrader (SERD) to be approved
for treatment of breast cancer; the injectable SERD
fulvestrant (Faslodex, and generics) was approved
more than 20 years ago.
Oxybutynin for Hot Flashes in Women with Breast Cancer
The Medical Letter on Drugs and Therapeutics • February 25, 2019; (Issue 1566)
Interim results of a double-blind, placebo-controlled
trial suggest that off-label use of the anticholinergic
drug oxybutynin may reduce the frequency and
severity of hot flashes in women with breast...
Interim results of a double-blind, placebo-controlled
trial suggest that off-label use of the anticholinergic
drug oxybutynin may reduce the frequency and
severity of hot flashes in women with breast cancer.
Extended-release oral oxybutynin (Ditropan XL, and
generics) has been shown to reduce the frequency and
severity of hot flashes in healthy menopausal women.
Paroxetine (Brisdelle) for Hot Flashes
The Medical Letter on Drugs and Therapeutics • October 28, 2013; (Issue 1428)
The FDA has approved a low-dose formulation of the
selective serotonin reuptake inhibitor (SSRI) paroxetine
mesylate (Brisdelle – Noven Therapeutics) for treatment
of moderate-to-severe vasomotor symptoms...
The FDA has approved a low-dose formulation of the
selective serotonin reuptake inhibitor (SSRI) paroxetine
mesylate (Brisdelle – Noven Therapeutics) for treatment
of moderate-to-severe vasomotor symptoms associated
with menopause. It is the first non-hormonal therapy to
be approved for this indication. Paroxetine mesylate
(Pexeva) and paroxetine hydrochloride (Paxil, and
generics) are marketed in higher doses for treatment of
depression and other psychiatric disorders.
Ospemifene (Osphena) for Dyspareunia
The Medical Letter on Drugs and Therapeutics • July 8, 2013; (Issue 1420)
The FDA has approved ospemifene (os pem’ i feen;
Osphena – Shionogi), an estrogen agonist/antagonist,
for oral treatment of moderate to severe dyspareunia in
postmenopausal women. Ospemifene is the...
The FDA has approved ospemifene (os pem’ i feen;
Osphena – Shionogi), an estrogen agonist/antagonist,
for oral treatment of moderate to severe dyspareunia in
postmenopausal women. Ospemifene is the fourth estrogen
agonist/antagonist to be marketed in the US, but it is
the only one that has an estrogen-like effect on vaginal
epithelium. The other three, tamoxifen (Nolvadex, and
generics), toremifene (Fareston), and raloxifene (Evista),
are used for treatment and prevention of breast cancer
and osteoporosis.
Aromatase Inhibitors for Adjuvant Treatment of Postmenopausal Breast Cancer
The Medical Letter on Drugs and Therapeutics • June 13, 2011; (Issue 1366)
Adjuvant hormone therapy with anti-estrogen drugs has
been shown to reduce disease recurrence and mortality
in postmenopausal women with estrogen receptor (ER)-positive breast cancer. In recent years,...
Adjuvant hormone therapy with anti-estrogen drugs has
been shown to reduce disease recurrence and mortality
in postmenopausal women with estrogen receptor (ER)-positive breast cancer. In recent years, aromatase
inhibitors (AI) have become the preferred first-line hormonal
treatment over tamoxifen for such patients.1,2
In Brief: Tamoxifen and SSRI Interactions
The Medical Letter on Drugs and Therapeutics • June 15, 2009; (Issue 1314)
Use of a selective serotonin reuptake inhibitor (SSRI) is common in women taking tamoxifen (Nolvadex, and others) for breast cancer, both to treat depression and to decrease hot flashes. However, tamoxifen must...
Use of a selective serotonin reuptake inhibitor (SSRI) is common in women taking tamoxifen (Nolvadex, and others) for breast cancer, both to treat depression and to decrease hot flashes. However, tamoxifen must be metabolized by CYP2D6 to become pharmacologically fully active (MJ Higgins et al. J Natl Compr Canc Netw 2009; 7:203), and the SSRIs fluoxetine (Prozac, and others) and paroxetine (Paxil, and others) are strong inhibitors of CYP2D6. Sertraline (Zoloft, and others) inhibits CYP2D6 to a lesser extent. Citalopram (Celexa, and others) and escitalopram (Lexapro), the 2 other SSRIs approved for treatment of depression, are only weak inhibitors of CYP2D6.
Two observational studies presented at a recent meeting of the American Society of Clinical Oncology (45th annual meeting, May 29-June 2, 2009, Orlando, FL abstracts CRA508, CRA509) examined the effect of strong inhibitors of CYP2D6 on the success rate of tamoxifen in preventing recurrence of breast cancer. One found that women who took fluoxetine, paroxetine or sertraline (or bupropion, duloxetine, terbinafine, quinidine or long-term diphenhydramine) with tamoxifen had a higher 2-year recurrence rate (13.9% vs. 7.5%). The other study found no association between cancer recurrence and use of a CYP2D6 inhibitor.
There is no good evidence that any one SSRI is more effective than any other for treatment of depression. For women who are taking tamoxifen and need to begin treatment with an SSRI to treat depression, citalopram or escitalopram might be the safest choice (Treat Guidel Med Lett 2006; 4:35). Use of an SSRI to treat hot flashes in women taking tamoxifen should probably be reconsidered.
Download: U.S. English
Two observational studies presented at a recent meeting of the American Society of Clinical Oncology (45th annual meeting, May 29-June 2, 2009, Orlando, FL abstracts CRA508, CRA509) examined the effect of strong inhibitors of CYP2D6 on the success rate of tamoxifen in preventing recurrence of breast cancer. One found that women who took fluoxetine, paroxetine or sertraline (or bupropion, duloxetine, terbinafine, quinidine or long-term diphenhydramine) with tamoxifen had a higher 2-year recurrence rate (13.9% vs. 7.5%). The other study found no association between cancer recurrence and use of a CYP2D6 inhibitor.
There is no good evidence that any one SSRI is more effective than any other for treatment of depression. For women who are taking tamoxifen and need to begin treatment with an SSRI to treat depression, citalopram or escitalopram might be the safest choice (Treat Guidel Med Lett 2006; 4:35). Use of an SSRI to treat hot flashes in women taking tamoxifen should probably be reconsidered.
Download: U.S. English
Raloxifene (Evista) for Breast Cancer Prevention in Postmenopausal Women
The Medical Letter on Drugs and Therapeutics • May 8, 2006; (Issue 1234)
Preliminary results from a new study, unpublished but reported in a press release from the National Cancer Institute and widely disseminated in the public press, suggest that raloxifene (Evista) might be a...
Preliminary results from a new study, unpublished but reported in a press release from the National Cancer Institute and widely disseminated in the public press, suggest that raloxifene (Evista) might be a better choice than tamoxifen (Nolvadex, and others) for prevention of breast cancer in high-risk postmenopausal women.
CYP3A and Drug Interactions
The Medical Letter on Drugs and Therapeutics • July 4, 2005; (Issue 1212)
Serious adverse interactions between drugs continue to be reported. Many of these are due to inhibition or induction of cytochrome P450 (CYP) enzymes, particularly CYP3A4. CYP3A is thought to be involved in the...
Serious adverse interactions between drugs continue to be reported. Many of these are due to inhibition or induction of cytochrome P450 (CYP) enzymes, particularly CYP3A4. CYP3A is thought to be involved in the metabolism of more than 50 percent of currently prescribed drugs.2 CYP3A4, which is more abundantly expressed than CYP3A5, accounts for most CYP3A activity in vivo.
Drugs for Breast Cancer
The Medical Letter on Drugs and Therapeutics • January 1, 2005; (Issue 29)
In addition to surgery and radiation therapy, a variety of drugs are used both singly and in combination to treat breast cancer. This article summarizes the principles of adjuvant therapy and treatment for...
In addition to surgery and radiation therapy, a variety of drugs are used both singly and in combination to treat breast cancer. This article summarizes the principles of adjuvant therapy and treatment for metastatic disease. A summary of individual drugs and their adverse effects begins on page 3.
Drug Interactions
The Medical Letter on Drugs and Therapeutics • June 8, 2003; (Issue 1158)
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug...
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug interactions, such as vasodilation caused by both sildenafil (Viagra) and nitrates, can also have adverse effects.
Anastrozole (Arimidex) vs. Tamoxifen for Treatment of Early Breast Cancer
The Medical Letter on Drugs and Therapeutics • March 17, 2003; (Issue 1152)
Anastrozole (Arimidex - AstraZeneca, Medical Letter 1996; 38:61), an aromatase inhibitor, has received accelerated approval from the FDA for adjuvant treatment of postmenopausal women with early...
Anastrozole (Arimidex - AstraZeneca, Medical Letter 1996; 38:61), an aromatase inhibitor, has received accelerated approval from the FDA for adjuvant treatment of postmenopausal women with early hormone-receptor-positive breast cancer. The drug was approved for treatment of postmenopausal women with metastatic breast cancer in 1996.
Drugs of Choice for Cancer
The Medical Letter on Drugs and Therapeutics • March 1, 2003; (Issue 7)
The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants....
The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. In some cases, such as elderly patients or those with many co-morbid illnesses, the regimen of choice might not be suitable. For many of the cancers listed, surgery and/or radiation therapy may be the treatment of choice or may also be part of the management. Anticancer drugs and their adverse effects are listed in Table II on page 46. A partial list of brand names appears on page 52.
Fulvestrant (Faslodex) for Advanced Breast Cancer
The Medical Letter on Drugs and Therapeutics • July 22, 2002; (Issue 1135)
Fulvestrant (Faslodex -- AstraZeneca), an estrogen receptor antagonist given intramuscularly (IM) once a month, was recently approved by the FDA for treatment of hormone-receptor-positive metastatic breast...
Fulvestrant (Faslodex -- AstraZeneca), an estrogen receptor antagonist given intramuscularly (IM) once a month, was recently approved by the FDA for treatment of hormone-receptor-positive metastatic breast cancer in postmenopausal women with disease progession on tamoxifen (Nolvadex, and others) or another antiestrogen.
Drugs For Prevention and Treament of Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • October 16, 2000; (Issue 1090)
Many drugs are now marketed for prevention and treatment of postmenopausal osteoporosis. All regimens should include an adequate intake of calcium and vitamin...
Many drugs are now marketed for prevention and treatment of postmenopausal osteoporosis. All regimens should include an adequate intake of calcium and vitamin D.
Exemestane For Advanced Breast Cancer
The Medical Letter on Drugs and Therapeutics • April 17, 2000; (Issue 1076)
The FDA has approved exemestane, an aromatase inhibitor, for the treatment of postmenopausal women with advanced breast cancer that has progressed during treatment with...
The FDA has approved exemestane, an aromatase inhibitor, for the treatment of postmenopausal women with advanced breast cancer that has progressed during treatment with tamoxifen.
Drug Interactions
The Medical Letter on Drugs and Therapeutics • July 2, 1999; (Issue 1056)
Reports of adverse interactions between drugs continue to accumulate. Recently, the FDA has expanded the recommendations on drug interactions found in the package inserts of new...
Reports of adverse interactions between drugs continue to accumulate. Recently, the FDA has expanded the recommendations on drug interactions found in the package inserts of new drugs.
Clopidogrel for Reduction of Atherosclerotic Events
The Medical Letter on Drugs and Therapeutics • June 5, 1998; (Issue 1028)
Clopidogrel bisulfate (Plavix - Bristol-Myers Squibb/Sanofi), a new thienopyridine antiplatelet agent similar to ticlopidine (Ticlid - Medical Letter, 34:65, 1992), has been approved by the US Food and Drug...
Clopidogrel bisulfate (Plavix - Bristol-Myers Squibb/Sanofi), a new thienopyridine antiplatelet agent similar to ticlopidine (Ticlid - Medical Letter, 34:65, 1992), has been approved by the US Food and Drug Administration (FDA) for secondary prevention of myocardial infarction, stroke and other vascular events.
Raloxifene for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • March 13, 1998; (Issue 1022)
Raloxifene (Evista - Lilly), a benzothiophene that acts on estrogen receptors, has recently been marketed for prevention of postmenopausal osteoporosis. Only estrogen (alone or in combination with a progestin)...
Raloxifene (Evista - Lilly), a benzothiophene that acts on estrogen receptors, has recently been marketed for prevention of postmenopausal osteoporosis. Only estrogen (alone or in combination with a progestin) and the bisphosphonate alendronate (Fosamax) were previously approved by the FDA for this indication.
Anastrozole for Metastatic Breast Cancer
The Medical Letter on Drugs and Therapeutics • July 5, 1996; (Issue 978)
Anastrozole (Arimidex - Zeneca), a selective nonsteroidal aromatase inhibitor, has been approved by the US Food and Drug Administration (FDA) for treatment of postmenopausal women with advanced breast cancer...
Anastrozole (Arimidex - Zeneca), a selective nonsteroidal aromatase inhibitor, has been approved by the US Food and Drug Administration (FDA) for treatment of postmenopausal women with advanced breast cancer that has progressed during treatment with tamoxifen (Nolvadex, and others).
Choice of Drugs for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • October 30, 1992; (Issue 882)
The bone mass of an average person reaches a maximum at the age of 25 to 30, stays the same for about 15 years, and then progressively declines at a rate of 0.2% to 0.5% per year. At menopause, women go through...
The bone mass of an average person reaches a maximum at the age of 25 to 30, stays the same for about 15 years, and then progressively declines at a rate of 0.2% to 0.5% per year. At menopause, women go through a period of increased bone resorption (2% per year) for about 10 years and then resume a gradual rate of bone loss. Current strategies for prevention and treatment of Postmenopausal Osteoporosis include increasing calcium intake to maximize peak bone mass, using antiresorptive drugs to decrease postmenopausal resorption, and using other drugs to stimulate bone systhesis (BL Riggs and LJ Melton, III, N Engl J Med, 327:620, Aug 27, 1992).
Adjuvant Chemotherapy of Early Breast Cancer
The Medical Letter on Drugs and Therapeutics • May 18, 1990; (Issue 818)
The most important prognostic variable in early breast cancer is axillary lymph node involvement. Based on past experience, after 10 years about 70% of node-negative patients will be alive and apparently free...
The most important prognostic variable in early breast cancer is axillary lymph node involvement. Based on past experience, after 10 years about 70% of node-negative patients will be alive and apparently free of disease; about 30% will have relapsed or died. Patients with positive nodes may have a 30% to 60% relapse rate, depending on the number of positive nodes and other prognostic factors, such as the presence of estrogen receptors (IC Henderson et al, in VT DeVita, Jr et al, eds, Cancer: Principles and Practice of Oncology, 3rd ed, Philadelphia:Lippincott, 1989, p 1197). Which of these patients should receive adjuvant treatment with cytotoxic drugs and/or endocrine therapy is controversial; a National Cancer Institute (NCI) Consensus Conference on this subject is scheduled for June.