5 Fluorouracil
Adverse Effect: an increased risk of thromboembolism Clinical Management: In patients undergoing therapy with tamoxifen for breast cancer, the risks of adding fluorouracil should be weighed against the potential benefits.
Acenocoumarol
Adverse Effect: An increased risk of bleeding Clinical Management: Concurrent administration of tamoxifen and coumarin-type anticoagulants, including acenocoumarol, is contraindicated in high-risk women where tamoxifen is indicated to reduce the incidence of breast cancer. In other clinical situations where tamoxifen is used concurrently with acenocoumarol, the prothrombin time ratio or INR (international normalized ratio) should be closely monitored with the addition and withdrawal of treatment with tamoxifen, and should be reassessed periodically during concurrent therapy.
Cyclophosphamide
An increased risk of thromboembolism Clinical Management: In patients undergoing therapy with tamoxifen for breast cancer, the risks of adding cyclophosphamide should be weighed against the potential benefits.
Methotrexate
Adverse Effect: an increased risk of thromboembolism Clinical Management: In patients undergoing therapy with tamoxifen for breast cancer, the risks of adding methotrexate should be weighed against the potential benefits.
Mitomycin
Adverse Effect: increased risk of hemolytic uremic syndrome Clinical Management: Monitor patients for signs of hemolytic uremic syndrome.
Phenobarbitone
Adverse Effect: Decreased steady-state serum levels of tamoxifen
Warfarin
Adverse Effect: an increased risk of bleeding Clinical Management: Concurrent administration of tamoxifen and coumarin-type anticoagulants, including warfarin, is contraindicated in high-risk women where tamoxifen is indicated to reduce the incidence of breast cancer |