Forum Discussion

Stormbird63's avatar
Stormbird63
Member
6 years ago

Hot flushes on Tamoxifen

Hello. Newby here. Just wondering if you could advise me. I have been on Tamoxifen for 8 months now and have been putting up with those pesky hot flushes at least 20 times in 24 hours. Started taking Evening Primrose Oil 1000mg three times a day. Not one to put too much faith in these types of remedies but the symptoms eased considerably. This lasted a few weeks and now back flushing away all be it possibly to a lesser frequency.  Any other things you could suggest???
thanks
hot-flushes
side-effects
tamoxifen
  • Dory65's avatar
    Dory65
    Member
    6 years ago

    Effexor Seems Just as Good as HRT in Easing Hot Flashes

    https://www.breastcancer.org/research-news/effexor-vs-hrt-for-hot-flashes

    However, be careful to avoid some antidepressants which are are "such strong inhibitors of CYP2D6 that women who take these drugs may not benefit from tamoxifen. Two papers suggest that three antidepressants — paroxetine (Paxil), fluoxetine (Prozac), and bupropion (Wellbutrin) — are most likely to inhibit CYP2D6 and interfere with tamoxifen treatment."

    Choosing among antidepressants

    Antidepressants vary in their ability to inhibit CYP2D6 (the enzyme that converts tamoxifen into its active form, endoxifen).

    Drug

    Effect on CYP2D6

    Advice

    venlafaxine (Effexor)

    Minimal

    Safest choice if taken with tamoxifen.

    desvenlafaxine (Pristiq), mirtazapine (Remeron)

    Direct studies with tamoxifen are lacking, but effect on endoxifen levels should be minimal.

    citalopram (Celexa), escitalopram (Lexapro), nefazodone (Serzone)

    Mild

    Secondary choices if above are not options.

    Only citalopram and sertraline have been studied directly with tamoxifen, so risk of reducing levels of endoxifen should be weighed against benefits of antidepressants.

    duloxetine (Cymbalta), sertraline (Zoloft), fluvoxamine (Luvox)

    Moderate

    paroxetine (Paxil), fluoxetine (Prozac), bupropion (Wellbutrin)

    Strong

    Best to avoid if taking tamoxifen.

    https://www.health.harvard.edu/newsletter_article/antidepressants-and-tamoxifen
  • Dory65's avatar
    Dory65
    Member
    6 years ago
    Ask you oncologist/GP re a particular antidepressant which is known to reduce intensity and frequency of hot flushes. :)
  • TonyaM's avatar
    TonyaM
    Member
    6 years ago
    I carried a cold bottle of water and a hand fan wherever I went! I put a small desk fan on my bedside table to blow on my face all night! I ended up taking a very low dose antidepressant called Endep 10mg which helped a lot and didn’t seem to give me any side effects. I was getting hot flushes every 15 minutes and couldn’t stand the lack of sleep. 
  • kezmusc's avatar
    kezmusc
    Member
    6 years ago
    You could try a different brand of Tamoxifen.  Sometimes that helps.  I switched brands and noticed a big difference within a week.  However, I was about 12 months further down the track so time could play a factor in there as well.
     It's also a lot worse if you had chemo induced menopause as well..  Unfortunately none of the menopause supplements are recommended for ER+ BC.  
    One of those cool towels is  helpful as well.  If you wet them and put it in the freezer for a few minutes they will calm the flushes down.  I also carried ample supply of Dove deodarant that I spray down my shirt as soon as I feel them coming. That gives them a little knock as well.
    All the best lovely.  They truly suck.
    xoxox