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Nolvadex-D
Tamoxifen
$102.00
10mg · 6 × 30 tablets · 3 months supply
GenericGeneric medicine· By Teva
$34.00 per month
Strength
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Annual cost
$408a year at this pack size
Prescription required
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10mg
20mg
FDA boxed warningEffects on the Uterus-Endometrial Cancer and Uterine Sarcoma
WARNING - For Women with Ductal Carcinoma in Situ (DCIS) and Women at High Risk for Breast Cancer:
Serious and life-threatening events associated with tamoxifen citrate in the risk reduction setting (women at high risk for cancer and women with DCIS) include uterine malignancies, stroke and pulmonary embolism. Incidence rates for these events were estimated from the NSABP P-1 trial (see
CLINICAL PHARMACOLOGY-Clinical Studies – Reduction in Breast Cancer Incidence In High Risk Women). Uterine malignancies consist of both endometrial adenocarcinoma (incidence rate per 1,000 women-years of 2.20 for tamoxifen citrate vs 0.71 for placebo) and uterine sarcoma (incidence rate per 1,000 women-years of 0.17 for tamoxifen citrate vs 0.4 for placebo)*. For stroke, the incidence rate per 1,000 women-years was 1.43 for tamoxifen citrate vs 1.00 for placebo**. For pulmonary embolism, the incidence rate per 1,000 women-years was 0.75 for tamoxifen citrate versus 0.25 for placebo**.
Some of the strokes, pulmonary emboli, and uterine malignancies were fatal.
Health care providers should discuss the potential benefits versus the potential risks of these serious events with women at high risk of breast cancer and women with DCIS considering tamoxifen citrate to reduce their risk of developing breast cancer.
The benefits of tamoxifen citrate outweigh its risks in women already diagnosed with breast cancer.
- Updated long-term follow-up data (median length of follow-up is 6.9 years) from NSABP P-1 study. See
- *See Table 3 under
CLINICAL PHARMACOLOGY-Clinical Studies
About Nolvadex-D
Overview
Nolvadex-D contains tamoxifen, a prescription antiestrogen medicine taken as a tablet. Tamoxifen is used to treat breast cancer that has spread in women and men, and as additional treatment after surgery for breast cancer in women. It is also used to reduce the risk of invasive breast cancer in women after surgery and radiation for ductal carcinoma in situ (DCIS), and to reduce breast cancer risk in women assessed as being at high risk. It works by opposing the effects of estrogen, and breast cancers with estrogen receptors are more likely to benefit.
What it treats
Treatment of breast cancer that has spread to other parts of the body in women and men. Additional treatment of breast cancer in women after surgery and radiation, whether or not underarm lymph nodes are involved. Reduction of invasive breast cancer risk in women with ductal carcinoma in situ (DCIS) after breast surgery and radiation. Reduction of breast cancer risk in women aged 35 or older at high risk, based on an individual assessment of benefits and risks.
Safety information
Side effects
Commonly reported side effects of tamoxifen include hot flashes, nausea, vaginal discharge, irregular or absent periods, fluid retention or swelling, tiredness, headache, dizziness and rash. Joint, muscle or bone pain, mood changes and difficulty sleeping have also been reported. Other possible effects include vaginal dryness, hair thinning and, in men, reduced sexual desire or difficulty getting an erection. In people with breast cancer that has spread, bone or tumour pain may increase shortly after treatment starts. Existing tumour areas may temporarily enlarge or become red, and new lesions may appear. Serious adverse events reported include blood clots in the legs or lungs, stroke, cancer of the lining of the womb, cataracts, low blood platelet counts and high blood calcium levels. Some blood clots have been fatal. These conditions warrant prompt medical attention. Contact a doctor about vaginal bleeding or new or worsening bone or tumour symptoms. The label also reports abnormal liver and kidney blood test results.
FDA boxed warning
Effects on the Uterus-Endometrial Cancer and Uterine Sarcoma
WARNING - For Women with Ductal Carcinoma in Situ (DCIS) and Women at High Risk for Breast Cancer:
Serious and life-threatening events associated with tamoxifen citrate in the risk reduction setting (women at high risk for cancer and women with DCIS) include uterine malignancies, stroke and pulmonary embolism. Incidence rates for these events were estimated from the NSABP P-1 trial (see
CLINICAL PHARMACOLOGY-Clinical Studies – Reduction in Breast Cancer Incidence In High Risk Women). Uterine malignancies consist of both endometrial adenocarcinoma (incidence rate per 1,000 women-years of 2.20 for tamoxifen citrate vs 0.71 for placebo) and uterine sarcoma (incidence rate per 1,000 women-years of 0.17 for tamoxifen citrate vs 0.4 for placebo)*. For stroke, the incidence rate per 1,000 women-years was 1.43 for tamoxifen citrate vs 1.00 for placebo**. For pulmonary embolism, the incidence rate per 1,000 women-years was 0.75 for tamoxifen citrate versus 0.25 for placebo**.
Some of the strokes, pulmonary emboli, and uterine malignancies were fatal.
Health care providers should discuss the potential benefits versus the potential risks of these serious events with women at high risk of breast cancer and women with DCIS considering tamoxifen citrate to reduce their risk of developing breast cancer.
The benefits of tamoxifen citrate outweigh its risks in women already diagnosed with breast cancer.
- Updated long-term follow-up data (median length of follow-up is 6.9 years) from NSABP P-1 study. See
- *See Table 3 under
CLINICAL PHARMACOLOGY-Clinical Studies
A boxed warning is the strongest warning the US Food and Drug Administration requires on a medicine label. Text is taken from the official label, with internal section references removed.
When to call your doctor
If symptoms are severe or getting worse quickly, seek emergency care rather than waiting.
Before taking this medicine
Do not take Nolvadex-D (tamoxifen) if you are allergic to tamoxifen or any of its ingredients. When used to reduce the risk of breast cancer in high-risk women or women with ductal carcinoma in situ (DCIS), tamoxifen must not be taken by women who need a coumarin-type anticoagulant (blood thinner) or have a history of deep vein thrombosis or pulmonary embolism.
Interactions
Tamoxifen can interact with the following medicines: • Coumarin-type blood thinners: tamoxifen may significantly increase their blood-thinning effect. Careful monitoring of blood-clotting time is recommended if they are used together. • Cytotoxic chemotherapy medicines: use with tamoxifen increases the risk of blood clots. • Anastrozole: should not be taken with tamoxifen. • Letrozole: tamoxifen lowers the amount of letrozole in the blood. • Rifampin and aminoglutethimide: can lower blood levels of tamoxifen and one of its breakdown products. • Phenobarbital: a lower tamoxifen blood level was reported in one patient, but the clinical significance is unknown. • Medroxyprogesterone: lowers blood levels of one tamoxifen breakdown product, but not tamoxifen itself. • Bromocriptine: can increase blood levels of tamoxifen and one of its breakdown products. Tell your doctor if you take any of these medicines. Tamoxifen’s effect on the processing and removal of some other cancer medicines, including cyclophosphamide, is not known.
Using Nolvadex-D
Dosing
Dosing is set by your prescriber. Each health care professional may prescribe medication differently according to a patient's medical history and condition, so follow the directions on your prescription label and speak to your doctor or pharmacist before changing anything.
Storage
Store below 25°C in a dry place, in the original pack, away from direct light and moisture. Do not keep it in a bathroom. Keep all medicines out of the sight and reach of children.
Clinical information on this page is summarised from the US FDA label TAMOXIFEN CITRATE TABLET, FILM COATED [NUCARE PHARMACEUTICALS, INC.] (DailyMed, retrieved 19 September 2026).
Patient information and references
Official and supporting information to read alongside advice from your prescriber or pharmacist.
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