Need Info on Drug Dosage??

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bartalo@webtv.net - 11 Jan 2004 04:08 GMT

I called my pharmacy guy today and asked him if one is concerned about
the Tamoxifen side effects such as stomach problems, nausea etc. and one
is on a dosage of 20 mg. per day, would it be better to take one 10 mg.
Tamoxifen after breakfast and another 10mg pill after supper or just the
one 20 mg.pill after supper?

I am confused by his answer. He said it would be best, in his opinion,
to take the one 20mg. pill after supper (I would have food in my
stomach) because it takes about 2 hours for the pill to go through the
stomach and I would just have to put up with any side effects just that
one time.

If I take the one 10 mg. pill twice a day, I will have to endure any
stomach side effects two times a day, in his opinion. Is this the
way side effects with drugs work? Does this sound logical to those of
you who have some knowledge of how drugs work in the body or even from
your own experiences?

Usually, if I get a side effect from a drug, it lasts longer than 2
hours even if it has to do with my stomach problems.

To my thinking the one 10mg. pill would give me milder side effects or
be easier on my stomach even if I have to take it twice a day. But now
I really am confused so could any of you give me your opinion on which
way seems best for milder side effects. The one 20 mg. once a day or
the two 10 mg. twice a day?

Sorry to be such a bother with this Tamoxifen stuff but I want to make
sure I do it right so I can stick it out for the 5 years. Thanks!

Bea

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Lance - 11 Jan 2004 06:57 GMT

> I called my pharmacy guy today and asked him if one is concerned about
> the Tamoxifen side effects such as stomach problems, nausea etc. and
[quoted text clipped - 7 lines]
> through the stomach and I would just have to put up with any side
> effects just that one time.

<snip>

The side-effects from tamoxifen depend on the person. Some people don't have
any at all (like my wife). Some have weight gain, some don't. Some have hot
flashes, some don't. Same goes for aches, low libido, nausea, etc. A very
very few will experience side-effect(s) severe enough that taking tamoxifen
is just not worth it.

With your ulcer, I would do what it is you normally do when taking any other
pill.

And don't worry about effectiveness of once vs twice a day dosing. Tamoxifen
has a half-life in the blood stream of around 7-10 days, so whether you take
10 mg tablets twice a day, or a 20 mg tablet once a day or two 10 mg tablets
at once, doesn't make a difference.

For maximum flexibility, perhaps getting a supply of 10 mg tablets from the
pharmacist would be a good start. Those 20 mg tablets are not that easy to
chop in half.

Lance
*****

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Tim Jackson - 11 Jan 2004 09:34 GMT

> If I take the one 10 mg. pill twice a day, I will have to endure any
> stomach side effects two times a day, in his opinion. Is this the
[quoted text clipped - 10 lines]
> way seems best for milder side effects. The one 20 mg. once a day or
> the two 10 mg. twice a day?

I think this is like trying to forecast the weather. You have five years to
experiment and find out what works best for you. I think attempting to
predict your reaction and sticking to the formula you so obtain is unlikely
to be optimal. What matters is that if you hit problems you have a range of
potential solutions to try.

Tim

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alexk - 11 Jan 2004 15:45 GMT

I think he was thinking you maybe able to sleep through any unpleasant side
effects. ALex

> I called my pharmacy guy today and asked him if one is concerned about
> the Tamoxifen side effects such as stomach problems, nausea etc. and one
[quoted text clipped - 27 lines]
>
> Bea

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A. P. Thorsen - 12 Jan 2004 16:52 GMT

> .... would it be better to take one 10 mg.
> Tamoxifen after breakfast and another 10mg pill after supper or just the
> one 20 mg.pill after supper?

I may be naive here, but I think I can see where your pharmacist is
coming from. It seems like a drug passes through your digestive system
shortly after you take it, then gets absorbed and spends its free time
ambling around it other parts of your body doing Good Stuff.

Most people do not have stomach problems with Tamoxifen, even taking it
on an empty stomach. So, if you turn out to be one of the very
sensitive people, the 10 mg may be enough to cause a stomach reaction,
and you'd have it twice a day.

Bea, odds are excellent that you'll have few or no problems with
Tamoxifen. In this group, you hear more about the problems, because
that's what people need help with & post about. Those of us with no or
only manageable problems (like me) don't post about it.

Why not start out taking the standard dose in the standard way? That
that has shown to work well for the majority of people with respect to
both efficacy & minimization of side effects. It will probably work
fine for you, too . . . and if it doesn't, you can work with your doctor
or pharmacist to make changes that are tailored to address the specific
issues you encounter.

It's not as if taking Tamoxifen, or taking it on a particular schedule,
is an irrevocable decision. You can try it, and make adjustments (or
quit taking it, at an extreme) if you need to.

Try not to worry; this is going to be manageable!

Best wishes,

Ann T.
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