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Compare Zoladex vs. Nolvadex

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Goserelin (Zoladex) and tamoxifen (Nolvadex) are both used to treat hormone receptor-positive (HR+) breast cancer, but they belong to different medication classes. Goserelin is a gonadotropin-releasing hormone (GnRH) agonist, while tamoxifen is a selective estrogen receptor modulator (SERM). Goserelin is administered as an implant under the skin every 4 weeks or every 3 months, whereas tamoxifen is an oral tablet usually taken once daily. Goserelin is also used for prostate cancer and endometriosis, while tamoxifen is also used to lower the risk of breast cancer in high-risk females. Goserelin can cause side effects like hot flashes and diarrhea, and it may weaken bones. Tamoxifen can also cause hot flashes and weaken bones and commonly causes vaginal discharge. Tamoxifen increases the risk of blood clots and uterine cancer. Tamoxifen is available as a lower-cost generic, whereas goserelin does not have a generic version. Both medications require careful monitoring for side effects and interactions, but tamoxifen has more known interactions.

  • Zoladex (goserelin)
    Tamoxifen (Nolvadex)
  • Zoladex (goserelin)
    Tamoxifen (Nolvadex)

  • Summary of Zoladex vs. Nolvadex

    Summary for GnRH agonist
    Prescription only

    Zoladex (goserelin) works well to treat prostate cancer in men and breast cancer and endometriosis in women. It's an implant that's injected under the skin of your stomach by a healthcare provider every 4 weeks.

    Summary for Selective estrogen receptor modulator (SERM)
    Prescription only

    Tamoxifen (Nolvadex) is a selective estrogen receptor modulator (SERM). It’s used to treat early stage and advanced or metastatic hormone receptor-positive (HR+) breast cancer in males and females. It’s also used to lower the risk for breast cancer in females who have a higher risk for breast cancer. Tamoxifen (Nolvadex) is an oral tablet that's taken by mouth, usually once a day. Common side effects of this medication include hot flashes, vaginal discharge, and swelling in the arms and legs, which might lead to weight gain. Brand name Nolvadex is no longer available.

  • Indications of Zoladex vs. Nolvadex

    Indications for
    •Prostate cancer
    •Advanced hormone-receptive positive (HR+) breast cancer
    •Endometriosis
    •Endometrial thinning before endometrial ablation
    Indications for
    •Metastatic HR+ breast cancer
    •Early-stage HR+ breast cancer after surgery to lower the risk of breast cancer coming back
    •Ductal carcinoma in situ (DCIS) in females after breast surgery and radiation to lower the risk of breast cancer coming back
    •Lowering the risk of breast cancer in females who are considered high risk

  • Pros and Cons of Zoladex vs. Nolvadex

    Pros and Const for GnRH agonist
    Pros
    •Convenient 4-week or 3-month implant, so you will only to have to get it once a month or every 3 months
    •Works well for several different conditions and for pain caused by endometriosis
    •Can still use if you have liver or kidney problems
    Cons
    •Can cause breast tenderness, hot flashes, changes in breast size, or a temporary worsening of your symptoms
    •Can raise your risk of broken bones
    •Only available as an implant through an injection
    •Is very expensive and no generic is available yet
    Pros and Const for Selective estrogen receptor modulator (SERM)
    Pros
    •Usually taken once a day
    •Oral tablet is available as a lower-cost generic
    •Might help prevent bone loss (osteoporosis) after menopause
    Cons
    •Might raise your risk for blood clots, uterine cancer, and cataracts
    •Can’t take while pregnant or breastfeeding
    •Usually taken long term (at least 5 years)

  • Common Side Effects of Zoladex vs. Nolvadex

    Common Side Effects for
    •Hot flashes (46%)
    •Diarrhea (40%)
    •Nausea (9%)
    •Skin rash (8%)
    Common Side Effects for
    •Hot flashes (up to 80%)
    •Vaginal discharge (up to 55%)
    •Swelling in the arms and legs (up to 32%)
    •Nausea (up to 26%)
    •Irregular or no monthly bleeding (up to 25%)
    •Vaginal bleeding (up to 23%)
    •Weight loss (23%)
    •Skin changes (19%)

  • Warnings of Zoladex vs. Nolvadex

    Common Side Effects for
    •HARM TO UNBORN BABY
    •TUMOR-FLARE SYNDROME
    •HIGH BLOOD SUGARS
    •HEART PROBLEMS
    •INJECTION SITE INJURY
    •SEVERE ALLERGIC REACTIONS
    Common Side Effects for
    •Blood clots
    •Changes in the uterus and risk of uterine cancer
    •Eye problems
    •Liver problems
    •High calcium levels in the blood
    •Low platelet count (risk of bleeding)
    •Harm to unborn baby

  • Prices with our coupons for Zoladex vs. Nolvadex

    Learn more about Zoladex
    Learn more about Tamoxifen

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