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Soltamox

tamoxifen
Used for Breast Cancer
Used for Breast Cancer

Soltamox (tamoxifen) 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. Soltamox (tamoxifen) is an oral solution that’s taken by mouth, typically once or twice daily. It might be an alternative for people who can’t swallow tamoxifen tablets (Nolvadex). Some of the more common side effects of Soltamox (tamoxifen) include hot flashes, vaginal discharge, and swelling that might lead to weight gain.

Reviewed by:
reviewer
Julia Lee, PharmD, BCOP
reviewer
Connie Zheng, PharmD
Last reviewed on April 21, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
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What is Soltamox (tamoxifen)?

What is Soltamox (tamoxifen) used for?

How Soltamox (tamoxifen) works

Soltamox (tamoxifen) is a selective estrogen receptor modulator (SERM). Some breast cancers depend on hormones like estrogen to grow. These breast cancers are called hormone receptor-positive (HR+).

Soltamox (tamoxifen) treats HR+ breast cancer by blocking estrogen from working on breast cancer tissue. By doing so, Soltamox (tamoxifen) prevents cancer cells from getting the fuel needed to grow, and stops the cancer from spreading

Are you looking for information on tamoxifen tablet (Nolvadex) instead?

Drug Facts

Common BrandsSoltamox
Drug ClassSelective estrogen receptor modulator (SERM)
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

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What are the side effects of Soltamox (tamoxifen)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Hot flashes (up to 80%)
  • Vaginal discharge (up to 55%)
  • Swelling (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%)

Other Side Effects

  • Headache
  • Cough
  • Fatigue
  • Cataracts
  • Mood changes
  • Muscle, joint, or bone pain
  • Weakness or tiredness
  • Breast pain

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Blood clots in your veins or lungs: pain or swelling in your arms or legs, trouble breathing, chest pain, fast heartbeat
  • Stroke: severe headache, sudden confusion, weakness on one side of your body, or trouble speaking or walking
  • Signs of uterine cancer: abnormal vaginal bleeding or discharge, pain or pressure in the area below the belly button (pelvis)

Source: DailyMed

More on Soltamox (tamoxifen) side effects

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The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
  • High calcium level—increased thirst or amount of urine, nausea, vomiting, confusion, unusual weakness or fatigue, bone pain
  • Infection—fever, chills, cough, or sore throat
  • Irregular menstrual cycles or spotting
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Low red blood cell count—unusual weakness or fatigue, dizziness, headache, trouble breathing
  • Stroke—sudden numbness or weakness in the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
  • Unusual bruising or bleeding
  • Vaginal bleeding after menopause, pelvic pain

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Soltamox (tamoxifen)

thumbs-up

Pros

Usually taken once a day

Oral solution, possible option for people who have trouble swallowing pills

Can be stored at room temperature

Might help prevent bone loss (osteoporosis) after menopause

thumbs-down

Cons

Soltamox is brand name only

Can’t take while pregnant or breastfeeding

Might raise your risk for blood clots, uterine cancer, and cataracts

Usually taken long term (at least 5 years)

pharmacist-tips

Pharmacist tips for Soltamox (tamoxifen)

pharmacist

  • Soltamox (tamoxifen) can be taken with or without food.

    • Use the supplied dosing cup to measure your Soltamox (tamoxifen) dose appropriately. Remember each 5 mL of the solution contains 10 mg of tamoxifen.

      • Soltamox (tamoxifen) is only good for 3 months after it’s been opened. To remind yourself, make sure to mark the date on the bottle when you first open it.

        • It's best to avoid drinking alcohol while you're taking Soltamox (tamoxifen). Doing so can worsen certain side effects of Soltamox (tamoxifen), such as hot flashes. Drinking can raise the level of estrogen in the body, and cause Soltamox (tamoxifen) to not work as well in treating cancer. If stopping alcohol is difficult for you, talk with your care team so they can recommend resources to help you quit.

          • Soltamox (tamoxifen) can cause hot flashes. Talk with your oncologist if these symptoms are very uncomfortable. They can recommend ways to ease your symptoms, such as wearing loose fitting layers that you can remove easily and drinking more water throughout the day, instead of alcohol or caffeine.

            • You might experience swelling in the arms and legs (edema) after starting Soltamox (tamoxifen). To ease swelling, consider wearing compression stockings to keep your blood flowing. Choosing a low-salt diet can also help.

              • In rare situations, Soltamox (tamoxifen) can cause blood clots, even 2 to 3 months after stopping the medication. If you notice symptoms of blood clots, such as pain or swelling in your arms and legs, chest pain, or severe headache, get medical help right away.

                • In very rare cases, people taking Soltamox (tamoxifen) for breast cancer developed cancer in the uterus later on. If you notice signs of uterine cancer, such as unusual vaginal discharge, bleeding or spotting, stomach pain, let your oncologist know. You'll need immediate medical attention.

                  • Talk with your oncologist if you're thinking about breastfeeding. Soltamox (tamoxifen) can pass into breast milk, which might pose a risk to breastfeeding infants. Because of this risk, you shouldn’t breastfeed while taking Soltamox (tamoxifen) and for 3 months after your last dose.

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                    faqs

                    Frequently asked questions about Soltamox (tamoxifen)

                    Is Soltamox (tamoxifen) chemotherapy?
                    Soltamox (tamoxifen) isn’t chemotherapy; it's a type of hormone therapy. Chemotherapy works by killing fast-growing cells in the body, including cancer cells. Soltamox (tamoxifen) doesn’t work that way. Instead, it works by blocking estrogen (a hormone) from targeting cancer cells. That's why it's able to treat certain hormone-sensitive (HR+) breast cancer that grows when there's estrogen around. Soltamox (tamoxifen) fights breast cancer by stopping estrogen from fueling the cancer.
                    Is Soltamox (tamoxifen) an aromatase inhibitor?
                    No, Soltamox (tamoxifen) isn’t an aromatase inhibitor; it’s a selective estrogen receptor modulator (SERM). Aromatase inhibitors, such as anastrozole (Arimidex), stop the body from making estrogen. SERMs, like Soltamox (tamoxifen), blocks estrogen’s effect on breast cancer cells. Both aromatase inhibitors and Soltamox (tamoxifen) are used to treat breast cancer. But Soltamox (tamoxifen) has an additional FDA-approval to lower the risk of breast cancer in females who are at high risk. Aromatase inhibitors aren't FDA-approved to lower breast cancer risk, but oncologists sometimes prescribe them off-label for this purpose because research suggests they can help as well. If you’d like to learn more about options for your specific breast cancer, talk with your oncologist.
                    How long do I need to take Soltamox (tamoxifen) for?
                    Your care team will talk with you about how long you’ll need to take Soltamox (tamoxifen). Usually, it’s recommended to take Soltamox (tamoxifen) or other hormone therapy for at least 5 years and sometimes up to 10 years. Don’t stop taking Soltamox (tamoxifen) without first talking with your oncologist.
                    What are the worst side effects of Soltamox (tamoxifen)?
                    Not everyone will have the same side effect experience with Soltamox (tamoxifen), so what's considered the "worst side effects" might differ from person to person. But one of the most common side effects of Soltamox (tamoxifen) is hot flashes, which can be very uncomfortable. Your oncologist can give you tips to ease hot flashes, such as wearing loose-fitting layers and avoiding certain foods or drinks that might worsen hot flashes, like caffeine or spicy foods. Another bothersome side effect of Soltamox (tamoxifen) is having more vaginal discharge. Your oncologist might recommend you to wear cotton underwear that’s more breathable and to use panty liners in the underwear to absorb the extra discharge. Talk with your oncology team if you have questions on any specific Soltamox (tamoxifen) side effect or risk.
                    Does Soltamox (tamoxifen) cause hair loss?
                    Yes, Soltamox (tamoxifen) can cause hair loss, but it isn’t a common side effect. When people did experience hair loss, hair thinning was more typical than complete hair loss. Talk with your oncologist if you’re concerned about hair change with Soltamox (tamoxifen) treatment. They can let you know about different options to help, such as using wigs, scarves, or turbans.
                    Does Soltamox (tamoxifen) cause uterine cancer?
                    Soltamox (tamoxifen) can cause changes to the cells lining the uterus, which can raise the chance of developing uterine cancer. Although rare, studies show that people tend to have a higher risk for developing uterine cancer if they’re 50 years or older, have already started menopause, have taken Soltamox (tamoxifen) for a longer period of time, or are taking higher than Soltamox (tamoxifen) 20 mg a day. But, the National Comprehensive Cancer Network (NCCN) and American College of Obstetricians and Gynecologists (ACOG) still recommend Soltamox (tamoxifen), since the benefit it offers in preventing breast cancer is still higher than the risk of developing uterine cancer. Talk with your oncologist if you have concerns about the risk of developing uterine cancer while using Soltamox (tamoxifen).
                    Does Soltamox (tamoxifen) cause weight gain?
                    In clinical studies, some people did report weight gain after starting Soltamox (tamoxifen). But it's unclear whether this weight gain is caused by Soltamox (tamoxifen) or other factors. One possible reason for this weight gain might be swelling from fluid buildup in the arms and feet (peripheral edema), a relatively common Soltamox (tamoxifen) side effect. If you notice leg swelling while taking Soltamox (tamoxifen), try elevating your legs or wearing compression stockings to ease the swelling. If you have more questions about how Soltamox (tamoxifen) might affect your weight, talk with your oncologist.
                    Is Soltamox (tamoxifen) safe to take during pregnancy?
                    Talk with your oncologist if you're pregnant or considering becoming pregnant before starting this medication. This is because Soltamox (tamoxifen) might cause harm to your unborn baby. If you're able to become pregnant, you should use non-hormonal birth control, like condoms or a diaphragm, while taking Soltamox (tamoxifen) and for 2 months after the last dose. Let your oncologist know right away if you become pregnant while taking this medication.
                    What’s the difference between Soltamox (tamoxifen) and tamoxifen citrate (Nolvadex)?
                    Soltamox (tamoxifen) and tamoxifen citrate (Nolvadex) contain the same active medication, tamoxifen. The main difference between them is that Soltamox (tamoxifen) is a liquid solution, while tamoxifen (Nolvadex) is a tablet. Soltamox (tamoxifen) might be a better option for people who have trouble swallowing tablets. Talk with your oncology care team if you have more questions about which formulation of tamoxifen might be more appropriate for you.
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                    What are the risks and warnings for Soltamox (tamoxifen)?

                    Soltamox (tamoxifen) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                    risk-warning

                    Blood clots

                    • Risk factors: Receiving chemotherapy at the same time | Past blood clots

                      Soltamox (tamoxifen) can raise your risk of blood clots. Blood clots can develop in any part of the body, including in the veins in your legs (deep venous thrombosis), lungs (pulmonary embolism) and brain (stroke). In clinical studies, people have reported blood clots anytime between 1 month to 5 years after starting treatment. This risk is higher for people receiving Soltamox (tamoxifen) at the same time as chemotherapy. If you’re having symptoms of blood clots, which can include swelling, pain, or redness in your legs, difficulty breathing, or chest pain, seek medical attention right away.

                      risk-warning

                      Changes in the uterus and risk of uterine cancer

                      • Risk factors: Taking tamoxifen for 2 years or longer

                        Though not common, there have been reports of people developing ovarian cysts, uterine fibroids, and uterine cancer after starting Soltamox (tamoxifen). The reason for this isn’t fully understood, but it’s thought that Soltamox (tamoxifen) acts like estrogen and can cause changes to the lining of the uterus. After you start Soltamox (tamoxifen), your oncologist might ask you to get yearly gynecology exams. Let your healthcare provider know if you have any abnormal vaginal bleeding or bloody discharge, changes in your period, and pain or pressure in the area below your belly button (pelvis). These can be signs of uterine cancer. If you’ve had surgery to remove the uterus, you aren’t at risk for uterine cancer.

                        risk-warning

                        Eye problems

                        Soltamox (tamoxifen) can raise your chance of developing cataracts and other eye problems. Let your provider know if you experience any changes in your vision, like slow blurring of your vision or changes in how you see color.

                        risk-warning

                        Liver problems

                        Soltamox (tamoxifen) might cause changes in liver enzyme levels. On rare occasions, people have reported serious liver problems and liver cancer, which can be life-threatening. Your healthcare provider will monitor your liver health regularly through blood draws while you're taking Soltamox (tamoxifen). If you develop liver problems, your healthcare provider might stop your treatment. Let your provider know if you experience yellowing of the eyes or skin, loss of appetite, or tiredness, as these can be signs of liver problems.

                        risk-warning

                        High calcium levels in the blood

                        Some people taking Soltamox (tamoxifen) for metastatic breast cancer that has spread to the bones have reported high blood calcium levels within a few weeks of starting treatment. Your oncologist might check your blood calcium level regularly after you start Soltamox (tamoxifen). If your level is very high, they’ll ask you to stop this medication. Symptoms of high blood calcium levels can include nausea, tiredness, and muscle weakness.

                        risk-warning

                        Low platelet count (risk of bleeding)

                        Though rare, some people have reported low platelet count after starting Soltamox (tamoxifen). It’s unclear whether the low platelet count is caused by Soltamox (tamoxifen) or by other factors. But having a low platelet level raises your risk for bleeding. Your oncologist will check your blood counts regularly to see if your levels are within a safe range. Let your healthcare team know if you notice bruises that won’t go away or bleeding that’s difficult to stop because these might be signs of low platelet count.

                        risk-warning

                        Harm to unborn baby

                        Soltamox (tamoxifen) can cause serious harm to an unborn baby. If you’re able to become pregnant, you should use non-hormonal birth control, like condoms or a diaphragm, while taking Soltamox (tamoxifen) and for 2 months after the last dose. Let your provider know right away if you become pregnant during this time.

                        dosage

                        Soltamox (tamoxifen) dosage forms

                        The average cost for 2 bottles of 150ml of 10mg/5ml of Soltamox (tamoxifen) is $60.00 with a free GoodRx coupon. This is 96.19% off the average retail price of $1575.89.
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                        150ml of 10mg/5ml2 bottles$60.00$30.00

                        Typical dosing for Soltamox (tamoxifen)

                        • Metastatic HR+ breast cancer: The typical dosing is 20 mg to 40 mg by mouth once daily. If your total daily dose is higher than 20 mg, your oncologist will ask you to divide it into 2 smaller doses and take it by mouth twice daily in the morning and evening.

                        • Early stage HR+ breast cancer after surgery: The typical dosing is 20 mg by mouth once daily for 5 to 10 years.

                        • Ductal carcinoma in situ (DCIS): The typical dosing is 20 mg by mouth once daily for 5 years.

                        • Lowering the risk of getting breast cancer: The typical dosing is 20 mg by mouth once daily for 5 years.

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                        contraindications-icon

                        Soltamox (tamoxifen) contraindications

                        Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Soltamox (tamoxifen) will not be safe for you to take.

                        • Females at high risk of developing breast cancer, and either currently taking warfarin (Coumadin) or have had blood clots in the past

                        alternatives

                        What are alternatives to Soltamox (tamoxifen)?

                        There are a number of medications that your doctor can prescribe in place of Soltamox (tamoxifen). Compare a few possible alternatives below.
                        Soltamox (tamoxifen)
                        Used for:
                        $60.00 Lowest GoodRx priceView Prices
                        Fulvestrant (Faslodex)
                        Used for:

                        • Hormone receptor (HR)-positive, advanced or metastatic breast cancer

                        $231.50 Lowest GoodRx priceView Prices
                        Tamoxifen (Nolvadex)
                        Used for:
                        $43.33 Lowest GoodRx priceView Prices
                        latest news

                        What is the latest news about Soltamox (tamoxifen)?

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                        References

                        Best studies we found

                        American College of Obstetricians and Gynecologists. (2023). Endometrial cancer.

                        Committee on Gynecologic Practice. (2024). Tamoxifen and uterine cancer. American College of Obstetricians and Gynecologists.

                        Cuzick, J., et al. (2019). Use of anastrozole for breast cancer prevention (IBIS-II): Long-term results of a randomised controlled trial. The Lancet.

                        View All References (6)

                        Fisher, B., et al. (2005). Tamoxifen for the prevention of breast cancer: Current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. Journal of the National Cancer Institute.

                        Ghanavati, M., et al. (2023). Tamoxifen use and risk of endometrial cancer in breast cancer patients: A systematic review and dose-response meta-analysis. Cancer Reports.

                        Mayne Pharma. (2021). Soltamox- tamoxifen citrate liquid [package insert]. DailyMed.

                        National Comprehensive Cancer Network. (2024). Ductal carcinoma in situ.

                        National Comprehensive Cancer Network. (2024). Invasive breast cancer.

                        Park, J., et al. (2014). Pattern alopecia during hormonal anticancer therapy in patients with breast cancer. Annals of Dermatology.

                        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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