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Nolvadex (tamoxifen), pregnancy and breastfeeding

Tamoxifen citrate (Nolvadex, Soltamox) is generally not considered safe for women who are pregnant. In animal studies that looked at the effects of the drug during pregnancy, it was shown to cause miscarriages and problems for the animals later in life.

In animal studies on tamoxifen and pregnancy, the drug was shown to not only increase the risk of miscarriages, but also to increase the risk of vaginal or cervical cancer later in life. If you are taking tamoxifen and pregnancy occurs, your healthcare provider will weigh the benefits and risks before making a recommendation.

Tamoxifen and Pregnancy Category D

Pregnancy Category D is given to medicines that have shown clear evidence of risk to the fetus in studies. This is a stronger warning than a pregnancy Category C classification. However, a pregnancy Category D medicine may still be given to a pregnant woman if the healthcare provider believes that the benefits to the mother outweigh the possible risks to the unborn child.

Tamoxifen was given a pregnancy Category D rating because of problems in animal studies. When given to pregnant rats, the drug increased the risk of miscarriage. In addition, there is evidence that female rodents that were exposed to tamoxifen as fetuses have a higher risk of vaginal or cervical cancer.

The manufacturers of tamoxifen recommend that women should not become pregnant while taking the drug or within two months of taking it. Women who may become pregnant should use non-hormonal contraception (such as condoms) while taking the drug and for at least two months after taking it.

If you are taking tamoxifen and pregnancy occurs, or if you are thinking of becoming pregnant while taking the drug, let your healthcare provider know. He or she will consider the benefits and risks of using the medication while pregnant before making a recommendation for your particular situation.

Tamoxifen and Breastfeeding

It is unclear if a woman who takes tamoxifen and is breastfeeding will pass the medication on to her nursing infant. However, because the medication carries the risk of potentially serious side effects, the manufacturer recommends that pregnant women not take the drug. It is known to decrease milk production in women, so if you are taking tamoxifen and breastfeeding is something you are considering, discuss this with your healthcare provider.

It is not known if tamoxifen citrate (Nolvadex®, Soltamox™) passes through breast milk. However, because of the potentially serious side effects that could occur in the nursing infant, the manufacturers of tamoxifen recommend that pregnant women not take the medication. Therefore, if you are breastfeeding or thinking of starting, make sure to let your healthcare provider know.

While researchers do not know if the drug passes through breast milk in humans, it is known that tamoxifen can inhibit lactation, decreasing milk production in women. The medication affects hormones; therefore, it may cause serious side effects, including certain cancers. If your healthcare provider recommends taking tamoxifen while breastfeeding, be sure to watch for any side effects in your child.

You should talk with your healthcare provider about tamoxifen and breastfeeding. Everyone's situation is different, and your healthcare provider understands your situation best. After considering what you want and expect, as well as your current health situation, you and your healthcare provider can make a shared decision about tamoxifen and breastfeeding that is right for you.

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