HIMTAM

*Pre- and peri-menopausal women with oestrogen receptor positive breast cancer not previously treated with tamoxifen:* Adult: 20 mg daily increasing to 40 mg daily if necessary. *Anovulatory infertility:* Adult: Initially 20 mg daily on days 2, 3, 4 and 5 of cycle, if necessary increased to 40 mg then 80 mg for subsequent courses; if cycles irregular, start initial course on any day, with subsequent course starting 45 days later or on day 2 of cycle if menstruation occurs.

Treatment of infertility contraindicated if personal or family history of idiopathic venous thromboembolism or genetic predisposition to thromboembolism

Porphyria, leukopenia, thrombocytopenia or hyperlipidaemias.

Warfarin, allopurinol, cyclosporin, bromocriptine, rifampicin, paroxetine, fluoxetine, bupropion, quinidine, anticonvulsants.

Alopecia, anaemia, cataracts, corneal changes, decreased platelet counts, endometrial changes, GI disturbances, hot flushes, thromboembolic events, leucopenia, liver enzyme changes, oedema, pancreatitis, pruritus vulvae, retinopathy, suppression of menstruation, thrombocytopenia, tumour flare, uterine fibroids, vaginal bleeding, visual disturbances. Rare: Angioedema, bullous pemphigoid, cholestasis, fatty liver, hepatitis, hypertriglyceridaemia, interstitial pneumonitis, neutropenia, Stevens-Johnson syndrome (discontinue)