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Tamoxifen has rarely caused very serious (possibly fatal) strokes, blood clots in the lungs/legs, and cancer of the uterus. If you are taking tamoxifen to reduce the risk of breast cancer, or if your cancer is limited to the milk ducts (ductal carcinoma in situ-DCIS), then discuss the benefits and risks of taking this medication with your doctor. However, if you are taking tamoxifen to treat breast cancer, then the benefits of taking tamoxifen are greater than the risks of side effects. Get medical help right away if you develop symptoms of a stroke or blood clots in the lungs/legs, such as weakness on one side of the body, trouble speaking, sudden vision changes, confusion, shortness of breath, chest pain, or calf pain/swelling. Tell your doctor right away if you develop symptoms of cancer of the uterus, such as unusual changes in your monthly period (such as the amount or timing of bleeding), unusual vaginal discharge, or pain/pressure below your "belly button" (navel).

Hot flashes, nausea, leg cramps, muscle aches, hair thinning, headache, and numb/tingling skin may occur. A loss of sexual ability/interest may occur in men. If these effects last or get worse, tell your doctor promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: vision changes (such as blurred vision), eye pain, easy bruising/bleeding, mental/mood changes, swelling of ankles/feet, unusual tiredness, signs of infection (such as sore throat that doesn't go away, fever), signs of liver disease (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine). A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Some products that may interact with this drug are: anastrozole, "blood thinners" (such as warfarin), estrogens, letrozole, hormonal forms of birth control (such as birth control pills, patches, implants), ribociclib. Other medications can affect the removal of tamoxifen from your body, which may affect how tamoxifen works. Examples include butalbital, cimetidine, mitotane, rifamycins (such as rifampin), secobarbital, SSRI antidepressants (such as fluoxetine, paroxetine), St. John's wort, drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin, primidone), among others. This medication may interfere with certain lab tests (such as thyroid tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.