Which antidepressants are important to be aware of with patients on tamoxifen (Nolvadex)?

The principle behind using specific antidepressants with caution in patients taking tamoxifen is relative to the metabolite endoxifen, which has a significant role in the anticancer effects of tamoxifen and is metabolized via the CYP2D6 pathway. Certain antidepressants, which also metabolize through the CYP2D6 pathway, have the potential to inhibit the efficacy of tamoxifen if taken concomitantly. Limited data support the risks or benefits of utilizing strong CYP2D6 inhibitors with tamoxifen, but caution is highly recommended when strong CYP2D6 inhibitors such as fluoxetine, paroxetine, and bupropion are administered concomitantly with tamoxifen (Clin Oncol. 2011;6[2]:8) — Jiajoyce R. Conway, DNP, FNP-BC, NP-C

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