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Topic: Tamoxifen and clotting risks in a COVID world

Forum: All things COVID-19 or coronavirus —

A place to discuss the impact of COVID-19 (Coronavirus) on you and the ones you love.

Posted on: May 16, 2020 11:14AM - edited May 16, 2020 11:16AM by greenie

greenie wrote:

Given that tamoxifen carries with it an increased risk of developing blood clots and pulmonary embolism, I'm wondering what conversations anyone here has had regarding the risk of getting COVID while on Tamoxifen.

BBC is reporting today that 1 in 3 COVID patients develop dangerous blood clots. Coming in to that while taking tamoxifen, which has a relative risk for pulmonary embolism of 3.5 during the first two years of taking tamoxifen and 2.4 overall, must pose some increased risk. I'm just wondering what discussions folks here are having with their providers about this combined risk.

BACKGROUND on how tamoxifen increases risk:
2008 study in England reported that: The effects of tamoxifen on coagulant levels were significant and complex; tamoxifen significantly decreased levels of protein C and the anticoagulant ATIII, which investigators theorized might "explain the increased risk of deep vein thrombosis observed with this drug." The agent also caused a significant increase in protein S free.

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May 16, 2020 11:24AM pupmom wrote:

That's a very scary thought. I have one more year on it, but will discuss at my next ONC meeting.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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May 17, 2020 08:51AM flashlight wrote:

HI greenie, I just had surgery this past Feb. I had asked my MO if I should stop Tamoxifen before and after due to blood clots. He said no he felt it wasn't an issue and didn't want me to stop taking it. My NP said to make sure I was getting up and was walking around as much as possible. I still didn't feel comfortable with the chance so I did stop it for about 6 weeks. I do not have any history of blood clots. I feel a DVT would be more easily diagnosed than a pulmonary embolism which would need prompt treatment. I'm not worried about blood clots at this time while taking Tamoxifen. I still take a vitamin E supplement rather than aspirin.

Dx 11/15/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR-, HER2- Dx DCIS, Left, <1cm, Stage 0, Grade 1, 0/1 nodes Radiation Therapy Whole-breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lumpectomy: Left
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May 17, 2020 10:47AM gb2115 wrote:

I've thought about this, and figure the big risk is if you are out of it on a vent. In that case they would probably have you on clot prophylaxis. If you just are sick at home, you would know you still need to move around every couple of hours.

Dx IDC in Oct 2016, stage 2A, 1.2 cm ER/PR+ Her2-, Grade 2, 1/3 nodes, Lumpectomy + rads + tam. Age 38. 5/21 Dx IDC. 1.6 cm ER/PR+, Her2 -. Gr 2. 2/2 nodes positive. AC/T. Age 42

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