A patient will begin taking tamoxifen [Nolvadex] to treat breast cancer. The nurse performs a medication history and learns that the patient is taking sertraline [Zoloft] for depression
The nurse will tell the patient to contact her provider to ask about: a. increasing her dose of sertraline.
b. changing from sertraline to escitalopram [Lexapro].
c. switching from sertraline to fluoxetine [Prozac].
d. decreasing her dose of tamoxifen.
B
Inhibitors of CYP2D6, such as sertraline, can negate the benefits of treatment with tamoxifen. Patients taking sertraline should request switching to another antidepressant, such as escitalopram. Increasing the dose of sertraline would only exacerbate the problem. Fluoxetine is similar to sertraline so changing to this drug would be incorrect. It is not correct to decrease the dose of tamoxifen.
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