Tamoxifen and clotting risks in a COVID world

greenie

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.

pupmom

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

flashlight

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.

gb2115

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.