tamoxifen metabolite
What it is4-hydroxy-N-desmethyltamoxifen, formed by CYP2D6, roughly a hundred times more potent at the estrogen receptor than tamoxifen.
Why it mattersIt is the species that actually does the work — tamoxifen itself is nearly inactive.
What it changesThis is why CYP2D6 poor metabolizers and strong CYP2D6 inhibitors such as fluoxetine and paroxetine blunt tamoxifen’s benefit.
NO BOXED WARNINGS
Principal riskLittle in its own right; see the parent drug
