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Exposure to N-desmethyl tamoxifen was comparable between the pediatric and adult patients. The safety and efficacy of Nolvadex for girls aged two to 10 years with McCune-Albright Syndrome and precocious puberty have not been studied beyond one year of treatment. The long-term effects of Nolvadex therapy in girls have not been established. The clinical significance of these in vitro studies is unknown. Aminoglutethimide reduces Clomid and N-desmethyl tamoxifen plasma concentrations. Medroxyprogesterone reduces plasma concentrations Clomid pills N-desmethyl, but not tamoxifen. Nolvadex should not be co-administered with anastrozole.