(E,Z)-4-Hydroxytamoxifen is a mixture of cis- and trans-isomers of 4-hydroxytamoxifen. 4-Hydroxytamoxifen is the active metabolite of tamoxifen, a selective estrogen receptor modulator (SERM) that acts as an agonist or antagonist in various tissues. 4-Hydroxytamoxifen exhibits anticancer chemotherapeutic activity, inducing autophagy and vacuole formation as well as KRAS degradation in various cancer cell lines. In cardiac myocytes, 4-hydroxytamoxifen decreases Ca2+ amplitude, slowing relaxation and decreasing contractility.
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