I was very fortunate that I did not suffer from nausea as a side effect. I did, however, suffer from retinal crystalline deposits which my optometrist thinks may be due to the tamoxifen. I have a retinal consult next month and my onc took me off tamoxifen and put me on letrozole. I am also hoping to research a bit more because the potential side effects of these medications really concern me. So far I am not feeling any adverse effects but I have only been on it for two weeks. My recommendation would be to try and take with food in the morning, that is what I did and never had any issues with nausea.