What is the most important information I should know about toremifene?
You should not use toremifene if you have a history of long QT syndrome, or low levels of potassium or magnesium in your blood.
Toremifene can cause a life-threatening heart rhythm disorder. Stop using toremifene and call your doctor at once if you have: headache with chest pain and severe dizziness, fainting, and fast or pounding heartbeats.
What is toremifene?
Toremifene blocks estrogen from reaching cancer cells. Certain types of breast cancer require estrogen to grow.
Toremifene is used in postmenopausal women to treat metastatic breast cancer (cancer that has spread to other parts of the body).
Toremifene may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking toremifene?
You should not use toremifene if you are allergic to it, or if you have:
- long QT syndrome; or
- an uncontrolled electrolyte imbalance (low levels of potassium or magnesium in your blood).
To make sure toremifene is safe for you, tell your doctor if you have ever had:
- high levels of calcium in your blood (hypercalcemia);
- endometrial hyperplasia (overgrowth of cells lining the uterus);
- a family history of long QT syndrome;
- bone cancer; or
- if you have ever had a blood clot.
Taking toremifene may increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Talk to your doctor about your individual risk.
This medicine is for use only in women who can no longer get pregnant. Toremifene can harm an unborn baby. Do not use if you are pregnant. Use effective birth control if you are not past menopause. Tell your doctor if you think you may be pregnant.
Use a barrier form of birth control (condom or diaphragm with spermicide). Hormonal contraception (birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.
It is not known whether toremifene passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How should I take toremifene?
Your doctor may perform a pelvic exam to make sure you do not have conditions that would prevent you from safely using toremifene.
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
You may take toremifene with or without food. Take the medicine at the same time each day.
While using toremifene, you may need frequent blood tests. Your liver function may also need to be checked.
Store at room temperature away from moisture, heat, and light.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking toremifene?
Grapefruit and grapefruit juice may interact with toremifene and lead to unwanted side effects. Avoid the use of grapefruit products while taking toremifene.
Avoid taking an herbal supplement containing St. John's wort at the same time you are taking toremifene.
This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
What are the possible side effects of toremifene?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Toremifene can cause a life-threatening heart rhythm disorder. Stop using toremifene and call your doctor at once if you have:
- headache with chest pain and severe dizziness;
- a light-headed feeling, like you might pass out;
- seizure (convulsions); or
- fast or pounding heartbeats.
Also call your doctor at once if you have:
- pelvic pain, abnormal vaginal bleeding;
- slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);
- blurred vision, tunnel vision, eye pain, or seeing halos around lights;
-
heart attack symptoms --chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
-
high levels of calcium in your blood --nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, tired feeling;
-
liver problems --loss of appetite, upper stomach pain, tiredness, easy bruising or bleeding, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
-
signs of a blood clot --sudden numbness or weakness (especially on one side of the body), severe headache, slurred speech, problems with vision or balance, chest pain, wheezing, coughing up blood.
Common side effects may include:
- sweating, hot flashes;
- nausea; or
- vaginal discharge.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect toremifene?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Toremifene can cause a serious heart problem, especially if you use certain medicines at the same time, such as antibiotics, antifungal medicine, antidepressants, anti-malaria medicine, asthma inhalers, antipsychotic medicine, cancer medicine, certain HIV/AIDS medicine, heart or blood pressure medicine, or medicine to prevent vomiting. Tell your doctor about all your current medicines and any medicine you start or stop using.
Many other drugs can interact with toremifene. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Where can I get more information?
Your pharmacist can provide more information about toremifene.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2018 Cerner Multum, Inc. Version: 10.01. Revision date: 6/5/2017.
