Toremifene is used to treat a certain type of breast cancer that has spread to other parts of the body in women who have had their menopause.
Take Toremifene exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Toremifene must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor or pharmacist know.
Alert your doctor if you have the following conditions:
- heart rhythm disorder e.g. slow or irregular heartbeat
- heart failure
- abnormal growth or thickening of the lining of the uterus
- severe blood clot disorder
- severe liver disease
- electrolyte problems e.g. low potassium or magnesium level in the blood
as Toremifene may not be suitable for you.
Do not take Toremifene with medicines that may affect the heart rhythm. Please see the section Can I take this with other medicines? below for more information.
Inform your doctor if you have the following conditions:
- high blood pressure
- any other heart conditions e.g. severe chest pain
- if your cancer has spread to the bones
- mild to moderate liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Toremifene to the elderly. Elderly people may be more sensitive to the side effects.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver function, electrolyte levels, pelvic examination, blood tests) may be done while you are being treated with this medicine.
- Your doctor may also request an ECG before and during treatment.
- Regular monitoring of signs and symptoms of vaginal problems, blood clot disorders, heart problems, and changes in vision may also be needed.
Your doctor will advise you about how often you need to have these tests.
Toremifene may cause any of the following side effects: dizziness, nausea, vomiting, tiredness, hot flushes, unusual sweating, itching, rash, and vision problems.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- shortness of breath or sudden chest pain
- weakness, confusion, bone pain
- unusual vaginal bleeding or discharge, pelvic pain or pressure
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, swelling in the legs and ankles
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Toremifene with the following medicines:
- medicines for irregular heartbeat e.g. quinidine, amiodarone
- certain antibiotics e.g. moxifloxacin, erythromycin (infusion)
- certain medicines for malaria e.g. halofantrine
- certain medicines for cold or allergy e.g. terfenadine, astemizole, mizolastine
- medicines for mood disorders e.g. haloperidol, sertindole, pimozide
- certain medicines to treat depression e.g. amitriptyline, venlafaxine
- certain medicines for nausea and vomiting e.g. ondansetron, granisetron
- cisapride (medicine for stomach problems)
- bepridil (medicine for high blood pressure or chest pain)
Inform your doctor and pharmacist if you are taking any of these medicines:
- blood-thinning medicines e.g. warfarin
- medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenytoin, phenobarbital
- medicines for fungal infections e.g. itraconazole
- water pills or medicines for water retention e.g. hydrochlorothiazide
- medicines for HIV infection e.g. atazanavir, ritonavir
- certain antibiotics e.g. clarithromycin
- nefazodone (medicine to treat depression)
These lists do not include all medicines that may interact with Toremifene.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid excessive consumption of grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Protect from light and heat.
Medicines must not be used past the expiry date.
As Toremifene is a cancer medicine, always return any unused or expired tablets to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.