Toremifene - oral

Toremifene is used to treat metastatic breast cancer (tumour that has spread from the place it first started to another parts of the body). It is given to those who no longer have menstrual periods.

This medicine may be used to treat other conditions as decided by your doctor.

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
- abnormal growth or thickening of the lining of the uterus
- severe blood clot disorder
- severe liver disease
- heart disease
- low potassium level in the blood
- low magnesium level in the blood
as Toremifene may not be suitable for you.

Inform your doctor if you the following conditions:

- liver disease
- blood clot disorder

Let your doctor know if you are pregnant or breastfeeding.

For as long as you are taking Toremifene, you will need to have regular tests for blood count, liver function, calcium and magnesium concentration and an ECG (a recording of electrical activity of the heart) to check your body's response to the medicine. Your doctor will advise you about how often you will need to have these tests.

Toremifene may cause dizziness or some problems with your eyesight. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

Other side effects include any of the following: excessive sweating, hot flushes, nausea and unusual vaginal discharge.

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

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
- antibiotics e.g. erythromycin, moxifloxacin, pentamidine
- medicines for malaria e.g. halofantrine
- medicines for fungal infections e.g. ketoconazole
- medicines for tuberculosis (TB) e.g. rifampicin
- medicines for irregular or abnormal heartbeat e.g. quinidine, hydroquinidine, disopyramide, amiodarone, sotalol
- medicines for mood disorder e.g. pimozide, sertindole, haloperidol, sultopride
- medicines for allergies e.g. terfenadine, astemizole, mizolastine

This list does 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 alcohol.

Avoid excessive consumption (more than 1 litre a day) of grapefruit juice.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.

As this 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.