What is Toremifene
Toremifene is an oral nonsteroidal antiestrogen for the treatment of metastatic breast cancer in postmenopausal women.
It is a derivative of tamoxifen, which is also an antiestrogen. Toremifene is as effective as tamoxifen in treating metastatic breast cancer;
cross-resistance has been suggested.
Toremifene may also have a more favorable effect on lipid levels than tamoxifen. In one study, toremifene increased high-density lipoprotein (HDL) cholesterol serum concentrations whereas tamoxifen decreased HDL cholesterol serum concentrations.
Toremifene has been associated with QT prolongation, and is contraindicated in patients with congenital/acquired QT prolongation (long QT syndrome), uncorrected hypokalemia, or uncorrected hypomagnesemia.
The most common adverse reactions are hot flashes, sweating, nausea and vaginal discharge.
Brand Name
Fareston
Indications
- breast cancer
For the treatment of metastatic breast cancer in postmenopausal women with estrogen-receptor positive tumors or with tumors of unknown estrogen-receptor status
Side Effects
- alopecia
- angina
- anorexia
- arrhythmia exacerbation
- asthenia
- ataxia
- blurred vision
- cataracts
- constipation
- corneal opacification
- depression
- diaphoresis
- diplopia
- dizziness
- dyspnea
- edema
- elevated hepatic enzymes
- endometrial hyperplasia
- erythema
- fatigue
- heart failure
- hepatitis
- hot flashes
- hyperbilirubinemia
- hypercalcemia
- jaundice
- keratopathy
- lethargy
- leukopenia
- musculoskeletal pain
- myocardial infarction
- nausea
- paresis
- phlebitis
- pruritus
- pulmonary embolism
- QT prolongation
- skin discoloration
- stroke
- thrombocytopenia
- thrombosis
- tremor
- vaginal bleeding
- vaginal discharge
- vertigo
- visual impairment
- vomiting
- xerophthalmia
Monitoring Parameters
- CBC
- ECG
- LFTs
- serum calcium
- serum magnesium
- serum potassium
Contraindications
- alcoholism
- bradycardia
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- contraception requirements
- coronary artery disease
- diabetes mellitus
- electrolyte imbalance
- endometrial cancer
- endometrial hyperplasia
- females
- geriatric
- heart failure
- hepatic disease
- hepatitis
- hepatotoxicity
- hypercalcemia
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- infertility
- leukopenia
- long QT syndrome
- malnutrition
- myocardial infarction
- pregnancy
- QT prolongation
- reproductive risk
- thrombocytopenia
- thromboembolic disease
- thyroid disease
Interactions
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfuzosin
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Anagrelide
- Apalutamide
- Apomorphine
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azithromycin
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Carbamazepine
- Ceritinib
- Chloramphenicol
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Cobicistat
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Conivaptan
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Crizotinib
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Degarelix
- Delavirdine
- Desipramine
- Deutetrabenazine
- Dexamethasone
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diclofenac
- Diclofenac; Misoprostol
- Dienogest; Estradiol valerate
- Diethylstilbestrol, DES
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronabinol
- Dronedarone
- Droperidol
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix; Estradiol; Norethindrone acetate
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Entrectinib
- Enzalutamide
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estrogens
- Estropipate
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etravirine
- Ezogabine
- Fingolimod
- Flecainide
- Fluconazole
- Fluoroestradiol F 18
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Fosamprenavir
- Foscarnet
- Fosphenytoin
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glyburide
- Glyburide; Metformin
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- grapefruit juice
- Halogenated Anesthetics
- Haloperidol
- Histrelin
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Idelalisib
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indinavir
- Inotuzumab Ozogamicin
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Letermovir
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levofloxacin
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Macimorelin
- Maprotiline
- Mefloquine
- Meloxicam
- Meperidine; Promethazine
- Mephobarbital
- Mestranol; Norethindrone
- Metaproterenol
- Methadone
- Metronidazole
- Midostaurin
- Mifepristone
- Mirtazapine
- Mitotane
- Moxifloxacin
- Nateglinide
- Nefazodone
- Nelfinavir
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Ondansetron
- Osilodrostat
- Osimertinib
- Ospemifene
- Oxaliplatin
- Ozanimod
- Paliperidone
- Panobinostat
- Pasireotide
- Pazopanib
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phenylephrine; Promethazine
- Phenytoin
- Pimavanserin
- Pimozide
- Pirbuterol
- Pitolisant
- Posaconazole
- Primaquine
- Primidone
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rilpivirine
- Risperidone
- Ritonavir
- Romidepsin
- Salmeterol
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selpercatinib
- Sertraline
- Short-acting beta-agonists
- Siponimod
- Solifenacin
- Sorafenib
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Sugammadex
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telavancin
- Telithromycin
- Terbutaline
- Tetrabenazine
- Thiazide diuretics
- Thioridazine
- Tiotropium; Olodaterol
- Tipranavir
- Tolterodine
- Torsemide
- Trazodone
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Triptorelin
- Tucatinib
- Umeclidinium; Vilanterol
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Voriconazole
- Vorinostat
- Warfarin
- Ziprasidone
