Generic Name and Formulations:
Toremifene (as citrate) 60mg; tabs.
Kyowa Kirin, Inc.
Indications for FARESTON:
Metastatic breast cancer in postmenopausal women with estrogen-receptor positive or unknown tumors.
60mg once daily. Continue until disease progression is observed.
Congenital/acquired QT prolongation. Uncorrected hypokalemia or hypomagnesemia.
Avoid in long QT syndrome. CHF. Hepatic impairment. Electrolyte abnormalities. Correct hypokalemia or hypomagnesemia prior to initiation; monitor periodically during therapy. Pre-existing endometrial hyperplasia; long-term therapy not established. Do baseline and annual gynecological exam; esp. monitor those at high risk of endometrial cancer. History of thromboembolic disease: not recommended. Bone metastases; monitor for hypercalcemia during first weeks of treatment, discontinue if severe. Leukopenia, thrombocytopenia; obtain leukocyte and platelet counts. Monitor CBCs, ECGs, calcium levels, liver function tests periodically. Pregnancy (Cat.D). Females of reproductive potential should use effective non-hormonal contraception. Nursing mothers: not recommended.
Caution with drugs that decrease renal calcium excretions (eg, thiazide diuretics). Avoid concomitant with drugs that prolong QT interval including Class 1A (eg, quinidine, procainamide, disopyramide) and Class III (eg, amiodarone, sotalol, ibutilide, dofetilide) antiarrhythmics, certain antipsychotics (eg, thioridazine, haloperidol), certain antidepressants (eg, venlafaxine, amitriptyline), certain antibiotics (eg, erythromycin, clarithromycin, levofloxacin, ofloxacin), certain anti-emetics (eg, ondansetron, granisetron); if needed, interrupt toremifene therapy; if interruption not possible, then monitor closely. Potentiated by strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole). Avoid grapefruit juice. Antagonized by strong CYP3A4 inducers (eg, dexamethasone, phenobarbital, phenytoin, carbamazepine, rifampin, rifabutin, St. John's Wort). Caution with concomitant CYP2C9 substrates with a narrow therapeutic index (eg, warfarin, phenytoin); monitor.
Hot flashes, sweating, nausea, vaginal discharge, dizziness, edema, vomiting, vaginal bleeding; Torsade de pointes, hepatotoxicity, hypercalcemia, tumor flare, endometrial hyperplasia; rare: leukopenia, thrombocytopenia.
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Adjunctive Therapies for Bipolar Disorder Show Promise, Need More Evidence
- Predicting Treatment-Emergent Mania to Tailor Pharmacotherapy in Bipolar Disorder
- Abnormalities of Cortical Thickness in Bipolar Disorder With Auditory Hallucinations
- Prevalence of ADHD Relatively Stable Over Time Despite Increase in Diagnoses
- Prevalence of Major Depressive Disorder Remains High In US Population
- The Way to the Head May Be Through the Gut: Probiotics for Depression
- Suicide-Screening Toolkit Can Help Identify Youths at High Risk for Suicide
- Agoraphobia: An Evolving Understanding of Definitions and Treatment
- Parental Pressure to Diet Linked With Long-term Harm in Adolescents
- Does Access to Medical Cannabis Reduce Risk for Opioid Abuse?
- Evidence of Methylphenidate Abuse: Characterizing Patterns of Use in Pediatric and Adult Populations
- Intranasal Oxytocin Reduces Negative Effects, Improves Cognitive Function in Schizophrenia
- Most Patients Comfortable With Clinicians Asking About Sexual Orientation
- Peer-to-Peer Depression Awareness Program May Be Beneficial
- Examining Rates of Long-term Opioid Use in Youth With Psychiatric Disorders