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Why is Fareston prescribed?

Fareston (Toremifene) works by blocking the effects of estrogen on metastatic hormone receptor-positive breast cancer cells. It does this by binding to the estrogen receptors on the cells, preventing estrogen from attaching to the cancer cell. As a result, the cancer cell doesn't receive the signals from estrogen to grow and multiply.

Fareston is not effective for hormone receptor-negative breast cancer.

What does it do?

Toremifene blocks the activity of estrogen in certain tissues. It is believed to work by binding to estrogen receptors, thereby preventing the growth of breast tissue that relies on estrogen for growth.

How should I take it?

Take Fareston exactly as prescribed by your doctor with a usual dose of one tablet a day. Do not use more of it, take it more frequently, or use it for a longer period than directed by your doctor. Avoid eating or drinking grapefruit while using this medicine.

What if I missed a dose?

If you miss Fareston, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once.

What are the special precautions before taking Fareston?

Inform your doctor about all the medications you are taking, your current and previous medical history.

Other medical conditions may impact the use of this medication. Be sure to inform your doctor if you have any other health issues, especially:

• Bone problems (e.g., bone cancer)
• Congestive heart failure
• Heart rhythm issues (e.g., QT prolongation)
• Blood clots or a history of blood clots—Use is generally not recommended for individuals with this condition.
• Leukopenia (low white blood cell count) or thrombocytopenia (low platelet count)—Use with caution, as these conditions may worsen.
• Heart rhythm disorders (e.g., congenital or acquired long QT syndrome)
• Uncorrected hypokalemia (low potassium) or hypomagnesemia (low magnesium)—This medication should not be used in individuals with these conditions.
• Unusual growth of the uterine lining—Long-term use of toremifene is generally not recommended in these cases.
• Liver disease (e.g., Cirrhosis)—Use with caution, as the medication may stay in the body longer due to slower removal.

This medication may cause vaginal bleeding, particularly when you first begin using it. If the bleeding persists or becomes concerning, contact your doctor. It may also increase the risk of uterine issues, including endometrial cancer. If you have any concerns about this, speak with your doctor.

Does it have any side effects?

Like most breast cancer treatments, Fareston can cause side effects, some of which may be serious.

Common side effects may include:
• Hot flashes
• Sweating
• Nausea
• Vaginal discharge

Serious side effects may include:

QT prolongation, which can affect your heart's rhythm. Contact your doctor immediately if you experience:

• Chest pain
• Dizziness or fainting
• Shortness of breath
• Heart fluttering or palpitations
• Lightheadedness that comes and goes
• Seizures

This document does not cover all possible side effects, and other effects may occur. Speak with your doctor for more information about potential side effects.

Is it safe to take it with another drug?

Always inform your healthcare provider about any prescription or over-the-counter medications, and other supplements you are taking.

In particular, discuss with your doctor if you are using any of the following before taking Toremifene:

• Antifungals (e.g., Ketoconazole)
• Nefazodone (for depression)
• Antiarrhythmic drugs (e.g., Quinidine)
• Antibiotics (e.g., Clarithromycin)
• Seizure medications (e.g., Carbamazepine)
• Dexamethasone (for inflammatory conditions)
• Anti-nausea medications (e.g., Ondansetron)
• Medications that can cause QT prolongation (e.g., Venlafaxine)
• St. John’s Wort (for depression)
• Rifampin or rifabutin (used for tuberculosis or infections)
• Protease inhibitors (e.g., Ritonavir) used for HIV
• Thiazide diuretics (e.g., Hydrochlorothiazide) for blood pressure
• Warfarin (a blood thinner)

Other medications may also interact with toremifene, affecting its blood levels and vice versa. Always have a list of all medications you are currently taking or have recently used.

This list may not cover all possible interactions. Always consult your doctor for more details.

How should I store it?

Store the medication in a sealed container at room temperature, and keep it out of reach of children.

What action should I take in case of overdose?

If you or someone else has taken too much Toremifene, seek medical assistance immediately and you may experience vertigo and headaches.

Is it safe for pregnant or breastfeeding women?

Fareston should only be used during pregnancy if prescribed by your doctor, as it may harm the fetus. If you become pregnant or suspect you might be pregnant, notify your doctor immediately. Women taking this medication should use two forms of birth control. Be sure to discuss birth control options, as well as the risks and benefits of this medication, with your doctor.

It is unknown whether this medication passes into breast milk, and due to potential risks to the infant, breastfeeding is not recommended while using this drug.

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