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.
Endocrinology Advisor Articles
- Use of In-Hospital Continuous Subcutaneous Insulin Infusion: A Consensus Statement
- Better Control With DPP-4 Inhibitors vs NPH Insulin in Type 2 Diabetes
- Achieving Glycemic Control in T2D After Basal Insulin Initiation
- Osteoporosis Drug Shows Cardioprotective Potential at 10-Year Follow-Up
- Effects of the Two Types of Anorexia Nervosa on Bone Metabolism
- Diabetes Treatments
- Incretins, Thiazolidinediones Associated With Better Glycemic Control in T2D
- No Link Between HbA1c Levels and Wound Healing in Patients With Diabetic Foot Ulcers
- Risk for Fetal Loss Early in Pregnancy Not Greater With Noninsulin vs Insulin Therapy
- Risk for Iodine Deficiency and Hypothyroidism High in Children on Parenteral Nutrition
- Inverse Association Between Serum 25(OH)D Levels and Risk for Diabetes
- Glycemic Control Variations for Children, Adolescents With T1D in High-Income Countries
- Late-Life Mobility Limitations Linked to Obesity After Arthroplasty for OA in Women
- Fracture Risk Should Be Monitored in Bisphosphonate Drug Holiday
- Provider Counseling for Weight Loss Up for Arthritis, Overweight