Toremifene Citrate, Oral

Type of medicine: antineoplastic (anticancer)

Generic and brand names: toremifene citrate, oral; Fareston

This medicine is taken by mouth to treat breast cancer in women who have permanently stopped having monthly periods.

Before taking this medicine, tell your health care provider if you have ever had:

• an allergic reaction to any medicine
• a blood clot in your legs or lungs
• a stroke
• abnormal vaginal bleeding
• bleeding problems or blood disorders
• liver disease.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your health care provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your health care provider right away. Do not breast-feed while you are receiving this medicine.

Take this medicine exactly as your health care provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your health care provider's approval.

You may take this medicine with or without food. Take it with water at the same time each day.

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take a double dose the next day. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your health care provider.

This medicine may increase your risk for blood clots.

If this medicine causes vaginal bleeding or if your vision changes, contact your health care provider.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

You will need to have blood tests regularly to find out how this medicine affects you. Keep all your appointments.

You may have increased bone pain and hot flashes when you first start taking this medicine. These should get better as your body adjusts to the medicine.

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or get worse.

Serious (report these to your health care provider right away): Depression, fatigue, confusion, loss of appetite, nausea, vomiting, constipation, increased urination, irregular or rapid heartbeat, vaginal bleeding, chest pain, shortness of breath, vision changes, dark yellow or brown urine, unusual bleeding or bruising, yellowing of the eyes or skin.

Other: Hot flashes, sweating, vaginal discharge, dizziness, swelling in your ankles or feet, bone pain, dry eyes.

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your health care provider if you are taking:

• antibiotics such as erythromycin (Erythrocin, E.E.S., Ilosone, Pediazole, EryPed), troleandomycin (Tao), and clarithromycin (Biaxin)
• antifungals such as ketoconazole (Nizoral), fluconazole (Diflucan), clotrimazole (Mycelex), itraconazole (Sporanox), and miconazole (Monistat, Micatin)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, and phenytoin (Dilantin)
• diuretics such as hydrochlorothiazide (Esidrix), chlorothiazide (Diuril), and chlorthalidone (Thalitone)
• warfarin (Coumadin).

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your health care provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.