Toremifene

Registered South African indications:

• Hormone-dependent metastatic breast cancer in postmenopausal patients

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Pregnancy
• Breastfeeding
• Severe hepatic impairment
• Pre-existing endometrial hyperplasia
• History of severe thromboembolic disease

Cautions

• Mild to moderate hepatic impairment
• Elderly
• Hypertension 
• Diabetes
• High BMI (> 30) 
• History of hormone replacement therapy
• History of severe thromboembolic disease 
• Ongoing proarrhythmic conditions
• Non-compensated cardiac insufficiency 
• Severe angina pectoris 
• Bone metastasis 
• Labile diabetes
• Severely altered performance status 
• Cardiac failure
• Galactose intolerance
• Lapp lactase deficiency 
• Glucose-galactose malabsorption

Forms avail. in SA and covered in this monograph: tab

Used for the treatment of

Hormone-dependent metastatic breast cancer in postmenopausal patients
- As first line treatment

Consult specialist for dosages and regimens

Not indicated for use in children

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• Mild to moderate: Caution; no dose adjustment recommended
• Severe: Contraindicated 

Elderly            

• Caution; no dose adjustment recommended

Central Nervous System Disorders

• Dizziness
• Headache
• Depression
• Insomnia
• Fatigue

Cardiovascular Disorders

• Hot flushes
• Thromboembolic events

Respiratory Disorders

• Dyspnoea

Gastrointestinal Disorders

• Nausea and vomiting
• Constipation

Hepatobiliary Disorders

• Increase of transaminases
• Jaundice
• Hepatitis

Genitourinary Disorders

• Uterine bleeding leukorrhea
• Endometrial hypertrophy
• Endometrial polyps
• Endometrial hyperplasia

Endocrine and Metabolic Disorders

• Loss of appetite
• Increased weight 

Skin and Subcutaneous Tissue Disorders

• Sweating
• Rash
• Itching
• Alopecia
• Oedema

Immune, Blood and Lymphatic System Disorders

• Endometrial cancer
• Thrombocytopenia
• Anaemia 
• Leukopenia

Sensory Disorders

• Transient corneal opacity
• Vertigo

• QT prolonging agents
• Agents which decrease renal calcium excretion
• Enzyme inducers
• Warfarin 
• CYP3A enzyme  inhibitors

• Gynaecological examination
• Full blood count with differential
• ECG
• Electrolytes
• Hepatic function

Toremifene is a nonsteroidal triphenylethylene derivative. Toremifene binds specifically to estrogen receptors, competitively with oestradiol, and inhibits estrogen-induced stimulation of DNA synthesis and cell replication.

Tablet 60mg

• Fareston (MSD) originator