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Fareston Generic Name & Formulations
Legal Class
Rx
General Description
Toremifene (as citrate) 60mg; tabs.
Pharmacological Class
Nonsteroidal antiestrogen.
How Supplied
Tabs—30, 100
Manufacturer
Fareston Indications
Indications
Metastatic breast cancer in postmenopausal women with estrogen-receptor positive or unknown tumors.
Fareston Dosage and Administration
Adult
60mg once daily. Continue until disease progression is observed.
Children
Not applicable.
Fareston Contraindications
Contraindications
Congenital/acquired QT prolongation. Uncorrected hypokalemia or hypomagnesemia.
Fareston Boxed Warnings
Boxed Warning
QT prolongation.
Fareston Warnings/Precautions
Warnings/Precautions
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.
Fareston Pharmacokinetics
See Literature
Fareston Interactions
Interactions
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.
Fareston Adverse Reactions
Adverse Reactions
Hot flashes, sweating, nausea, vaginal discharge, dizziness, edema, vomiting, vaginal bleeding; Torsade de pointes, hepatotoxicity, hypercalcemia, tumor flare, endometrial hyperplasia; rare: leukopenia, thrombocytopenia.
Fareston Clinical Trials
See Literature
Fareston Note
Not Applicable
Fareston Patient Counseling
See Literature
