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Toremifene (Fareston) is a medication that requires careful consideration due to its potential risks and necessary precautions. Below is a summary of important safety information and warnings to help ensure its safe use.

• Heart Rhythm Concerns: Toremifene may lead to serious heart rhythm issues, such as QT prolongation, which can be life-threatening. This risk is higher if you have existing heart conditions, low potassium or magnesium levels, or are taking other medications that affect heart rhythm. Regular monitoring of heart function and electrolyte levels by your healthcare provider is essential. Seek immediate medical help if you notice symptoms like an irregular heartbeat, severe dizziness, fainting, or seizures.

• Liver Health: Some individuals may experience liver problems while taking toremifene, including hepatitis or jaundice. Your healthcare provider will monitor your liver function through lab tests. Inform them if you experience symptoms like loss of appetite, nausea, stomach pain, dark urine, or yellowing of the skin and eyes.

• Tumor Flare: In cases where cancer has spread to the bones, toremifene can cause a temporary increase in tumor size, known as a tumor flare, usually within the first few weeks of treatment. This may cause muscle pain or skin redness, and elevated calcium levels. Your provider will monitor these symptoms and may adjust treatment if necessary.

• Uterine Health Risks: Toremifene can increase the risk of endometrial cancer and other uterine issues. Regular gynecological examinations are recommended. Report any abnormal vaginal bleeding, discharge, or pelvic pain to your healthcare provider promptly.

• Blood Clots: This medication may elevate the risk of blood clots, especially in individuals with a history of clots, older age, or those who are immobile. Symptoms can include leg swelling, warmth, or tenderness, and more severe cases may lead to breathing difficulties or chest pain. Immediate medical attention is necessary if these symptoms occur.

• Pregnancy Precautions: Animal studies suggest that toremifene can harm an unborn baby. Women who can become pregnant should use non-hormonal birth control methods and inform their healthcare provider immediately if pregnancy occurs while on this medication.

• Contraindications: Avoid using toremifene if you have heart rhythm disorders (such as QT syndrome), low potassium, or low magnesium levels, as these conditions could pose serious health risks.

Consult with your healthcare provider for personalized advice and to address any concerns regarding the use of toremifene. Always inform them of all medications and supplements you are taking to avoid potential interactions.

Common side effects:

• Hot flashes
• Sweating
• Nausea
• Vaginal discharge
• Cataracts
• Dry eyes

Less common but important to monitor:

• Dizziness
• Changes in vision
• Swelling
• Vomiting

Serious side effects:

• Blood clots
• Abnormal heart rhythms
• Uterine cancer
• Serious allergic reactions

Toremifene (Fareston) can interact with various medications and supplements. It's crucial to inform your doctor and pharmacist about all the medications and supplements you are taking, including both prescription and over-the-counter drugs, as well as vitamins and herbal products.

Certain medications should not be used with Toremifene. These include Bepridil, Cisapride, Dronedarone, Fluconazole, Ketoconazole, Mesoridazine, Nelfinavir, Pimozide, Piperaquine, Posaconazole, Saquinavir, Sparfloxacin, Terfenadine, Thioridazine, and Ziprasidone. Your doctor may choose different treatments if these medications are part of your regimen.

Additionally, there are drugs that usually should not be combined with Toremifene unless necessary, in which case your doctor might adjust the dosage or frequency of one or both drugs. These drugs include, but are not limited to, Alfuzosin, Amiodarone, various antidepressants and antipsychotics, some antibiotics like Clarithromycin and Erythromycin, and other medications that can affect heart rhythm or interact with Toremifene's metabolism.

Toremifene can also be affected by medications that alter its elimination from the body, potentially impacting its effectiveness. These include azole antifungals (like ketoconazole), rifamycins, seizure medications (such as Carbamazepine, Phenytoin, Phenobarbital), and St. John's Wort. Always discuss with your healthcare provider before making any changes to your medication regimen.