The drug toremifene has the potential to cause QT prolongation, an abnormal heartbeat that can result in seizures, convulsions, and sudden death. Inform your doctor if you or anyone in your family has or has ever had long QT syndrome, a genetic condition that increases the risk of QT prolongation. Also mention low blood potassium or magnesium levels, an irregular heartbeat, heart failure, or liver disease. Inform your doctor and pharmacist if you’re using amitriptyline (Elavil), clarithromycin (Biaxin, in Prevpac), antifungal medications like ketoconazole (Nizoral), itraconazole (Sporanox), or voriconazole (Vfend), erythromycin (also known as E.E.S., E-Mycin, or Erythrocin), granisetron (also known as Kytril), haloperidol (also known as Haldol), as well as some anti-HIV or anti-AIDS drugs like atazanavir (Reyataz), indinavir (also known as Crixivan), nelfinavir (also known as Viracept),  ritonavir (Norvir, in Kaletra); the drugs amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), ibutilide (Corvert), procainamide (Procanbid, Pronestyl), along with levofloxacin (Levaquin), nefazodone, ofloxacin, ondansetron (Zofran), telithromycin (Ketek), thioridazine, and venlafaxine (Effexor), other medications include quinidine, sotalol, and betapace (Betapace, Betapace AF). Call your physician right away and stop taking toremifene if you have any of the following signs: fainting, losing consciousness, an erratic or rapid heartbeat, seizures, or any of these.

Keep all of your appointments with your physician and the lab. To monitor your body’s reaction to toremifene, your doctor will request specific lab tests. To make sure that taking toremifene is safe for you, your doctor may also request electrocardiograms (EKGs), tests that record the electrical activity of the heart, both before and during your therapy.

The dangers of using toremifene should be discussed with your doctor.

Women who have undergone menopause (the “change of life”; the cessation of monthly menstrual cycles) are treated with toremifene for breast cancer that has progressed to other regions of the body. The drug toremifene belongs to the group of drugs known as nonsteroidal antiestrogens. It functions by preventing estrogen, a feminine hormone, from acting in the breast. Some breast tumors that require estrogen to grow may have their growth halted by this.

Toremifene is available as an oral tablet. It is typically taken once day, with or without food. Take toremifene every day at roughly the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the toremifene directions exactly. Never take it in larger or less amounts or more frequently than directed by your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking toremifene,

• If you have an allergy to toremifene, any other medications, or any of the substances in toremifene tablets, let your doctor and pharmacist know right once. Request a list of the ingredients from your pharmacist.
• Inform your doctor and pharmacist about any prescription and over-the-counter drugs, vitamins, and dietary supplements you are currently taking or intend to take. Mention the drugs in the IMPORTANT WARNING section as well as any of the following: blood thinners (anticoagulants) like warfarin (Coumadin); diltiazem (Cardizem, Dilacor, Tiazac, among others); carbamazepine (Epitol, Equetro, Tegretol); cimetidine (Tagamet); clonazepam (Klonopin); dexamethasone (Decadron, Dexone); diltiazem; diuretics (‘water pills’); fluvoxamine, phenobarbital, phenytoin (Dilantin, Phenytek), rifampin (Rifadin, Rimactane), rifabutin (Mycobutin), and verapamil (Calan, Covera, Isoptin, Verelan) are some examples of these medications. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all of the medications you are taking, including any not on this list, since many other drugs may also interact with toremifene.
• In particular, mention St. John’s wort to your doctor when you use any herbal remedies.
• Inform your doctor if your cancer has spread to your bones, if you currently have or have had endometrial hyperplasia (an enlargement of the uterus’ lining), or if you have ever had any condition that makes your blood clot more easily than normal.
• If you are expecting a baby, intend to get pregnant, or are currently nursing, let your doctor know. When taking toremifene, contact your doctor if you become pregnant. The fetus might be harmed by toremifene. To avoid conception while using toremifene, women who have not yet gone through menopause should utilize a trustworthy nonhormonal method of birth control.
• Inform the surgeon or dentist that you are taking toremifene if you are undergoing surgery, including dental surgery.
• You should be aware that once you start toremifene therapy, your tumor can get a little bigger. You might feel pain in the bones and skin redness if this occurs. This is typical and does not indicate a worsening of your malignancy. Your tumor will lessen as long as you receive toremifene treatment.

While taking this medication, avoid grapefruit-related foods and beverages.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

There may be adverse consequences from toremifene. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Hot flash
• Sweating
• Weird or blurry vision
• Light sensitivity or the perception of haloes surrounding lights
• Having trouble seeing at night
• Color fade or yellowing
• Wet eyes
• Dizziness
• Edema of the lower legs, ankles, feet, or hands

Some adverse effects can be very harmful. Call your doctor right away if you have any of these signs or any of those in the IMPORTANT WARNING section:

• Uterine bleeding
• Pelvic pressure or pain
• Unusual time frames
• Strange vaginal discharge
• Sleepiness
• Confusion
• Aching or weakened muscles
• Joints hurt
• Abdomen ache
• Constipation
• Excessive urination
• Extreme thirst
• Reduced appetite
• Nausea
• Vomiting

Some people who used toremifene experienced uterine lining cancer. There is insufficient data to determine whether toremifene contributed to these individuals’ cancer development. The dangers of using this drug should be discussed with your doctor.

Other side effects of toremifene are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

Keep this medication tightly closed in the original container and out of the reach of children. It should not be kept in the bathroom. Store it at room temperature and away from light, excessive heat, and moisture.

To make sure that pets, kids, and other people cannot take leftover pharmaceuticals, they should be disposed of in a specific manner. You shouldn’t flush this medication down the toilet, though. The best option to get rid of your medication is instead through a medication take-back program. To find out about take-back initiatives in your neighborhood, speak with your pharmacist or get in touch with your city’s waste/recycling department. If you do not have access to a take-back program, you can find more information at the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p).

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose signs could include the following:

• Headache
• Nausea
• Vomiting
• Dizziness
• Hallucinations (seeing things or hearing voices that do not exist)
• Unsteadiness
• Hot flash
• Uterine bleeding

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.