Toremifene is also known as Fareston ®. It is used to treat breast cancer.
Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.
Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made or how they work in the body.
Many breast cancers rely on the hormone oestrogen to grow. This is called oestrogen-receptor positive (ER positive) breast cancer. Toremifene blocks oestrogen from reaching the cancer cells. This means the cancer may grow more slowly or stop growing altogether.
Taking toremifene tablets
Toremifene comes as tablets you can take at home. Your nurse or doctor will talk to you about your treatment plan.
Always take the tablets exactly as explained. This is important to make sure they work as well as possible for you.
You take toremifene as a tablet, usually once a day. You can take it with or without food. You take it at the same time each day, morning, or evening.
If you forget to take the tablet, you should take the next tablet as usual. Do not take a double dose. If you have missed several doses, tell your doctor or nurse.
Other things to remember about your tablets:
- Keep them in the original package and at room temperature, away from heat and direct sunlight.
- Keep them safe and out of the sight and reach of children.
- Get a new prescription before you run out of tablets, and make sure you have plenty for holidays.
- If your treatment is stopped, return any unused tablets to the pharmacist.
Your nurse or pharmacist may also give you other medicines to take home. Take all your medicines exactly as they have been explained to you. Do not stop taking any of your medicines unless your doctor tells you to.
We explain the most common side effects of this treatment here. We also include some less common side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
Hot flushes and sweats
These are a common side effect of toremifene. They may gradually lessen over the first few months, but some women continue to have them for as long as they take toremifene.
There are a number of ways to help to reduce or control hot flushes and sweats. Some women find it helpful to avoid or cut down on tea, coffee, nicotine and alcohol.
Some drugs, including low doses of some antidepressants or the hormone progesterone, may be helpful in controlling this side effect. Your nurse or doctor can discuss this with you.
Some women may find complementary therapies, such as acupuncture, help. Your GP may be able to give you details about having these on the NHS.
We have more information about treatments for menopausal symptoms like hot flushes.
Some women have a white or yellowish vaginal discharge or bleeding when on this treatment. If bleeding continues for more than a few days, tell your doctor or nurse.
Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
Fluid build-up (oedema)
You may find your ankles or fingers become swollen when taking toremifene. This is caused by a build-up of fluid, which is called oedema. It is usually mild. If you notice any swelling or puffiness, ask your nurse or doctor for advice.
This treatment may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. The treatment may cause a rash, which may be itchy.
Always tell your doctor or nurse about any skin changes. They can give you advice and may give you creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
Dizziness or changes in vision
This treatment may make you feel dizzy. Rarely, it causes blurred vision or changes in eyesight. These side effects may be worse if you take toremifene with alcohol. Always tell your doctor or nurse if you have any of these side effects. Do not drive or operate machinery if you have them.
You may have some mood changes during this treatment. You may feel low or depressed. Let your doctor or nurse know if you notice any changes.
Blood clot risk
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
- pain, redness or swelling in a leg or arm
- chest pain.
If you have any of these symptoms, contact a doctor straight away.
A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.
Increased risk of womb cancer
Always tell your doctor if you have vaginal bleeding after the menopause so they can check for the cause. It can be an early sign of womb cancer, although it is usually caused by conditions other than cancer.
Effects on the heart
Chemotherapy can affect the way the heart works. You may have tests to see how well your heart is working. These may be done before, during and sometimes after treatment. If the treatment is causing heart problems, your doctor can change the type of chemotherapy you are having.
Contact a doctor straight away if you:
- have pain or tightness in your chest
- feel breathless or dizzy
- feel your heart is beating too fast or too slowly.
Other conditions can cause these symptoms, but it is important to get them checked by a doctor.
Some medicines can affect the hormonal treatment or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.
Problems with lactose
Toremifene tablets contain a type of sugar called lactose. If you have been told by a doctor that you cannot digest some sugars or are lactose intolerant, talk to your doctor before taking this drug.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.