Before Using This Medicine

In deciding to use a medicine, the risks of taking [using] the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For toremifene, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to toremifene.

Pregnancy—Tell your doctor if you are pregnant or if you intend to become pregnant. Studies in rats and rabbits have shown that toremifene causes miscarriages, birth defects, and death of the fetus. Studies in animals have also shown that toremifene may cause some of the same problems as an estrogen called diethylstilbestrol (DES). DES causes genital tract problems and, rarely, an increased risk of cancer of the cervix or vagina in daughters of women who took it during their pregnancy; it is not known whether toremifene causes these same problems.

Tell your doctor right away if you think you have become pregnant while taking toremifene.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking toremifene, it is especially important that your health care professional know if you are taking any of the following:

• Anticoagulants, coumarin-type (blood thinners)--Use with this medicine may increase the amount of time it takes blood to clot

• Carbamazepine (e.g., Tegretol) or
• Phenobarbital or
• Phenytoin (e.g., Dilantin)—These medicines may decrease blood levels of toremifene, which could make it less effective

Other medical problems—The presence of other medical problems may affect the use of toremifene. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood clots (history of)—Use of toremifene is usually not recommended

• Unusual growth of the lining of the uterus (womb)—Long-term use of toremifene is usually not recommended