Fareston
Fareston: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. For violations of liver function
- 11. Use in the elderly
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Fareston
ATX code: L02BA02
Active ingredient: toremifene (toremifene)
Manufacturer: Orion Corporation (Finland)
Description and photo updated: 2018-26-11
Prices in pharmacies: from 2239 rubles.
Buy
Fareston is a non-steroidal drug with antiestrogenic and antitumor effects.
Release form and composition
Fareston is available in the form of tablets: white, round, flat, on one side there is a code TO20 or TO60, the edge of the tablet is beveled (10 pcs. In blisters, in a cardboard box 3 or 10 packs; 30, 60 or 100 pcs.. in polyethylene bottles, in a cardboard box 1 bottle).
1 tablet contains:
- active substance: toremifene (in the form of toremifene citrate) - 20 mg or 60 mg;
- auxiliary components: lactose, sodium starch glycolate (type A), corn starch, povidone, colloidal anhydrous silicon, microcrystalline cellulose, magnesium stearate.
Pharmacological properties
Pharmacodynamics
Fareston is a drug with antiestrogenic and antitumor effects. Its active substance - toremifene - is a nonsteroidal antiestrogen derived from triphenylethylene and has the ability to specifically bind to estrogen receptors. Competing with estradiol, it inhibits estrogen-induced DNA synthesis (deoxyribonucleic acid) and cell replication.
In breast cancer, the antitumor effect of toremifene is largely due to its antiestrogenic activity. At the same time, it is also associated with such mechanisms of action of an active substance as regulation of oncogene expression, secretion of growth factors, induction of apoptosis, and kinetics of the cell cycle. High doses of toremifene are capable of producing an antitumor effect that is not related to its antiestrogenic effect.
Pharmacokinetics
After taking Fareston inside, toremifene is completely absorbed and the maximum concentration in the blood serum is reached within 2-5 hours. Simultaneous food intake does not affect the completeness of absorption, but can increase the period of onset of maximum concentration by 1.5–2 hours, although this has no clinical significance.
Plasma protein binding (mainly albumin) - 99.5%. The equilibrium concentration of toremifene in plasma with a dose of 60 mg per day is established after 21-28 days of therapy.
In the liver, it is metabolized with the participation of cytochrome CYP3A4 by demethylation and hydroxylation with the formation of an active metabolite (N-demethyltoremifene) and three inactive (4-hydroxytoremifene, deaminogydroxytoremifene, N, N-didemethyltoremifene).
The total clearance of the drug is 5 l / h.
After the fast distribution phase, the slow elimination phase begins. The half-life of toremifene averages 5 days, N-demethyltoremifene - 11 days.
It is excreted mainly in the form of metabolites within 7 days: the main part through the intestines, about 10% through the kidneys.
Indications for use
According to the instructions, Fareston is indicated for women for the treatment of estrogen-dependent breast cancer in the postmenopausal period.
Contraindications
- endometrial hyperplasia, including history;
- thromboembolism, including history;
- prolongation of the QT interval;
- the simultaneous use of drugs that prolong the QT interval;
- clinically significant bradycardia;
- an indication of a history of symptomatic arrhythmia;
- clinically significant heart failure with reduced left ventricular ejection fraction;
- hypokalemia and other electrolyte imbalance;
- severe hepatic impairment, including history;
- period of pregnancy;
- breast-feeding;
- hypersensitivity to the components of the drug.
Fareston should be used with caution for thrombocytopenia, leukopenia, hypercalcemia (including patients with bone metastases), severe angina pectoris, decompensated heart failure, proarrhythmogenic conditions (prolongation of the QT interval, acute myocardial ischemia), lactose intolerance, glucose-lactose deficiency malabsorption, in old age.
Instructions for the use of Fareston: method and dosage
Fareston tablets are taken orally.
The doctor sets the dose and duration of therapy individually.
Recommended dosage:
- first line of hormone therapy: 60 mg once a day for a long period of time;
- second line of hormone therapy: 120 mg 2 times a day.
In the event of signs indicating the progression of the disease, Fareston should be discontinued.
Side effects
- from the nervous system: often - dizziness; infrequently - headache;
- from the side of the vessels: very often - hot flashes (hot flashes); infrequently - thromboembolic conditions (thrombophlebitis, deep venous thrombosis, pulmonary embolism);
- benign, malignant and unspecified neoplasms, including polyps and cysts: very rarely, endometrial cancer;
- from the gastrointestinal tract: often - nausea, vomiting; infrequently - constipation;
- from the hematopoietic and lymphatic systems: the frequency has not been established - anemia, thrombocytopenia, leukopenia;
- on the part of nutrition and metabolism: infrequently - loss of appetite;
- mental disorders: often - depression; infrequently - insomnia;
- from the respiratory system: infrequently - shortness of breath;
- from the hearing organs: rarely - vertigo;
- on the part of the organs of vision: very rarely - corneal opacity;
- from the hepatobiliary system: rarely - increased activity of hepatic transaminases; very rarely - jaundice;
- from the reproductive system and mammary glands: often - uterine bleeding, vaginal discharge in the form of leucorrhoea; infrequently - endometrial hypertrophy; rarely - endometrial polyps; very rarely - endometrial hyperplasia;
- dermatological reactions: very often - increased sweating; often - itching in the genital area, rash; very rarely - alopecia;
- general disorders: often - increased fatigue, edema; infrequently - weight gain.
Overdose
Symptoms: while taking 680 mg per day - nausea and / or vomiting, vertigo, headache, dizziness. Perhaps - hot flashes, vaginal bleeding, prolongation of the QT interval.
Treatment: the appointment of symptomatic therapy.
special instructions
The appointment of Fareston should be made on the basis of the results of the gynecological examination of the patient, with special attention should be paid to the state of the endometrium. The risk group for endometrial cancer includes patients with a body mass index of more than 30, arterial hypertension, diabetes mellitus, who are on long-term hormone replacement therapy. In addition, careful monitoring of the condition is required in severe angina pectoris, decompensated heart failure. During the period of treatment, a woman should be observed by a gynecologist and undergo control tests at least once a year.
It should be borne in mind that the likelihood of developing hypercalcemia in patients with bone metastases appears at an early stage of toremifene therapy.
Prolongation of the QT interval was noted with an increase in the dose of Fareston. If the QT interval is more than 500 msec, then remifene should not be taken.
If symptoms of arrhythmia appear, therapy should be canceled.
Treatment should be accompanied by regular studies to monitor the number of erythrocytes, leukocytes, platelets.
Influence on the ability to drive vehicles and complex mechanisms
The use of Fareston does not affect the ability to drive vehicles and mechanisms.
Application during pregnancy and lactation
The use of Fareston is contraindicated during gestation and during breastfeeding.
For violations of liver function
The use of Fareston is contraindicated in severe hepatic failure, including a history.
Use in the elderly
With caution, Fareston should be prescribed to elderly patients.
Drug interactions
Due to the risk of synergistic action on prolongation of the QT interval and the occurrence of ventricular arrhythmias (including ventricular arrhythmias of the "pirouette" type), the combination of toremifene with the following drugs is contraindicated: class IA antiarrhythmics (including quinidine, disopyramide, hydroquinidine), class III antiarrhythmics (including amiodarone, ibutilide, sotalol, dofetilide), antipsychotics (including sertindole, haloperidol, phenothiazine, pimozide, sultopride), erythromycin, moxifloxacin, pentamidine, antimalarial drugs (especially halofantrine), mizolastine, terfenadamine, cysthizapramine diphemanil, vincamine (with intravenous administration).
With the simultaneous use of Fareston:
- thiazide diuretics, other drugs that reduce renal calcium excretion: increase the risk of hypercalcemia;
- phenobarbital, carbamazepine, phenytoin, other drugs that potentiate the intensity of microsomal oxidation: can accelerate the metabolism and excretion of toremifene, reducing its concentration in the blood serum. If necessary, this combination, the daily dose of the drug should be doubled;
- indirect anticoagulants, including warfarin: cause a pronounced increase in the bleeding period (it is recommended to avoid this combination);
- inhibitors of cytochrome CYP3A isoenzymes - oleandomycin, erythromycin, antifungal drugs, including ketoconazole: reduce the metabolic rate of toremifene.
Analogs
Fareston's analogues are: Fazlodex, Nolvadex, Vero-Tamoxifen, Tamoxifen.
Terms and conditions of storage
Keep out of the reach of children.
Store at a temperature of 15 to 25 ° C, protected from moisture.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Fareston
Reviews about Fareston are positive. Comparing with analogs, the patients note a higher efficacy of the drug and less severity of side effects.
The disadvantages include the high cost of the drug.
The price of Fareston in pharmacies
The price of Fareston for a package containing 30 tablets at a dose of 20 mg can be from 1,754 rubles, 60 tablets at a dose of 60 mg - from 4,750 rubles.
Fareston: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Fareston 20 mg tablets 30 pcs. 2239 RUB Buy |
|
Fareston tablets 20mg 30 pcs. 2380 RUB Buy |
|
Fareston 60 mg tablets 60 pcs. 5255 RUB Buy |
|
Fareston 60mg tablets 60 pcs. RUB 5412 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
