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Can you take Enzalutamide with Toremifene?

1 drug interaction and 16 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

toremifene enzalutamide

Applies to: toremifene and enzalutamide

Enzalutamide may significantly reduce the blood levels of toremifene, which may make the medication less effective in treating your cancer.

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition.

It can be intentional, when combining drugs with similar actions adds demonstrated therapeutic benefit — or unintentional, such as when a patient sees multiple prescribers or fills prescriptions at more than one pharmacy, which can lead to adverse effects.

Duplication:

Antineoplastic hormones

The recommended maximum number of medicines in the 'antineoplastic hormones' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antineoplastic hormones' category:

  • enzalutamide
  • toremifene

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

toremifene Food/Lifestyle

Applies to: toremifene

You should avoid drinking grapefruit juice during treatment with toremifene. Grapefruit juice may increase the blood levels of toremifene.

This can make you more likely to develop side effects such as:

  • vaginal bleeding
  • blood clots
  • an irregular heart rhythm that may be serious or life-threatening

Contact your doctor if you experience potential signs and symptoms of blood clots such as:

  • chest pain
  • shortness of breath
  • sudden loss of vision
  • pain, redness or swelling your arms or legs

You should also seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with toremifene.

Talk to your doctor before using toremifene with soy products. There is some evidence that substances present in soy may stimulate breast tumor growth and interfere with the action of toremifene, although this has not been proven. Whether soy products are effective for hot flashes is also uncertain.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

14 potential interactions Applies to: 14 conditions, including Heart Failure, Seizures, Hypokalemia, Head Injury, and Thrombotic/Thromboembolic Disorder.

Brain Tumor

Moderate:

enzalutamide

Enzalutamide has a moderate potential interaction with Brain Tumor.

Seizures occurred in 0.5% of patients receiving enzalutamide in clinical trials. Patients with predisposing factors for seizures were generally excluded. Caution is advised if using in patients with possible predisposing factors such as history of seizures, history of trauma or head injury, cerebrovascular accident or transient ischemic attack, Alzheimer's disease, meningioma or brain tumor or infection, and any unexplained loss of consciousness in the past 12 months. Enzalutamide should be discontinued permanently in any patient who develops a seizure during treatment.

CNS Infection

Moderate:

enzalutamide

Enzalutamide has a moderate potential interaction with CNS Infection.

Seizures occurred in 0.5% of patients receiving enzalutamide in clinical trials. Patients with predisposing factors for seizures were generally excluded. Caution is advised if using in patients with possible predisposing factors such as history of seizures, history of trauma or head injury, cerebrovascular accident or transient ischemic attack, Alzheimer's disease, meningioma or brain tumor or infection, and any unexplained loss of consciousness in the past 12 months. Enzalutamide should be discontinued permanently in any patient who develops a seizure during treatment.

Endometrial Dysplasia

Moderate:

toremifene

Toremifene has a moderate potential interaction with Endometrial Dysplasia.

Endometrial cancer, endometrial hyperplasia, hypertrophy, and uterine polyps have been reported in some patients treated with toremifene. Long-term use of toremifene has not been established in patients with preexisting endometrial hyperplasia. All patients should have baseline and annual gynecological examinations. In particular, patients at high risk of endometrial cancer should be closely monitored.

Head Injury

Moderate:

enzalutamide

Enzalutamide has a moderate potential interaction with Head Injury.

Seizures occurred in 0.5% of patients receiving enzalutamide in clinical trials. Patients with predisposing factors for seizures were generally excluded. Caution is advised if using in patients with possible predisposing factors such as history of seizures, history of trauma or head injury, cerebrovascular accident or transient ischemic attack, Alzheimer's disease, meningioma or brain tumor or infection, and any unexplained loss of consciousness in the past 12 months. Enzalutamide should be discontinued permanently in any patient who develops a seizure during treatment.

Heart Failure

Major:

toremifene

Toremifene has a major potential interaction with Heart Failure.

Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.

History, Thrombotic/Thromboembolic Disorder

Moderate:

toremifene

Toremifene has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.

Thromboembolic events such as thrombophlebitis and pulmonary embolism have been noted during toremifene therapy. Patients with an active or past history of thromboembolic events should generally not be administered toremifene.

History - Cerebrovascular Disease

Moderate:

enzalutamide

Enzalutamide has a moderate potential interaction with History - Cerebrovascular Disease.

Seizures occurred in 0.5% of patients receiving enzalutamide in clinical trials. Patients with predisposing factors for seizures were generally excluded. Caution is advised if using in patients with possible predisposing factors such as history of seizures, history of trauma or head injury, cerebrovascular accident or transient ischemic attack, Alzheimer's disease, meningioma or brain tumor or infection, and any unexplained loss of consciousness in the past 12 months. Enzalutamide should be discontinued permanently in any patient who develops a seizure during treatment.

Hypokalemia

Major:

toremifene

Toremifene has a major potential interaction with Hypokalemia.

Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.

Liver Disease

Moderate:

toremifene

Toremifene has a moderate potential interaction with Liver Disease.

Hepatotoxicity, hepatitis, and non-alcoholic fatty liver disease have been reported in clinical trials and postmarketing with toremifene. Liver function tests should be performed periodically. Caution is advised in patients with any hepatic impairment.

Long QT Syndrome

Major:

toremifene

Toremifene has a major potential interaction with Long QT Syndrome.

Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.

Magnesium Imbalance

Major:

toremifene

Toremifene has a major potential interaction with Magnesium Imbalance.

Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.

Renal Dysfunction

Moderate:

enzalutamide

Enzalutamide has a moderate potential interaction with Renal Dysfunction.

Enzalutamide has not been assessed in patients with severe renal impairment or end-stage renal disease. Caution is advised if used on these patients. No initial dosage adjustment is required on patients with mild to moderate renal impairment.

Seizures

Moderate:

enzalutamide

Enzalutamide has a moderate potential interaction with Seizures.

Seizures occurred in 0.5% of patients receiving enzalutamide in clinical trials. Patients with predisposing factors for seizures were generally excluded. Caution is advised if using in patients with possible predisposing factors such as history of seizures, history of trauma or head injury, cerebrovascular accident or transient ischemic attack, Alzheimer's disease, meningioma or brain tumor or infection, and any unexplained loss of consciousness in the past 12 months. Enzalutamide should be discontinued permanently in any patient who develops a seizure during treatment.

Thrombotic/Thromboembolic Disorder

Moderate:

toremifene

Toremifene has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.

Thromboembolic events such as thrombophlebitis and pulmonary embolism have been noted during toremifene therapy. Patients with an active or past history of thromboembolic events should generally not be administered toremifene.

More resources

enzalutamide

A total of 703 drugs are known to interact with enzalutamide.

toremifene

A total of 434 drugs are known to interact with toremifene.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.