Aspirin, sodium bicarbonate, and citric acid and Toremifene Citrate

• Generic Name: aspirin / citric acid / sodium bicarbonate
• Dosage Forms: n.a.
• Other Brand Names: Alka-Seltzer Extra Strength, Alka-Seltzer, Medi-Seltzer, Neutralin

Aspirin, sodium bicarbonate, and citric acid combination is used to relieve pain occurring together with heartburn, sour stomach, or acid indigestion.

The aspirin in this combination is the pain reliever. Aspirin belongs to the group of medicines known as salicylates and to the group of medicines known as anti-inflammatory analgesics. The sodium bicarbonate in aspirin, sodium bicarbonate, and citric acid is an antacid. It neutralizes stomach acid by combining with it to form a new substance that is not an acid.

Aspirin, sodium bicarbonate, and citric acid combination may also be used to lessen the chance of heart attack, stroke, or other problems that may occur when a blood vessel is blocked by blood clots. The aspirin in aspirin, sodium bicarbonate, and citric acid helps prevent dangerous blood clots from forming. However, this effect of aspirin may increase the chance of serious bleeding in some people. Therefore, aspirin should be used for this purpose only when your doctor decides, after studying your medical condition and history, that the danger of blood clots is greater than the risk of bleeding. Do not take aspirin to prevent blood clots or a heart attack unless it has been ordered by your doctor.

This combination medicine is available without a prescription.

• Generic Name: toremifene
• Dosage Forms: n.a.
• Other Brand Names: Fareston

Palliative treatment of metastatic breast cancer in postmenopausal women with estrogen-receptor positive or estrogen-receptor unknown tumors (designated an orphan drug by FDA for this use). Not recommended for treatment of estrogen-receptor negative breast tumors. Similar efficacy and toxicity as tamoxifen. Not known whether toremifene offers a therapeutic advantage over tamoxifen for the treatment of advanced breast cancer in eligible patients.

Under investigation for use as adjuvant therapy for early-stage breast cancer in node-positive postmenopausal women. Results from trials to date suggest similar efficacy and toxicity as tamoxifen.

Efficacy in treatment of advanced breast cancer in men not demonstrated.

Because of demonstrated cross-resistance with tamoxifen, usefulness of toremifene as second-line endocrine therapy for treatment of metastatic breast cancer refractory to tamoxifen appears to be limited.

Under investigation as a preventive agent for prostate cancer in men with high-grade prostatic intraepithelial neoplasia and no evidence of prostate cancer.