Indications
Fulvestrant is used to treat hormone receptor-positive (oestrogen receptor-positive) advanced or metastatic breast cancer in women who have gone through menopause. It may be used alone, or together with other cancer medicines such as Palbociclib, Ribociclib or Abemaciclib, as decided by a cancer specialist.
How It Works
Some breast cancers need the hormone oestrogen to grow. Fulvestrant is a selective oestrogen receptor degrader (SERD). It binds to oestrogen receptors on cancer cells, blocks them and causes them to be broken down, so oestrogen can no longer drive the cancer’s growth.
Dosage and Administration
Fulvestrant is given only by a doctor or nurse as a slow injection into the muscle of each buttock. The usual dose is 500 mg (two 250 mg injections, one in each buttock) on days 1, 15 and 29, and then once a month, as prescribed by the oncologist. Keep all scheduled appointments.
Interactions
- Blood thinners such as Warfarin: higher risk of bruising or bleeding at the injection site.
- Tell the doctor about all medicines, herbal products and supplements, especially those containing oestrogen.
- It may interfere with some blood tests for oestradiol, giving falsely high results.
Contraindications
- Allergy to Fulvestrant or any ingredient.
- Pregnancy and breastfeeding.
- Severe liver impairment.
Side Effects
Common side effects include pain or reactions at the injection site, hot flushes, nausea, tiredness, joint and muscle pain, headache, back pain, loss of appetite, rash and raised liver enzymes. Bleeding or bruising at the injection site may occur.
Get urgent medical help if you have signs of a severe allergic reaction (swelling of the face, lips or throat, difficulty breathing), yellowing of the skin or eyes, unusual bleeding, severe pain at the injection site with numbness or weakness in the leg (possible nerve injury), or a painful swollen leg or sudden breathlessness (possible blood clot).
Pregnancy and Lactation
Fulvestrant can harm an unborn baby and must not be used in pregnancy. Women who could become pregnant should use effective contraception during treatment and for 2 years after the last dose, as advised by the doctor. Do not breastfeed during treatment and for 1 year after the last dose.
Precautions and Warnings
Use with care in people with liver problems, low platelets, bleeding disorders or those on blood thinners. Fulvestrant may reduce bone density over time; the doctor may check bone health. It may cause tiredness; take care when driving.
Overdose
There is limited experience with overdose. If too much is given, the doctor will provide supportive care and monitoring.
Therapeutic Class
Antineoplastic hormonal agent; selective oestrogen receptor degrader (SERD).
Storage
Store in a refrigerator at 2 to 8°C. Do not freeze. Keep in the original pack to protect from light. Handled by the clinic or hospital as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.