Fulvestrant
Uses of Fulvestrant
Fulvestrant is used mainly to manage certain types of advanced breast cancer in postmenopausal women and falls under the group of selective oestrogen receptor degraders (SERDs) medicines.
Additionally, it might be prescribed when the breast cancer is metastatic i.e., has spread to other parts of the body.
Side effects of Fulvestrant
Pain, swelling, redness, or itching at the injection site
Nausea
Fatigue and weakness
Headaches
Hot flashes
How Fulvestrant works
Fulvestrant is a Selective Oestrogen Receptor Degrader (SERD).
It works by binding strongly to oestrogen receptors in the body, specifically those found on hormone-sensitive breast cancer cells. After binding, Fulvestrant triggers the degradation and elimination of these oestrogen receptors. This mechanism prevents oestrogen, a hormone, from stimulating the growth of these breast cancer cells. Consequently, it slows down or stops the progression of hormone-sensitive breast cancer. This mode of action differs from other types of cancer medications like aromatase inhibitors, which primarily work by reducing oestrogen levels in the body. Fulvestrant directly targets and degrades the receptors instead.
Certified content
Written By
BDS, MDS
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Fulvestrant can be administered intramuscularly (injection).
Age and Dose Restrictions
This medicine is typically intended for use in postmenopausal women.
Contraindications
Fulvestrant is contraindicated in people who have a known hypersensitivity to the active substance or any other components of this medication.
Other Medications to Avoid
Fulvestrant may interact with strong CYP3A4 inducers (such as rifampin or phenytoin) and strong CYP3A4 inhibitors (like ketoconazole).
Overdose and Missed Dose
An overdose of Fulvestrant can possibly result in more severe side effects like nausea, vomiting, fatigue, and musculoskeletal pain. If you suspect an overdose, seek immediate medical attention.
If you miss a dose of Fulvestrant, contact your doctor or healthcare provider straight away for further instructions. Do not double the dose to compensate for a missed one.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
Drinking plenty of fluids may help manage side effects such as nausea or constipation.
Resting and maintaining a balanced diet can alleviate fatigue and weakness.
Applying a cool compress at the injection site may help alleviate local reactions like pain, swelling, redness or itching.
Use in Driving and Operating Machinery
Fulvestrant may cause fatigue or weakness which could affect your ability to drive or operate machinery. If you feel unwell or unable to perform these activities, refrain from doing so.
Use in Pregnancy and Lactation
Fulvestrant is contraindicated during pregnancy as it can cause foetal harm. Women are advised not to breastfeed while undergoing treatment with this medicine.
Caution in Other Conditions
Patients with severe liver problems may need to use a reduced dose of Fulvestrant and be closely monitored during treatment.
Fulvestrant should be used with caution in patients with a history of bleeding disorders or those taking anticoagulant medication.
Special Dietary and Lifestyle Recommendations
Get enough rest to counter fatigue and promote recovery.
Avoid grapefruit and grapefruit juice which can interact with medications metabolised by CYP3A4.
Frequently asked questions
Is Fulvestrant a steroid?
No, Fulvestrant is not a steroid. It is a medicine used to manage certain types of advanced breast cancer in postmenopausal women and belongs to a class of medicines called selective oestrogen receptor degraders (SERDs).
Does Fulvestrant have any effect on sleep?
Fulvestrant does not directly affect sleep. However, some side effects such as fatigue and weakness could indirectly affect your sleep patterns.
Will Fulvestrant affect fertility?
Fulvestrant is unlikely to affect fertility directly, but it can cause hormonal changes that might influence reproductive health. Always consult a doctor for personalized advice regarding fertility concerns.
What is the best time to take Fulvestrant?
Fulvestrant is an injectable medication that needs to be administered by a healthcare professional. Therefore, the timing will depend on your appointment schedule with the healthcare professional.
Can men take Fulvestrant?
Fulvestrant is only approved for use in postmenopausal women with advanced HR-positive breast cancer. It is not indicated for use in male patients.
How much time does Fulvestrant take to work?
Some patients may notice improvement in symptoms within a few weeks, but it typically takes 2-3 months to evaluate the efficacy of Fulvestrant. Tumour response is assessed every 2-3 months with imaging.
Is the Fulvestrant available over the counter, or do I need a prescription?
Fulvestrant usually requires a prescription and is not available over the counter.
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