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Fulvestrant

Fulvestrant

Why is this medication prescribed?

Fulvestrant injection is used to treat a certain type of hormone receptor positive, advanced breast cancer (breast cancer that depends on hormones such as estrogen to grow) in women who have experienced menopause (change of life; end of monthly menstrual periods) and have not previously been treated with an anti-estrogen medication such as tamoxifen (Nolvadex). Fulvestrant injection is also used to treat hormone receptor positive, advanced breast cancer in women who have experienced menopause and whose breast cancer has worsened after they were treated with an anti-estrogen medication such as tamoxifen. Fulvestrant injection is also used in combination with palbociclib (Ibrance®) to treat hormone receptor positive, advanced breast cancer in women whose breast cancer has worsened after they were treated with anti-estrogen medication such as tamoxifen. Fulvestrant is in a class of medications called estrogen receptor antagonists. It works by blocking the action of estrogen on cancer cells. This can slow or stop the growth of some breast tumors that need estrogen to grow.

How should this medicine be used?

Fulvestrant comes as a solution (liquid) to be injected slowly over 1 to 2 minutes into a muscle in the buttocks. Fulvestrant is administered by a doctor or nurse in a medical office. It is usually given once every 2 weeks for the first 3 doses (days 1, 15, and 29) and then once a month thereafter. You will receive your dose of medication as two separate injections (one in each buttock).

Ask your doctor or pharmacist for a copy of the manufacturer's information for the patient.

What side effects can this medication cause?

Fulvestrant may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • constipation
  • diarrhea
  • stomach pain
  • loss of appetite
  • sore throat
  • mouth sores
  • weakness
  • hot flashes or flushing
  • headache
  • pain in bones, joints, or back
  • pain, redness, or swelling in the place where your medication was injected
  • swelling of the hands, feet, ankles, or lower legs
  • dizziness
  • difficulty falling asleep or staying asleep
  • depression
  • anxiety
  • nervousness
  • feelings of numbness, tingling, pricking, or burning on the skin
  • sweating
  • abnormal vaginal bleeding

Precautions

Before starting fulvestrant treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.

Let your health care professional know if you have ever had a blood clot that required medical treatment.

Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (fulvestrant may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).

For both men and women: Do not conceive a child (get pregnant) while taking fulvestrant. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

Do not breast feed while taking this medication.

How Fulvestrant Works

Hormones are chemical substances that are produced by glands in the body, which enter the bloodstream and cause effects in other tissues.  For example, the hormone testosterone made in the testicles and is responsible for male characteristics such as deepening voice and increased body hair.  The use of hormone therapy to treat cancer is based on the observation that receptors for specific hormones that are needed for cell growth are on the surface of some tumor cells.  Hormone therapies work by stopping the production of a certain hormone, blocking hormone receptors, or substituting chemically similar agents for the active hormone, which cannot be used by the tumor cell.  The different types of hormone therapies are categorized by their function and/or the type of hormone that is affected.

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