Fulvestrant
Pronouncation: (fool-VESS-trant)Class: Antiestrogen
Trade Names:
Faslodex
- Solution for injection 50 mg/mL
Pharmacology
Feedback for Fulvestrant
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Fulvestrant competitively binds to the estrogen receptor and downregulates the estrogen receptor protein in human breast cancer cells.
Pharmacokinetics
Absorption
C max is about 8.5 ng/mL and about 15.8 ng/mL at steady state. T max is 7 days. C min is about 2.6 ng/mL and about 7.4 ng/mL at steady state. AUC is about 131 ng•day/mL and about 328 ng•day/mL at steady state.
Distribution
Apparent Vd ss is 3 to 5 L/kg. Protein binding is 99%.
Metabolism
Metabolism takes place in the liver by oxidation via CYP-450 3A4 isoenzyme, aromatic hydroxylation, and conjugation with glucuronic acid and/or sulphate.
Elimination
The t 1/ 2 is about 40 days. Cl is about 690 mL/min. Fulvestrant is cleared by the hepatobiliary route; renal elimination is less than 1%. It is primarily excreted in the feces (about 90%).
Indications and Usage
Treatment of hormone receptor-positive metastatic breast cancer in postmenopausal women with disease progression following antiestrogen therapy.
Contraindications
Pregnancy; hypersensitivity to the drug or any component of the product.
Dosage and Administration
AdultsIM 250 mg into buttock at 1-mo intervals using prefilled syringe(s) and supplied safety needle(s).
General Advice
- For IM administration only. Not for IV, SC, or ID administration.
- Administer as single 5 mL injection or concurrent 2.5 mL injections into buttock.
- Do not administer if cloudiness or particulate matter is noted.
Storage/Stability
Store prefilled syringes in refrigerator (36° to 46°F).
Drug Interactions
None well documented.
Laboratory Test Interactions
None well documented.
Adverse Reactions
CNS
Headache; dizziness; insomnia; paresthesia; depression; anxiety.
Dermatologic
Rash; sweating.
EENT
Pharyngitis.
GI
Nausea; vomiting; constipation; diarrhea; abdominal pain; anorexia.
Genitourinary
Urinary tract infection.
Hematologic
Anemia.
Respiratory
Dyspnea; increased cough.
Miscellaneous
Back pain; hot flushes; bone pain; arthritis; asthenia; pain; transient pain and inflammation at injection site; vasodilation; pelvic pain; peripheral edema; chest pain; flu-like syndrome; fever; accidental injury.
Precautions
Pregnancy
Category D .
Lactation
Undetermined.
Children
Safety and efficacy not established.
Patient Information
- Advise patient that medication will be prepared and administered by health care provider in a health care setting on a monthly basis.
- Instruct patient to inform health care provider if any of the following symptoms occur: intolerable nausea, vomiting, constipation, diarrhea, stomach pain, headache, hot flushes, injection site pain or inflammation.
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Fulvestrant - Includes detailed dosage instructions.























