fulvestrant (Intramuscular route)
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antiestrogen
Uses For fulvestrant
Fulvestrant injection is used to treat hormone-receptor positive metastatic breast cancer (cancer that has spread) in postmenopausal women that have received other cancer medicines that did not work well. fulvestrant is also used in combination with palbociclib to treat HR positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer in women who have received hormonal therapy.
Many of the breast cancer tumors will grow when estrogen is available in the body. fulvestrant blocks the effects of the estrogen hormone in the body. As a result, the amount of estrogen that the tumor is exposed to is reduced, which will limit the growth of the tumor.
fulvestrant is to be given only by or under the direct supervision of your doctor.
Before Using fulvestrant
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For fulvestrant, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to fulvestrant or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of fulvestrant injection in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fulvestrant injection in the elderly.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving fulvestrant, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using fulvestrant with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine
Using fulvestrant with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Influenza Virus Vaccine, Live
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine
- Yellow Fever Vaccine
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of fulvestrant. Make sure you tell your doctor if you have any other medical problems, especially:
- Bleeding problems or
- Thrombocytopenia (low platelets in the blood)—Use with caution. May make these conditions worse.
- Liver disease, moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Proper Use of fulvestrant
Medicines used to treat cancer are very strong and can have many side effects. Before receiving fulvestrant, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
You will receive fulvestrant while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you fulvestrant. fulvestrant is given as a shot into the buttocks slowly on days 1, 15, 29 and once monthly thereafter.
fulvestrant comes with patient instructions. Read and follow the instructions carefully. Ask your doctor if you have any questions.
fulvestrant needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.
Precautions While Using fulvestrant
It is very important that your doctor check your progress at regular visits to make sure that the medicine is working properly. Blood tests may be needed to check for unwanted effects.
Using fulvestrant while you are pregnant can harm your unborn baby. If you are a woman who can bear children, your doctor may give you a pregnancy test 7 days before you start using fulvestrant to make sure you are not pregnant. Use a highly effective form of birth control to keep from getting pregnant during treatment and for 1 year after your last dose. If you think you have become pregnant while using the medicine, tell your doctor right away.
fulvestrant may increase your risk of bleeding. This is more likely to occur if you have bleeding problems or taking a blood thinner (eg, warfarin). Tell your doctor right away if you have unusual bleeding or bruising after receiving fulvestrant.
fulvestrant may cause you to have bleeding from the vagina, especially when you first start using it. If the bleeding continues or is bothersome, check with your doctor right away.
Tell your doctor if you have numbness, tingling, or weakness in your legs after receiving fulvestrant.
Before you have any medical tests, tell the medical doctor in charge that you are using fulvestrant. The results of some tests (eg, serum estradiol) may be affected by fulvestrant.
Talk with your doctor before using fulvestrant if you plan to have children. Some men and women who use fulvestrant have become infertile (unable to have children).
Cancer medicines can cause nausea or vomiting, even after receiving medicines to prevent it. If you have nausea and vomiting after receiving fulvestrant, talk to your doctor or nurse about ways to control these effects.
fulvestrant Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:More common
- Bloating or swelling of the face, arms, hands, lower legs, or feet
- rapid weight gain
- tingling of the hands or feet
- unusual weight gain or loss
- Difficult or labored breathing
- tightness in the chest
- Black, tarry stools
- chest pain
- flushing or redness of the skin
- hives or welts, itching, or rash
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- pain in the chest, groin, or legs, especially the calves
- painful or difficult urination
- severe and sudden headache
- slurred speech
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- sudden and severe weakness or numbness in the arm or leg
- sudden loss of coordination
- sudden unexplained shortness of breath
- swollen glands
- unusual bleeding or bruising
- unusual tiredness or weakness
- vaginal bleeding
- vision changes
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Back pain
- bladder pain
- bloody or cloudy urine
- body aches or pain
- bone pain
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- difficulty having a bowel movement (stool)
- difficulty with moving
- dryness or soreness of the throat
- feeling faint, dizzy, or lightheaded
- feeling of warmth or heat
- feeling sad or empty
- frequent urge to urinate
- general feeling of discomfort or illness
- joint pain
- lack or loss of appetite
- lack or loss of strength
- loss of interest or pleasure
- lower back or side pain
- muscle aches and pains
- muscle stiffness
- pain at the injection site
- pain in the arms or legs
- pelvic pain
- stomach pain
- sudden sweating
- tender, swollen glands in the neck
- trouble concentrating
- trouble with swallowing
- unable to sleep
- voice changes
- weight loss
- pain, swelling, or redness in the joints
- pale skin
- Dizziness or lightheadedness
- feeling of constant movement of self or surroundings
- sensation of spinning
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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