elacestrant dihydrochloride at a glance
Medicine class
Selective oestrogen receptor degrader and antagonist
Cancer type
ESR1-mutated, ER-positive, HER2-negative locally advanced or metastatic breast cancer
How it is taken
Swallow the tablet whole with a light meal; do not chew, crush or split it.
Important food interaction
Avoid grapefruit and grapefruit juice because they can increase elacestrant exposure and side effects.
What is elacestrant dihydrochloride used for?
It is licensed on its own for:
Postmenopausal women and men with ER-positive, HER2-negative, locally advanced or metastatic breast cancer carrying an activating ESR1 mutation, after progression following endocrine therapy that included a CDK4/6 inhibitor.
How does elacestrant dihydrochloride work?
Elacestrant attaches to oestrogen receptor-alpha, blocks its activity and promotes its degradation. This reduces growth signals in ER-positive breast-cancer cells, including those carrying activating ESR1 mutations.
elacestrant dihydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 86 mg, 345 mg
How to take elacestrant dihydrochloride
Follow the oncology team's prescription. Take the tablets with a light meal and swallow them whole.
Do not chew, crush, split or use a broken or damaged tablet.
Food may reduce nausea and vomiting.
Avoid grapefruit and grapefruit juice.
Do not stop treatment without discussing it with the oncology team.
elacestrant dihydrochloride side effects
Common or expected effects
- Nausea or vomiting
- Indigestion, abdominal pain, diarrhoea or constipation
- Reduced appetite
- Fatigue
- Headache or hot flushes
- Joint or back pain
- Anaemia
- Changes in cholesterol, triglycerides, liver enzymes, creatinine, calcium, sodium or potassium
Get urgent medical advice
- Sudden breathlessness, chest pain, coughing up blood or collapse—possible venous thromboembolism
- Yellow skin or eyes, dark urine, unusual bleeding or confusion—possible serious liver injury
- Severe or persistent vomiting, diarrhoea or inability to keep fluids down
elacestrant dihydrochloride in pregnancy
Elacestrant should not be used during pregnancy because its mechanism and animal findings indicate a risk of foetal harm and miscarriage. Pregnancy should be excluded before treatment where relevant, and effective contraception is required during treatment and for one week after the last dose. Contact the oncology team promptly if pregnancy occurs.
elacestrant dihydrochloride while breastfeeding
Breastfeeding is not recommended during treatment or for one week after the last dose. It is unknown whether elacestrant enters human milk, and serious effects in a breastfed infant cannot be excluded.
elacestrant dihydrochloride interactions
The oncology team and pharmacist should review all prescribed, over-the-counter and herbal products before treatment.
Strong or moderate CYP3A4 inhibitors
Clarithromycin, itraconazole, ketoconazole, ritonavir, erythromycin, fluconazole, diltiazem and verapamil can raise elacestrant exposure and increase adverse effects; alternatives are preferred.
Grapefruit and grapefruit juice
May inhibit CYP3A4 and increase elacestrant exposure, so they should be avoided.
Strong or moderate CYP3A4 inducers
Rifampicin, carbamazepine, phenytoin, phenobarbital, efavirenz and similar medicines can substantially lower elacestrant exposure and may reduce its activity.
Common questions about elacestrant dihydrochloride
Answers are fully visible for fast scanning and source review.
What type of cancer is elacestrant dihydrochloride used for?
It is licensed for certain ER-positive, HER2-negative locally advanced or metastatic breast cancers with an activating ESR1 mutation after specified previous endocrine treatment.
Can men be treated with elacestrant dihydrochloride?
Yes. The UK indication includes adult men who meet the tumour and previous-treatment criteria.
Is elacestrant dihydrochloride chemotherapy?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.