fulvestrant at a glance
Medicine class
Oestrogen-receptor antagonist and endocrine therapy
Main use
Selected hormone-sensitive locally advanced or metastatic breast cancers
Administration
Slow intramuscular injections into the buttocks, given by a healthcare professional
What is fulvestrant used for?
The selected product is licensed for:
Oestrogen-receptor-positive locally advanced or metastatic breast cancer in postmenopausal women who have not previously received endocrine therapy, or whose disease has relapsed or progressed after anti-oestrogen therapy.
Use with palbociclib for hormone-receptor-positive, HER2-negative locally advanced or metastatic breast cancer after prior endocrine therapy. Pre- or perimenopausal women also require ovarian suppression with an LHRH agonist.
How does fulvestrant work?
Fulvestrant competes with oestrogen for its receptor, blocks oestrogen-driven signalling and reduces oestrogen receptors in cancer cells. It has no partial oestrogen-like activity.
fulvestrant preparations and strengths
Injection
Route: Parenteral
Strengths: 250 mg
How to take fulvestrant
Fulvestrant is not swallowed. A doctor or nurse injects it slowly into the buttock muscles, taking care around the sciatic nerve.
Tell the treatment team about anticoagulants, low platelets, bleeding disorders, previous blood clots, liver or kidney problems, and osteoporosis.
Do not drive or use machinery if treatment makes you unusually tired.
The pre-filled syringes are single-use and handled by healthcare professionals.
fulvestrant side effects
Common or expected effects
- Injection-site pain or inflammation
- Tiredness or weakness
- Feeling sick
- Hot flushes
- Joint, muscle or limb pain
- Rash
- Headache, vomiting, diarrhoea or reduced appetite
- Raised liver enzymes or bilirubin
- Back pain
- Urinary tract infection
Get urgent medical advice
- Severe allergic reaction, including facial, tongue or throat swelling
- Blood-clot symptoms, such as sudden breathlessness, chest pain or one-sided leg swelling
- Hepatitis or liver failure symptoms, including jaundice or dark urine
- Injection-related nerve symptoms, such as sciatica, weakness, numbness or difficulty walking
- Unusual bleeding or bruising, including an injection-site haematoma
fulvestrant in pregnancy
Fulvestrant is contraindicated during pregnancy because it may cause harm. People who could become pregnant should use effective contraception during treatment and for two years after the last administration. Contact the oncology team promptly if pregnancy occurs.
fulvestrant while breastfeeding
Breastfeeding is contraindicated during treatment because serious effects in a breastfed child cannot be excluded.
fulvestrant interactions
Give the oncology team a complete list of medicines, including non-prescription products.
Anticoagulants
Intramuscular injections may increase bleeding or injection-site haematoma risk.
CYP3A4 inhibitors or inducers
Studies with ketoconazole and rifampicin found no clinically relevant change in fulvestrant clearance.
Antibody-based estradiol tests
Fulvestrant can cause falsely raised estradiol results.
Common questions about fulvestrant
Answers are fully visible for fast scanning and source review.
Is fulvestrant chemotherapy?
No. It is endocrine therapy that blocks oestrogen receptors rather than conventional cytotoxic chemotherapy.
Can fulvestrant be used before menopause?
Under the selected licence, pre- or perimenopausal women may receive it with palbociclib and an LHRH agonist after prior endocrine therapy.
Can fulvestrant affect the liver?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.