fulvestrant
Fulvestrant (Faslodex) is injected into the muscles and used to treat certain types of breast cancer. After the initial starting doses, this medication is given monthly. It can be used by itself, or in combination with other anticancer medications. Fulvestrant (Faslodex) is a kind of hormone therapy and it has less serious side effects compared with chemotherapy.
What is Fulvestrant (Faslodex)?
What is Fulvestrant (Faslodex) used for?
- Hormone receptor (HR)-positive, advanced or metastatic breast cancer
How Fulvestrant (Faslodex) works
Many breast cancers are hormone receptor (HR)-positive and need estrogen and progesterone (2 types of female sex hormones) to grow and spread.
Fulvestrant (Faslodex) is an estrogen receptor antagonist. It’s a type of hormone therapy that specifically blocks estrogen from binding to breast cancer cells. This medication is useful in treating breast cancers that have estrogen receptors (ERs). Without estrogen, these types of cancer cells won’t have the "fuel" they need to spread.
Drug facts
Side effects of Fulvestrant (Faslodex)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Joint pain (8-17%)
- Injection site pain (12%)
- Nausea (10-11%)
- Hot flash (7-11%)
- Fatigue (8-11%)
Please note: These side effects were reported in clinical trials by people who received fulvestrant (Faslodex) 500 mg monthly only. Your side effects can differ if you’re receiving fulvestrant (Faslodex) with other medications.
Less Common Side Effects
- Headache
- Back pain
- Muscle pain
- Bone pain
- Pain in the hands and feet
The following Fulvestrant (Faslodex) side effects have also been reported
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
Black, tarry stools
bleeding gums
bloating or swelling of the face, arms, hands, lower legs, or feet
blood in the urine or stools
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chest pain or tightness
chills
cloudy urine
difficulty breathing
fainting
hoarseness
irregular heartbeat, recurrent
lower back or side pain
painful or difficult urination
pale skin
pinpoint red spots on the skin
rapid weight gain
sores, ulcers, or white spots on the lips or in the mouth
tender, swollen glands in the neck
tingling of the hands or feet
trouble with swallowing
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain or loss
Less common
confusion
dizziness or lightheadedness
fast heartbeat
mood or mental changes
muscle cramps in the hands, arms, feet, legs, or face
numbness and tingling around the mouth, fingertips, or feet
pain in the chest, groin, or legs, especially the calves
pain, redness, or swelling in the arm or leg
seizures
severe, sudden headache
slurred speech
stomach cramps
sudden loss of coordination
sudden, severe weakness or numbness in the arm or leg
vision changes
Incidence not known
Dark urine
flushing or redness of the skin
general feeling of tiredness or weakness
headache
hives or welts, itching, skin rash
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
light-colored stools
stomach pain, continuing
upper right abdominal pain
vaginal bleeding
vomiting
yellow eyes or skin
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
body aches or pain
bone pain
change in or loss of taste
decreased appetite
difficulty having a bowel movement
difficulty with moving
dryness or soreness of the throat
feeling of warmth or heat
feeling sad or empty
frequent urge to urinate
general feeling of discomfort or illness
hair loss or thinning of hair
irritability
joint pain
lack or loss of appetite
lack or loss of strength
loss of interest or pleasure
muscle aches and pains
muscle stiffness
pain at the injection site
pain in the arms or legs
pelvic pain
shivering
stomach pain
sudden sweating
trouble concentrating
voice changes
Incidence not known
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.
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Pros and cons of Fulvestrant (Faslodex)
Pros
- Less serious side effects compared with chemotherapy
- Monthly injections (after the first 3 doses)
- Short injection times (1 to 2 minutes per injection)
Cons
- Usually requires regular visits to the clinic or infusion center to receive your dose
- Can cause pain at the injection sites
- Not safe in pregnancy or breastfeeding
Pharmacist tips for Fulvestrant (Faslodex)
- Fulvestrant (Faslodex) is injected into the muscle and can cause bleeding at the injection site. Your risk of bleeds is higher if you're more prone to bleeding or taking blood thinning medications, such as warfarin (Coumadin). Let your provider know if you notice bleeding or bruising that doesn’t stop or go away.
- Each 500 mg dose of fulvestrant (Faslodex) is given as two 250 mg injections, one injected into each buttock (gluteal muscle).
- Let your provider know if you feel nerve pain, numbness, or tingling at the injection sites.
- If you’re a female who’s able to get pregnant, you're recommended to use birth control while receiving fulvestrant (Faslodex) and for 1 year after your last dose. This medication can cause harm to an unborn baby if received by mothers during pregnancy.
Common questions about Fulvestrant (Faslodex)
About 3 in 4 breast cancers are HR-positive and can be treated with hormone therapy, such as fulvestrant (Faslodex). Your provider will first test a sample of your tumor to see if your cancer is HR-positive.
You should receive fulvestrant (Faslodex) treatment as instructed by your provider. This medication is usually given monthly after the first 3 doses, so it’s important to follow the schedule your provider gives you. How long you receive fulvestrant (Faslodex) therapy depends on several factors, including how well the medication is working to treat your cancer and how well you tolerate it. Don’t stop receiving fulvestrant (Faslodex) without first discussing with your provider.
Let your provider know if you have problems with your liver, because you’ll need to be monitored more closely. If you have liver problems, your body might have a harder time breaking down this medication. This can cause fulvestrant (Faslodex) to build up in your body and raise your risk for more side effects. Depending on how serious your liver problems are, you might need to take the medication at a lower dose, or you might not be able to receive fulvestrant (Faslodex) entirely.
Fulvestrant (Faslodex) isn’t recommended during pregnancy. While it hasn't been well-studied in human pregnancy, animal studies show that it can cause harm to your unborn baby. This medication shouldn’t be used during pregnancy, unless your provider thinks the benefit is greater than the risk for both you and your unborn baby. Let your provider know right away if you become pregnant while receiving fulvestrant (Faslodex).
Breastfeeding isn’t recommended if you’re receiving fulvestrant (Faslodex). We don’t know if the medication can pass into human breast milk, but there’s a risk of serious harm to nursing infants if it does. Because of this risk, you shouldn’t breastfeed during fulvestrant (Faslodex) treatment and for 1 year after your last dose. Talk with your provider if you have any questions about breastfeeding or other ways to feed your baby while receiving fulvestrant (Faslodex).
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Risks and warnings for Fulvestrant (Faslodex)
Fulvestrant (Faslodex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Bleeding
- Risk factors: Bleeding problems | Low platelet counts | Taking blood thinner medications
Fulvestrant (Faslodex) is given as an injection into the muscle, which can cause bleeding. Your risk for bleeding might be higher if you have a history of bleeding problems, low platelet counts, or are taking blood thinner medications. Let your provider know as soon as possible if you notice bleeding or bruising at the injection site that doesn’t stop or go away.
Injection site reaction
You can experience pain, nerve pain, numbness, or tingling at the site of fulvestrant (Faslodex) injection. Tell your provider if this is bothersome for you.
Possible harm to unborn baby
Based on animal studies, fulvestrant (Faslodex) can cause harm to unborn babies if used by mothers during pregnancy. If you’re a female who’s able to get pregnant, your provider might ask you to take a pregnancy test to make sure you’re not pregnant before you start the medication. In addition, you should use birth control during fulvestrant (Faslodex) treatment and continue to do so for one year after your last dose. Let your provider know right away if you or your partner become pregnant during this time.
Fulvestrant (Faslodex) dosage
Syringe| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5ml of 50mg/ml | 2 syringes | $66.00 | $33.00 |
Typical dosage for Fulvestrant (Faslodex)
The typical starting dose is 500 mg injected into muscles of the buttocks every 2 weeks for the first 3 doses (Days 1, 15, and 29). After that, you’ll continue with a maintenance dose of 500 mg monthly.
Depending on your condition, you might be receiving fulvestrant (Faslodex) along with other medications to treat your cancer.
Interactions between Fulvestrant (Faslodex) and other drugs
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 this medicine, 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 this medicine 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.
- Fluoroestradiol F 18
How much does Fulvestrant (Faslodex) cost?
$66.00
What are alternatives to Fulvestrant (Faslodex)?
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