Orserdu
Orserdu (elacestrant) is a selective estrogen receptor degrader (SERD), also known as an antiestrogen. It's used to treat advanced or metastatic ER-positive, HER2-negative breast cancer. Orserdu (elacestrant) isn't a first-choice option for this type of cancer, but typically only prescribed when other hormone therapy stopped working. Orserdu (elacestrant) is available as a tablet that’s taken by mouth once a day. This medication can cause side effects such as nausea, and muscle and joint pain.
What is Orserdu (elacestrant)?
What is Orserdu (elacestrant) used for?
- Advanced or metastatic breast cancer that's ER-positive, HER2-negative, with the ESR1 mutation (after previous hormone therapies have stopped working)
How Orserdu (elacestrant) works
Many breast cancers depend on hormones, like estrogen and progesterone, to grow. These specific types of breast cancer have the estrogen receptor (ER) or progesterone receptor (PR) on their cells. They are called hormone-receptor positive (HR+) breast cancer.
Orserdu (elacestrant) is a selective estrogen receptor degraders (SERDs), which is a type of hormone therapy. It binds and destroys estrogen receptors on breast cancer cells. Without estrogen, the breast cancer cells can’t grow or spread as easily.
Drug facts
Side effects of Orserdu (elacestrant)
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
- Muscle, bone or joint pain (41%)
- Nausea (35%)
- Higher blood cholesterol and triglyceride levels (up to 30%)
- Signs of stress to the liver on blood tests (up to 29%)
- Feeling very tired (26%)
- Lower hemoglobin levels (26%)
Less Common Side Effects
- Vomiting
- Not feeling hungry
- Diarrhea
- Constipation
- Headache
- Stomach pain
- Hot flash
The following Orserdu (elacestrant) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Bone, joint, or muscle pain
- Constipation
- Hot flashes
- Loss of appetite
- Nausea
- Stomach pain
- Vomiting
Pros and cons of Orserdu (elacestrant)
Pros
- Taken by mouth once a day
- Targeted therapy, so it works in a more specific way than traditional chemotherapy
- Don't need to take it with other anticancer medications
Cons
- Can raise cholesterol levels in the blood
- Commonly causes nausea and muscle pain
- Interacts with many medications, supplements, and food products (e.g. grapefruit juice)
Pharmacist tips for Orserdu (elacestrant)
- Orserdu (elacestrant) is available as 345 mg tablets and 86 mg tablets. You might need to take more than one 86 mg tablet to make your prescribed dose. Take the entire Orserdu (elacestrant) dose at once at around the same time every day.
- It’s best to take Orserdu (elacestrant) with food to avoid nausea. Make sure to swallow the tablets whole, don’t chew or crush the tablets.
- If you forget to take your Orserdu (elacestrant) dose and it’s more than 6 hours after the usual time, skip that dose and take your next dose at the regular time.
- Orserdu (elacestrant) can raise your cholesterol levels, which can raise your risk for heart attacks and strokes. Your provider will do blood tests and check on your lipid panel while you’re taking Orserdu (elacestrant). To keep your cholesterol level in a healthy range, it’s a good idea to maintain a balanced diet and engage in exercise regularly.
- Orserdu (elacestrant) can interact with other medications, supplements, and foods. For example, the herbal supplement St. John’s Wort can lower Orserdu (elacestrant) levels in the blood, which might make the medication not work as well. On the other hand, grapefruit juice can raise Orserdu (elacestrant) levels in the blood, which could put you at higher risk for side effects with the medication. It’s a good idea to share a complete list of medications, supplements, and herbals with your provider so they can make sure they’re safe to take with Orserdu (elacestrant).
- If you’re able to become pregnant, or if you’re male and have a partner who’s able to become pregnant, continue using effective birth control while taking Orserdu (elacestrant) and for at least a week after the last dose. There's a risk that Orserdu (elacestrant) can cause harm in an unborn baby.
Common questions about Orserdu (elacestrant)
Orserdu (elacestrant) and fulvestrant (Faslodex) are both selective estrogen receptor degraders (SERDs). Both can treat HR-positive, HER2-negative breast cancer. But, Orserdu (elacestrant) only treats breast cancer that has the ESR1 mutation. In addition, Orserdu (elacestrant) and fulvestrant (Faslodex) are used in slightly different ways and have different dosing strategies. For example, fulvestrant (Faslodex) is a first-choice treatment for breast cancer, while Orserdu (elacestrant) is only prescribed after the first-choice treatment no longer works well. Another example is that fulvestrant (Faslodex) is an injection usually given once a month, while Orserdu (elacestrant) is a pill that’s taken by mouth once a day. Talk with your healthcare team about which treatment might be best for you.
Orserdu (elacestrant) is FDA-approved for people with advanced or metastatic breast cancer that’s ER-positive, HER2-negative, and ESR-1 mutated. It’s typically only prescribed after you’ve already tried a first-choice hormone treatment, but it’s no longer working well to treat the cancer. Before considering Orserdu (elacestrant), your healthcare team will check if your cancer has an ESR1 mutation with a blood test or biopsy. If so, then Orserdu (elacestrant) might be a treatment option for you.
If you vomit after taking your Orserdu (elacestrant) dose, skip the dose and take your next dose at the regularly scheduled time. There’s no need to make up the dose or take a double dose. To prevent nausea and vomiting, try taking Orserdu (elacestrant) with food. If you often have a hard time keeping this medication down, let your provider know and they can recommend antinausea medications that are appropriate for you.
Nausea is a common Orserdu (elacestrant) side effect. Make sure to take Orserdu (elacestrant) with food to help prevent nausea. If your provider prescribed you an antinausea medication, take it 30 minutes to an hour before your Orserdu (elacestrant) dose. Eating smaller meals more often, instead of larger meals 3 times a day can also help you prevent stomach upset. If the nausea makes it hard for you to get through the day, talk to your healthcare team. If your side effects are severe and aren’t well-controlled by medications, your provider might lower your Orserdu (elacestrant) dose, or have you take a break from the medication.
Orserdu (elacestrant) commonly causes fatigue. If you feel tired or weak, do your best to get enough sleep, eat a healthy diet, and stay hydrated. If you're up for it, doing some light exercise and movement can also help you feel less tired. It’s a good idea to keep track of your energy levels throughout the day, so you can schedule activities for times when you have more energy. If you're too tired to go through your typical daily activities, talk with your healthcare team. They might have other recommendations to help with your fatigue. They might also adjust your Orserdu (elacestrant) dose or have you take a break from the medication.
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Risks and warnings for Orserdu (elacestrant)
Orserdu (elacestrant) 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.
Higher cholesterol levels
Orserdu (elacestrant) commonly raises triglyceride and cholesterol levels (lipids) in the blood. Before you start treatment with Orserdu (elacestrant), your provider will have you do a blood test to check on your cholesterol levels. They’ll continue checking your blood tests throughout treatment to make sure your lipid levels are in a safe range for you to continue the medication.
Harm to the unborn baby and breastfeeding child
Let your provider know if you are pregnant or plan to become pregnant. Orserdu (elacestrant) is likely to harm unborn babies. If you’re able to become pregnant, your provider will have you do a pregnancy test before starting treatment. If you’re able to become pregnant, or you’re male and have a partner who’s able to become pregnant, continue using effective birth control while taking Orserdu (elacestrant) and for at least a week after the last dose. Since Orserdu (elacestrant) hasn’t been studied in people who are lactating, avoid breastfeeding while taking this medication and for 1 week after stopping.
Orserdu (elacestrant) dosage
Typical dosage for Orserdu (elacestrant)
The typical dose is 345 mg by mouth with food once a day.
What are alternatives to Orserdu (elacestrant)?
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