Fulvestrant

Uses

Precaution

Side Effects

Handling

Uses

What is Fulvestrant for?

Fulvestrant is used to treat breast cancer that is hormone-sensitive (estrogen receptor positive). It may be used alone or in combination with other medications such as palbociclib, abemaciclib, or ribociclib.
Fulvestrant works by blocking the effects of estrogen (a hormone), to stop or slow the growth of hormone-sensitive breast cancer cells.

How should I take or use Fulvestrant?

Fulvestrant is injected into the muscles of your buttocks as two injections, one injection in each buttock.

It is given as two injections on day 1, day 15, and day 29 of the first month, and as two injections once every month in the following months.

Precaution

What precautions should I take when taking or using Fulvestrant?

Inform your healthcare professional if:
- You are allergic to this medication or any of the other ingredients of this medication.
- You are taking any other medications (such as blood thinners), including supplements, traditional medications and herbal remedies.
- You have any other medical conditions such as liver, kidney or bleeding conditions.
- You are going to receive any vaccination or surgery, including dental surgery.
You should not breastfeed during treatment of Fulvestrant and at least1 year after stopping Fulvestrant.
You should not become pregnant during treatment. You should use an effective birth control method during treatment and for at least 1 year after stopping Fulvestrant.

Side Effects

What are some common side effects of Fulvestrant?

The table below will list some of the common side effects as well as the rare but serious side effects.

Side Effect	Management
Swelling, bruising, tenderness and redness of the skin at the injection site. May also cause nerve damage at the injection site, which is close to a large nerve (sciatic nerve) that runs from your lower back to your legs.	Apply cool compress at the injection site for 15 to 20 minutes several times a day. Seek medical attention if you have: Symptoms that do not go away Sharp pain at the buttock or hip that spreads down the leg (sciatica) Numbness, tingling or weakness of the legs
Hot flushes (sudden sweating and feeling of warmth)	Wearing light clothing, and staying in a cool environment may reduce these symptoms. Inform your doctor if these symptoms affect you significantly.
Muscle aches and/or joint pain	Light exercises e.g. stretching can help with joint stiffness and aches. Mild pain can be relieved by taking Paracetamol. Inform your doctor if the pain is not better. Do not take Paracetamol if you are having a fever at the same time. Taking regular warm baths may help.
Nausea or vomiting. This is usually mild.	Take small and frequent meals. Avoid foods or smells that may make you feel nauseous, such as oily, fried or strong-smelling food. Avoid tight-fitting clothes around the waist. Your doctor may prescribe medications to help relieve or prevent nausea or vomiting. Take these as instructed.
Feeling tired or lack of energy	Do not drive or operate machinery if you are feeling tired. Eat well and get enough sleep. Prioritize tasks to ensure you make the best use of your energy. Simple exercise such as walking can help to boost your energy. Avoid alcohol as this may cause you to feel more tired and drowsy.
Liver problems	Proceed to the A&E department immediately if you experience any: Dark or tea-coloured urine Pale or light-coloured stools Yellowing of skin or eyes Nausea, vomiting with loss of appetite Severe abdominal pain
Symptoms of drug allergy including one or more of the following: Swollen face/eyes/lips/tongue Difficulty in breathing Itchy skin rashes over your whole body	If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Handling

How should I store Fulvestrant?

Store in the refrigerator between 2-8°C, away from direct sunlight. Do not freeze. Keep this medication away from children.

Disclaimers

Please take note that the above is not a complete list of all possible side-effects. If you have any concerns about your medication or if you have other side-effects that you think are caused by this medication, please consult your doctor or pharmacist. If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (NHG Health, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.