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Fulvestrant  (Faslodex® )

Brand name: Faslodex® 

Generic name: Fulvestrant  

Therapeutic Class: estrogen receptor antagonists 

Manufacturer / Distributor: AstraZeneca 

Availability: Fulvestrant is available by prescription only  

Indication: Fulvestrant is used to treat hormone-dependent locally metastatic breast cancer in some postmenopausal women. Fulvestrant may also be used to treat other types of breast cancers that have been unsuccessfully treated with antiestrogen medications such as tamoxifen (Nolvadex).  

Fulvestrant may also be prescribed for other medical conditions not mentioned in this article; talk to your doctor or pharmacist for more information.   

Dosage form: Fulvestrant is taken as an injection into the muscle (intramuscular).  

Dosage: to determine an effective dosage to fight your cancer, your doctor will consider your state of health, other medications you are taking, the severity of the tumor and your body surface area (BSA). After the evaluation of these criteria, you will be recommended to take the most effective doses. It is important to take Fulvestrant as recommended by your doctor. Even if you are experiencing side effects, it is important to continue and complete the therapy as indicated by your doctor or pharmacist. 

Fulvestrant is given intramuscularly (injection into the muscle). Usually, the drug is given once per month in the muscle of the buttocks. Fulvestrant may be injected by your health care provider or by yourself. If you take Fulvestrant by yourself, you must learn how to do so if you are not a medical professional. It is necessary that you understand exactly how to inject the drug as directed by your health care provider.  

Before taking the medication, make sure it is in good quality. Fulvestrant solution comes as a thick, transparent, colorless or turning yellow substance. Before injecting it, check whether it retains its color. Regardless the circumstances, do not use the drug if it is cloudy or discolored. In addition, avoid using Fulvestrant if you realize there particles floating in the content.  

Storage: store Fulvestrant at room temperature (15-25 ° C), away from light, moisture and heat above 40 ° C. Fulvestrant and all other medications should not be used beyond the expiration date printed on the container. Keep the medication out of the reach of children.    

Overdose: high or/and long term Fulvestrant overdose can be dangerous. In fact, even at normal dose, Fulvestrant can lead to a decrease in white blood cells or in platelets that can cause serious infections. If you take an overdose, contact your doctor or poison control center nearest you to reduce or prevent complications. All chemotherapy drugs can lead to death when they are overdosed.  

Missing dose: it is important to do  your best to take the medication as recommended by your doctor or pharmacist; and this is important not only for Fulvestrant but all other drugs . Fulvestrant is taken once a month; chance of missing dose is very low. 

Contraindication: Fulvestrant is contraindicated or should be used with precaution in the following conditions: 

  • allergic to Fulvestrant  or to any of its ingredients 
  • severe liver disease  
  • children 
  • infants 
  • newborns
  • young adults 
  • p regnant women 
  • women who are breast-feeding 
  • Chronic alcoholism. 

Before beginning a Fulvestrant treatment, talk to your doctor if you have chronic kidney disease, hemorrhagic disease, thrombocytopenia, osteoporosis and epilepsy.  In addition, let your doctor know if you are being treated with anticoagulants. 

Mechanism of action (MOA): Fulvestrant belongs to estrogen receptor antagonists, a group of chemotherapy drugs that inhibit and combat the development of cancer cells. The fact that the cells of hormone-dependent breast cancers need estrogen for their growth and survival, Fulvestrant works by blocking the effects of the hormone estrogen in the body. 

Interactions: before taking Fulvestrant, tell your doctor about all medications you are taking, whether prescription or non prescription. Talk to your doctor before taking vitamins and nutritional supplements. Some drugs such as anticoagulants (blood thinners) and warfarin (Coumadin) can cause health problems when they are combined with Fulvestrant.  

Side effects: Fulvestrant may cause adverse effects in some patients; most Fulvestrant side effects include:    

  • hair loss 
  • headache
  • mouth sores
  • nausea and vomitting
  • constipation or diarrhea
  • decreased appetite 
  • trouble sleeping
  • flushing 
  • dizziness  
  • impotence or decreased sexual desire  
  • swollen or tenderness of breasts  
  • feeling of fullness in abdomen  
  • dry mouth  
  • Flu-like symptoms: runny nose, headache, muscle or joint pain, fatigue, sore throat, etc. 

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor immediately if you experience any of these symptoms:   

  • nervousness 
  • confusion 
  • depression  
  • chest pain  
  • shortness of breath or difficulty breathing  
  • pain or tenderness in the stomach  
  • dizziness or fainting  
  • unusual bleeding or bruising 
  • yellowing of the skin or eyes  
  • persistent hoarseness or cough  
  • chest tightness or wheezing  
  • stools containing blood or blackish stools 
  • pain in lower back or side 
  • numbness, tingling, pain or weakness in hands, arms, legs or feet  
  • skin rash  
  • swelling of face, fingers, feet or lower legs  
  • bluish lips, fingernails, or palms Hand  
  • Bloody or dark urine.