(fool-VES-trant)

Trade names: Faslodex^®

Chemocare.com uses generic names in all descriptions of drugs. Faslodex is the trade name for fulvestrant. In some cases, health care professionals may use the trade name faslodex when referring to the generic drug name fulvestrant.

Drug type:  Fulvestrant is a hormone therapy.  It fights cancer as an "estrogen receptor downregulator."  (For more detail see "How this drug works," below).

What Fulvestrant Is Used For:

• To treat estrogen receptor positive metastatic breast cancer (cancer that has spread) in postmenopausal women, with disease progression following antiestrogen therapy.

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Fulvestrant Is Given:

• As an injection into the muscle (intramuscular, IM).
• Fulvestrant is usually given as a once a month injection.  Your doctor will determine any variations to this dosing or schedule.

Side Effects:

Important things to remember about the side effects of fulvestrant:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration. 
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking fulvestrant:

• None occurring greater than 30%

These side effects are less common side effects (occurring in about 10-29%) of patients receiving fulvestrant:

• Nausea and vomiting  
• Weakness 
• Hot flashes (see sexuality)
• Sore throat (pharyngitis, see cold symptoms)
• Headache 
• Bone pain 
• Constipation 
• Diarrhea 
• Abdominal pain 
• Injection site reaction with mild temporary pain and swelling at the site.
• Cough 

Other:

• Vaginal bleeding reported infrequently (less than 1%), mainly in patients during the first 6 weeks after changing from existing hormonal therapy to treatment with fulvestrant.  If bleeding persists contact your health care provider.
• A rare (less than 1%), but serious side effect of fulvestrant is blood clots, including deep vein thrombosis (DVT) and pulmonary embolus. 
• You should seek emergency help and notify your health care provider immediately if you develop sudden chest pain and shortness of breath.  Notify your health care provider within 24 hours if you notice that one leg is swollen, red, painful and/or warm to touch and the other is not.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

• Sudden shortness of breath and/or chest pain

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

• Swelling, redness and/or pain in one leg or arm and not the other
• Excessive vaginal discharge or bleeding, menstrual (period) pain or irregularities
• Nausea (interferes with ability to eat and unrelieved with prescribed medication)
• Diarrhea (4-6 episodes in a 24-hour period)
• Constipation unrelieved by laxative use

Always inform your health care provider if you experience any unusual symptoms.

Precautions

• Before starting fulvestrant treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
• Let your health care professional know if you have ever had a blood clot that required medical treatment.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (fulvestrant may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
• For both men and women: Do not conceive a child (get pregnant) while taking fulvestrant. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self-Care Tips:

• If you are experiencing hot flashes, wearing light clothing, staying in a cool environment, and putting cool cloths on your head may reduce symptoms. Consult your health care provider if these worsen, or become intolerable
• This medication causes little nausea.  But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals.  Sucking on lozenges and chewing gum may also help. 
• Avoid sun exposure.  Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
• Get plenty of rest. 
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking fulvestrant, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.   

How Fulvestrant Works:

Hormones are chemical substances that are produced by glands in the body, which enter the bloodstream and cause effects in other tissues.  For example, the hormone testosterone made in the testicles and is responsible for male characteristics such as deepening voice and increased body hair.  The use of hormone therapy to treat cancer is based on the observation that receptors for specific hormones that are needed for cell growth are on the surface of some tumor cells.  Hormone therapies work by stopping the production of a certain hormone, blocking hormone receptors, or substituting chemically similar agents for the active hormone, which cannot be used by the tumor cell.  The different types of hormone therapies are categorized by their function and/or the type of hormone that is affected.

Many breast cancers have estrogen receptors, and the growth of these tumors can be stimulated by estrogen. Fulvestrant is an estrogen receptor downregulator, this means it binds to the estrogen receptor site in competition with estrogen in the body.  Once it binds to the site it causes the receptors to break down, thereby preventing normal cellular response to estrogen.
 
Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.  

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