Formulary
Fulvestrant: Indications, Dosing, Side Effects and Interactions
Fulvestrant clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Fulvestrant: Indications, Dosing, Side Effects and Interactions
Fulvestrant clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Oestrogen-receptor-positive breast cancer**
- **Adult** (By Deep Intramuscular Injection): 500 mg every 2 weeks for the first 3 doses, then 500 mg every month, to be administered into the buttock.
Side effects
Common or very common Appetite decreased; arthralgia; asthenia; diarrhoea; headache; hot flush; hypersensitivity; increased risk of infection; nausea; pain; rash; vaginal haemorrhage; venous thromboembolism; vomiting Uncommon Hepatic disorders; vaginal discharge Frequency not known Myalgia
Interactions
**Other interactions (3):**
- A clinical interaction study with midazolam (substrate of CYP3A4) demonstrated that fulvestrant does not inhibit CYP3A4.
- Clinical interaction studies with rifampicin (inducer of CYP3A4) and ketoconazole (inhibitor of CYP3A4) showed no clinically relevant change in fulvestrant clearance.
- Dose adjustment is therefore not necessary in patients who are receiving fulvestrant and CYP3A4 inhibitors or inducers concomitantly.
Pregnancy
Manufacturer advises avoid-increased incidence of fetal abnormalities and death in animal studies.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in mild to moderate impairment-risk of increased exposure; avoid in severe impairment-no information available.
Renal impairment
Manufacturer advises caution if creatinine clearance less than 30 mL/minute-no information available. See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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