Selective oestrogen receptor degrader (SERD)
Fulvestrant
Brand names: Faslodex
Adult dose
Dose: 500mg IM (250mg into each buttock) on days 1, 15, 29, then monthly
Route: IM
Frequency: monthly
Clinical pearls
- Postmenopausal ER+ HER2- advanced/metastatic breast cancer
- Caution with anticoagulation — risk of haematoma at IM site
Contraindications
- Pregnancy/breastfeeding
- Severe hepatic impairment
- Bleeding disorders/anticoagulation (caution with IM)
Side effects
- Injection site reactions
- Hot flushes
- Nausea
- Hepatotoxicity
- Thromboembolism
Monitoring
- LFTs
Reference: BNF; NICE TA503/TA836; https://bnf.nice.org.uk/drugs/fulvestrant/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022