Side Effects of Fulvestrant

Common Side Effects

The National Comprehensive Cancer Network recommends that patients be monitored for musculoskeletal effects, as arthralgia (joint pain) affects approximately 17% of patients, making it one of the most frequently reported side effects 2
The National Comprehensive Cancer Network notes that vasomotor symptoms, such as hot flashes, occur in approximately 11% of patients 2

The use of fulvestrant in combination with CDK4/6 inhibitors, such as palbociclib, is associated with hematologic toxicities, including Grade 3-4 neutropenia (62% vs 0.6% with fulvestrant alone) and leukopenia (25.2% vs 0.6%) 3
The combination of fulvestrant with abemaciclib is associated with Grade 3-4 neutropenia (26.5% vs 1.7% with fulvestrant alone) and diarrhea (86.4% all grades, 13.4% grade 3-4) 4
The use of fulvestrant with ribociclib is associated with Grade 3-4 neutropenia (46.6% vs 0% with fulvestrant alone) 5

The National Comprehensive Cancer Network recommends that fulvestrant be administered as a monthly intramuscular injection (500 mg), sometimes with a loading dose regimen (500 mg every 2 weeks for 3 doses, then monthly) 2
The higher dose regimen (500 mg) has shown improved efficacy over the lower dose (250 mg) without additional toxicity 2

The National Comprehensive Cancer Network notes that fulvestrant generally maintains quality of life when used as monotherapy 2
The use of fulvestrant in combination with CDK4/6 inhibitors, such as palbociclib, is associated with maintained global quality of life 3
The combination of fulvestrant with CDK4/6 inhibitors is also associated with improved emotional functioning 3
The use of fulvestrant with CDK4/6 inhibitors, such as palbociclib and abemaciclib, is associated with improved pain control 3, 4
The combination of fulvestrant with abemaciclib is associated with delayed deterioration in physical and social functioning 4