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FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE

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About the medicine

How to use FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Fulvestrant Mylan 250 mg solution for injection in pre-filled syringe EFG

fulvestrant

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor, pharmacist, or nurse.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack

  1. What is Fulvestrant Mylan and what is it used for
  2. What you need to know before you use Fulvestrant Mylan
  3. How to use Fulvestrant Mylan
  4. Possible side effects
  5. How to store Fulvestrant Mylan
  6. Contents of the pack and other information

1. What is Fulvestrant Mylan and what is it used for

Fulvestrant Mylan contains the active substance fulvestrant, which belongs to the group of estrogen blockers. Estrogens, a type of female sex hormone, may be involved in the development of breast cancer in some cases.

Fulvestrant Mylan is used:

  • alone, to treat postmenopausal women with a type of breast cancer called hormone receptor-positive breast cancer, which is locally advanced or has spread to other parts of the body (metastatic) or,
  • in combination with palbociclib to treat women with a type of breast cancer called hormone receptor-positive, human epidermal growth factor receptor 2 (HER2) negative breast cancer, which is locally advanced or has spread to other parts of the body (metastatic). Women who have not reached menopause will also be treated with a medicine called luteinizing hormone-releasing hormone (LHRH) agonist.

Fulvestrant may be administered in combination with palbociclib. It is important that you also read the package leaflet of palbociclib. If you have any questions about palbociclib, ask your doctor.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you use Fulvestrant Mylan

Do not use Fulvestrant Mylan

  • if you are allergic to fulvestrant or any of the other ingredients of this medicine (listed in section 6)
  • if you are pregnant or breast-feeding
  • if you have severe liver problems

Warnings and precautions

Talk to your doctor, pharmacist, or nurse before using Fulvestrant Mylan if any of the following apply to you:

  • kidney or liver problems
  • low platelet count (which helps blood to clot) or bleeding disorders
  • previous blood clot problems
  • osteoporosis (loss of bone density)
  • alcoholism

Children and adolescents

Fulvestrant Mylan is not indicated in children and adolescents under 18 years.

Other medicines and Fulvestrant Mylan

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. In particular, you should tell your doctor if you are using anticoagulants (medicines to prevent blood clots).

Pregnancy and breast-feeding

You should not use Fulvestrant Mylan if you are pregnant. If you can become pregnant, you should use effective contraception while being treated with Fulvestrant Mylan and for 2 years after the last dose.

You should not breast-feed while being treated with Fulvestrant Mylan.

Driving and using machines

Fulvestrant Mylan is not expected to affect your ability to drive or use machines. However, if you feel tired after treatment, do not drive or use machines.

Fulvestrant Mylan contains 10% v/v ethanol (alcohol),i.e., 500 mg per dose, which is equivalent to less than 25 ml of beer or 10 ml of wine per treatment dose (i.e., two syringes). The small amount of alcohol in this medicine does not have any noticeable effect.

Fulvestrant Mylan contains benzyl alcohol

This medicine contains 500 mg of benzyl alcohol in each 5 ml, which is equivalent to 100 mg/ml (10% v/v). Benzyl alcohol may cause allergic reactions.

Fulvestrant Mylan contains benzyl benzoate

This medicine contains 750 mg of benzyl benzoate in each 5 ml, which is equivalent to 150 mg/ml (15% v/v).

3. How to use Fulvestrant Mylan

Follow exactly the instructions for administration of this medicine given by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

The recommended dose is 500 mg of fulvestrant (two injections of 250 mg/5 ml) administered once a month with an additional dose of 500 mg administered 2 weeks after the initial dose.

Your doctor or nurse will administer Fulvestrant Mylan by slow intramuscular injection into each buttock.

If you have any further questions on the use of this medicine, ask your doctor, pharmacist, or nurse.

Medicine questions

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4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

You may need urgent medical attention if you experience any of the following side effects:

  • Allergic reactions (hypersensitivity), including swelling of the face, lips, tongue, and/or throat, which may be symptoms of anaphylactic reactions
  • Thromboembolism (increased risk of blood clots)*
  • Hepatitis (inflammation of the liver)
  • Liver failure

Tell your doctor, pharmacist, or nurse immediately if you notice any of the following side effects:

Very common side effects(may affect more than 1 in 10 people)

  • Injection site reactions, such as pain and/or inflammation
  • Abnormal liver enzyme levels (in blood tests)*
  • Nausea (feeling sick)
  • Weakness, fatigue*
  • Joint and musculoskeletal pain
  • Hot flashes
  • Rash
  • Allergic reactions (hypersensitivity), including swelling of the face, lips, tongue, and/or throat

All other side effects:

Common side effects(may affect up to 1 in 10 people)

  • Headache
  • Vomiting, diarrhea, or loss of appetite*
  • Urinary tract infections
  • Back pain*
  • Increased bilirubin (a bile pigment produced by the liver)
  • Thromboembolism (increased risk of blood clots)*
  • Decreased platelet count (thrombocytopenia)
  • Vaginal bleeding
  • Lumbar pain radiating to one leg (sciatica)
  • Sudden weakness, numbness, tingling, or loss of movement in your leg, especially on one side of the body, sudden problems with walking or balance (peripheral neuropathy)

Uncommon side effects(may affect up to 1 in 100 people)

  • Thick, white, vaginal discharge and candidiasis (infection)
  • Hematoma and bleeding at the injection site
  • Increased gamma-GT, a liver enzyme identified in a blood test
  • Hepatitis (inflammation of the liver)
  • Liver failure
  • Numbness, tingling, and pain
  • Numbness, tingling, and pain
  • Anaphylactic reactions

*Including side effects for which the exact role of Fulvestrant Mylan cannot be evaluated due to the underlying disease.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse, even if it is possible that they are not listed in this leaflet. You can also report side effects directly through the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Fulvestrant Mylan

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton or on the labels of the syringes after the abbreviation EXP. The expiry date refers to the last day of the month stated.

Store and transport in a refrigerator (between 2°C and 8°C).

Temperature excursions outside the range of 2°C to 8°C are permitted, provided that the mean kinetic temperature does not exceed 25°C (but above 2°C to 8°C). After temperature excursions, the medicine should be immediately returned to the recommended storage conditions (store and transport in a refrigerator between 2°C and 8°C). Temperature excursions have a cumulative effect on the quality of the medicine, and the 28-day period should not be exceeded beyond the shelf life of Fulvestrant Mylan. Exposure to temperatures below 2°C will not harm the medicine, provided it is not stored below -20°C.

The pre-filled syringe should be kept in the original packaging to protect it from light.

Your healthcare professional will be responsible for the proper storage, use, and disposal of Fulvestrant Mylan.

This medicine may pose a risk to the aquatic environment. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and other information

What Fulvestrant Mylan contains

  • The active substance is fulvestrant. Each pre-filled syringe (5 ml) contains 250 mg of fulvestrant.
  • The other ingredients (excipients) are: benzyl benzoate (see section 2, ‘Fulvestrant Mylan contains benzyl benzoate’), benzyl alcohol (see section 2, ‘Fulvestrant Mylan contains benzyl alcohol’), anhydrous ethanol (see section 2, ‘Fulvestrant Mylan contains 10% v/v ethanol’), and refined castor oil.

Appearance and pack of Fulvestrant Mylan

Fulvestrant Mylan is a viscous, clear, colorless to yellow solution in a pre-filled syringe equipped with a tamper-evident closure, which contains 5 ml of injectable solution.

Fulvestrant Mylan is available in 4 formats: a pack containing 1 glass pre-filled syringe or a pack containing 2 glass pre-filled syringes or a pack containing 4 glass pre-filled syringes or a pack containing 6 glass pre-filled syringes. Safety needles (BD SafetyGlide) are also provided for connection to the syringe body.

Not all pack sizes may be marketed.

Marketing authorisation holder

MYLAN PHARMACEUTICALS LIMITED

Damastown Industrial Park

Mulhuddart

Dublin 15

DUBLIN

IRELAND

Manufacturer

MYLAN TEORANTA

Inverin

Co. Galway

IRELAND

Mylan Germany GmbH

Zweigniederlassung Bad Homburg v. d. Hoehe, Benzstrasse 1

Bad Homburg v. d. Hoehe

Hessen, 61352,

GERMANY

You can request more information about this medicine from the local representative of the marketing authorisation holder:

België/Belgique/Belgien

Mylan bvba/sprl

/Tel/Tél: + 32 (0)2 658 61 00

Lietuva

Mylan Healthcare UAB

Tel: +370 5 205 1288

Text in Bulgarian language including the name Майлан ЕООД and a phone number +359 2 44 55 400

Luxembourg/Luxemburg

Mylan bvba/sprl

Tél/Tel: + 32 (0)2 658 61 00

(Belgique/Belgien)

Ceská republika

Viatris CZ.s.r.o.

Tel: +420 222 004 400

Magyarország

Mylan EPD Kft.

Tel.: + 36 1 465 2100

Danmark

Viatris ApS

Tlf: + 45 28 11 69 32

Malta

V.J. Salomone Pharma Ltd

Tel: + 356 21 22 01 74

Deutschland

Viatris Healthcare GmbH

Tel: + 49800 0700 800

Nederland

Mylan BV

Tel: +31 (0)20 426 3300

Eesti

BGP Products Switzerland GmbH Eesti filiaal

Tel: +372 6363 052

Norge

Viatris Norge AS

Tlf: + 47 66 75 33 00

Ελλáδα

Generics Pharma Hellas ΕΠΕ

Τηλ: +30 210 993 6410

Österreich

Arcana Arzneimittel GmbH

Tel: +43 1 416 2418

España

Viatris Pharmaceuticals, S.L.U.

Tel: + 34 900 102 712

Polska

Mylan Healthcare Sp. z.o.o.

Tel.: + 48 22 546 64 00

France

Viatris Santé

Tél: +33 4 37 25 75 00

Portugal

Mylan, Lda.

Tel: + 351 21 412 72 00

Hrvatska

Mylan Hrvatska d.o.o.

Tel: +385 1 23 50 599

România

BGP Products SRL

Tel: + 40372 579 000

Ireland

Mylan Ireland Limited

Tel: +353 1 8711600

Slovenija

Viatris d.o.o.

Tel: + 386 1 23 63 180

Ísland

Icepharma hf.

Sími: + 354 540 8000

Slovenská republika

Viatris Slovakia s.r.o.

Tel: +421 2 32 199 100

Italia

Mylan Italia S.r.l.

Tel: + 39 02 612 46921

Suomi/Finland

Viatris Oy

Puh/Tel: + 358 20 720 9555

Κúπρος

Varnavas Hadjipanavis Ltd.

Τηλ: + 357 2220 7700

Sverige

Viatris AB

Tel: + 46 (0)8 630 19 00

Latvija

Mylan Healthcare SIA

Tel: +371 676 055 80

United Kingdom (Northern Ireland)

Mylan IRE Healthcare Limited

Tel: +353 18711600

Date of last revision of this leaflet:{MM/AAAA}.

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.

This information is intended only for healthcare professionals:

Fulvestrant Mylan 500 mg (2 × 250 mg/5 ml solution for injection) should be administered using two pre-filled syringes, see section 3.

Administration instructions

Warning: Do not autoclave the safety needle (hypodermic needle) before use. Hands should remain behind the needle at all times during use and disposal.

For each of the two syringes:

  • Remove the glass syringe body from the tray and check that it is not damaged.
  • Open the outer packaging of the safety needle.
  • Before administration, parenteral solutions should be inspected visually for particulate matter and discoloration.
  • Hold the syringe in an upright position, grasping the ribbed part (C). With the other hand, grasp the cap (A) and carefully tilt it back and forth until the cap comes off and can be removed, do not twist (see Figure 1).

Figure 1

Correct and prohibited rotation of an auto-injector device with arrows and letters indicating parts

  • Remove the cap (A) by pulling upwards. To maintain sterility, avoid touching the syringe tip (B) (see Figure 2).

Figure 2

Hand holding auto-injector with arrow indicating direction and parts labeled A, B, and C of the cylindrical device

  • Attach the safety needle to the “Luer-Lock” and screw it on until it is firmly attached (see Figure 3).
  • Check that the needle is attached to the Luer connector before releasing it from the upright position.
  • Pull the needle shield straight off to avoid damaging the needle tip.
  • Take the loaded syringe to the injection site.
  • Remove the needle shield.
  • Expel any excess air from the syringe.

Figure 3

Hand holding an insulin applicator and a pre-filled needle with arrow indicating direction of insertion

  • Administer slowly by intramuscular injection into the buttock (gluteal area) (1-2 minutes/injection). For greater comfort, the position of the needle with the bevel up has the same orientation as the lever raised (see Figure 4).

Figure 4

Hypodermic needle with bevel angled and sharp tip inside an enlarged circle and connected syringe

  • After injection, immediately touch the lever with one finger to activate the protective mechanism (see Figure 5).

NOTE: Activate the mechanism away from your body and others. Listen for the click and visually confirm that the needle tip is fully protected.

Figure 5

Connected needle with white parts and a black arrow indicating direction of insertion

Disposal

The pre-filled syringes are for single use only.

This medicine may pose a risk to the aquatic environment. Disposal of unused medicine and all materials that have been in contact with it should be done in accordance with local regulations.

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Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

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Frequently Asked Questions

Is a prescription required for FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE?
FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE?
The active ingredient in FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE is fulvestrant. This information helps identify medicines with the same composition but different brand names.
Who manufactures FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE?
FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE is manufactured by Mylan Pharmaceuticals Limited. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to FULVESTRANT MYLAN 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE?
Other medicines with the same active substance (fulvestrant) include AFULTRANT 250 mg Injectable Solution in Pre-filled Syringe, AMBIFUL 250 mg SOLUTION FOR INJECTION IN PRE-FILLED SYRINGE, FASLODEX 250 mg/5 ml INJECTABLE SOLUTION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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