raloxifene, Evista

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Medical Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: raloxifene

BRAND NAME: Evista

DRUG CLASS AND MECHANISM: Estrogen is a hormone which among other actions, regulates the turnover (formation and destruction) of bone. Decreases in estrogen levels that are seen after menopause or after removal of the ovaries, lead to a loss of bone density and weakened bones, a condition called osteoporosis. Raloxifene decreases bone turnover and increases bone density although not to the same extent as estrogen itself. This makes bones stronger and prevents fractures in women with osteoporosis. Raloxifene is called a "selective estrogen receptor modulator" since it has effects like estrogen on some tissues but inhibits the effects of estrogen on other tissues. Raloxifene decreases low density lipoprotein (LDL or "bad") cholesterol in the blood; however, unlike estrogen, raloxifene does not increase high density lipoprotein (HDL or "good") cholesterol. The FDA approved raloxifene in December 1997.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Tablets: 60 mg.

STORAGE: Tablets should be stored between 15C-30 C) and (59-86 F).

PRESCRIBED FOR: Raloxifene is prescribed for the prevention and treatment of osteoporosis in post-menopausal women. Supplemental vitamin D should be added to the diet if daily intake is not adequate.

DOSING: The recommended dose of raloxifene is 60 mg once daily. It can be taken with or without meals.

DRUG INTERACTIONS: Cholestyramine (Questran) reduces the absorption of raloxifene. Therefore, these two medications should be taken several hours apart. Raloxifene may slightly reduce the ability of blood to clot and thus increase the effects of medications that reduce clotting (blood thinners). Therefore, if raloxifene is given with blood thinners such as warfarin (Coumadin), the ability of blood to clot may need to be monitored more closely with frequent measurements of the prothrombin time of blood.

PREGNANCY: Raloxifene may cause fetal harm if used during pregnancy and should not be used during pregnancy or in women who may become pregnant.

NURSING MOTHERS: Raloxifene should not be used by women who are breastfeeding.

SIDE EFFECTS: The most common side effects of raloxifene are diarrhea, nausea, headache, hot flashes, sinusitis, weight gain, muscle pain, leg cramps, and ankle swelling. Raloxifene may increase blood triglyceride levels in some individuals Raloxifene increases the risk of blood clots, including stroke, deep vein thrombosis (DVT), and pulmonary embolism (blood clots in the lung). The greatest increase in risk occurs during the first 4 months of use. Patients taking raloxifene should avoid prolonged periods of restricted movement during travel when blood clots are more prone to occur. Patients should move around periodically during long trips.

Reference: FDA Prescribing Information

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