Facts about raloxifene
Susan Ott, M.D.
8/10/09
The brand name is Evista. This medication is not a bisphosphonate. It is related to estrogen because it activates the estrogen receptors on bone cells, so the effect on the bone is similar to low doses of estrogen. However, on the breast raloxifene inhibits the estrogen receptor, so it acts the opposite of estrogen on the breast.
The dose is 60 mg per day.
How to take
Take pill once a day, it doesn't really matter if it is with or without food.
Side effects
- Blood clots (thrombophlebitis) occur in 1 of 155 women over 3 years (about twice as many as seen in women who do not take raloxifene. These generally are in the calf, which becomes tender or swollen on one side. If this happens you should see a doctor right away to get checked for a blood clot.
- Leg cramps are seen in about 7% of women (twice as many as usual)
- Hot flashes are seen in about 10% of older women and about 25% in women closer to menopause. These are usually not as severe as the hot flashes that occured during menopause itself, and often they fade with time.
Benefits
The risk of spine fractures is reduced by approximately 40%. The risk of other kinds of fractures is not reduced. The studies of raloxifene, compared to a placebo, have lasted for 8 years and the drug remains beneficial during that time.
Women taking raloxifene will have about half as many cases of breast cancer as they would if they were not taking any medication. The company has not studied women who already have had breast cancer, so we don't know if it could prevent a recurrance.
No difference in risk of heart disease has been seen.
Follow-up
The bone density does not increase very much with raloxifene, even though the fracture rate is improved. The increase in bone density is about the same as the errors in the bone density machines, so it takes groups of women to prove that the medication increases bone density. For an individual, bone density can be measured every one to three years just to be sure it is not dropping rapidly. So far, no other tests are really recommended for follow-up.