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Evista vs. Reclast

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Raloxifene (Evista) and zoledronic acid (Reclast) are both used to treat osteoporosis in women, but they work in different ways and have different forms of administration. Raloxifene is a selective estrogen receptor modulator (SERM) taken as a daily oral tablet, while zoledronic acid is a bisphosphonate given as an intravenous (IV) infusion, typically once a year or every two years. Zoledronic acid can also be given as a one-time dose only. Raloxifene also helps lower the risk of invasive breast cancer in postmenopausal women, whereas zoledronic acid can be used to treat additional conditions like Paget's disease and osteoporosis in men. Common side effects of raloxifene include hot flashes and joint pain, while zoledronic acid can cause fever, muscle pain, and flu-like symptoms after infusion. Raloxifene carries a risk of blood clots and stroke, whereas zoledronic acid has risks like jawbone breakdown and kidney damage. Zoledronic acid and raloxifene are available in both brand and generic forms.

Raloxifene

(Evista)

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Reclast

(zoledronic acid)

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Summary for Evista

Prescription only

Raloxifene (Evista) is used to treat osteoporosis (bone loss) and lower the risk of breast cancer in women who've gone through menopause. This medication belongs to the drug class known as selective estrogen receptor modulators (SERMs). Raloxifene (Evista) is a tablet that's taken once a day. Side effects can include hot flashes, headaches, and joint pain.

Indications for Evista

  • Osteoporosis in women who've gone through menopause (postmenopausal)
  • Lower the risk of invasive breast cancer in postmenopausal women who are at high risk for breast cancer or who have osteoporosis

Pros and Cons for Evista

Pros

Cons

  • Not a first-choice option for osteoporosis
  • Has some serious risks, such as blood clots
  • Not approved for preventing breast cancer in women who haven't gone through menopause yet or who have a history of breast cancer
  • Not approved for treating breast cancer

Common Side Effects for Evista

  • Joint pain (16%)
  • Flu-like symptoms (14%)
  • Hot flashes (10%)
  • Bronchitis (10%)
  • Runny nose (10%)
  • Cough (9%)
  • Headache (9%)
  • Nausea (8%)
  • Sinus infection (8%)
  • Leg cramps (7%)
  • Diarrhea (7%)
  • Swelling in the arms or legs (5%)

Warnings for Evista

  • Higher risk for blood clots and stroke
  • High triglyceride levels
  • Continue to monitor for breast cancer
  • Interaction with warfarin (Coumadin)

Summary for Reclast

Prescription only

Reclast (zoledronic acid) is used to treat osteoporosis. It's only available as an intravenous (IV) infusion that's given at a clinic or your provider's office. The medication is an option for postmenopausal women with osteoporosis who can't take bisphosphonates by mouth or for those at very high fracture risk. Reclast (zoledronic acid) is a long-lasting medication, so the dosing isn't often (either one-time only, once a year, or once every 2 years). It can cause side effects like muscle and joint pain, headache, and fever. This medication is available under the brand name Reclast and as a generic.

Indications for Reclast

Pros and Cons for Reclast

Pros

  • Lowers the risk of fractures in different parts of the body, including the hip and back
  • Infusions are one-time only, once a year, or once every 2 years
  • Can freely choose when to eat, drink, or take other medications
  • Can use if you can't take other bisphosphonates because of trouble swallowing or too much stomach pain
  • Can consider using for postmenopausal women with osteoporosis who have very high fracture risk

Cons

  • Only available as an IV infusion that's given at a clinic or provider's office
  • Risk of many side effects, including joint or muscle pain and severe jaw problems
  • Risk of side effects like fever, pain, and chills after each infusion
  • Might cause breathing problems in people allergic to aspirin

Common Side Effects for Reclast

  • Joint pain (up to 24%)
  • Fever (up to 18%)
  • Higher blood pressure (up to 13%)
  • Headache (up to 12%)
  • Muscle pain (up to 12%)
  • Arm or leg pain (up to 11%)
  • Arthritis (up to 9%)
  • Flu-like symptoms (up to 9%)
  • Nausea (up to 9%)
  • Dizziness (up to 8%)
  • Shoulder pain (up to 7%)
  • Bone pain (up to 6%)
  • Diarrhea (up to 6%)
  • Vomiting (up to 5%)

Warnings for Reclast

  • Breakdown of the jaw (osteonecrosis)
  • Low calcium in the blood
  • Kidney damage
  • Leg bone fractures
  • Severe bone, joint, or muscle pain
  • Harm to unborn baby

Prices with our coupons for Evista vs. Reclast

Price Card Drug Icon
Raloxifene90 tablets / 60mg
$35.64$378.52
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Price Card Drug Icon
Zoledronic Acid1 vial / 5ml of 4mg/5ml
$17.68$908.12
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