raloxifene
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.
What is Raloxifene (Evista)?
What is Raloxifene (Evista) used for?
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
How Raloxifene (Evista) works
Raloxifene (Evista) is a selective estrogen receptor modulator (SERM). It either acts like estrogen or blocks the activity of estrogen, depending on where the medication works in the body.
In your bones, raloxifene (Evista) acts like estrogen. This helps prevent bone breakdown and improve bone mineral density (BMD), which is a measure of how dense your bones are. A higher BMD means your bones are stronger, which helps lower your risk of bone fractures.
In your breast, raloxifene (Evista) blocks estrogen from entering cells. This prevents estrogen from turning on signals that make breast cells cancerous.
Drug Facts
More on Raloxifene (Evista) essentials
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What are the side effects of Raloxifene (Evista)?
Common Side Effects
- 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%)
Other Side Effects
- Vertigo (feeling like your surroundings are spinning)
- Sweating
- Fever
- Vomiting
- Nerve pain
- Urinary tract problems
Serious Side Effects
- Blood clot: leg pain or swelling, skin that's warm to the touch, trouble breathing
- Stroke: sudden weakness on one side of the body, confusion, severe headache, changes in speech or vision
Source: DailyMed
More on Raloxifene (Evista) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Stop taking this medicine and get emergency help immediately if any of the following effects occur:
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Bloody or cloudy urine
difficult, burning, or painful urination
frequent urge to urinate
infection, including body aches or pain, congestion in throat, cough, dryness or soreness of throat, runny nose, and loss of voice
leg cramping
skin rash
swelling of hands, ankles, or feet
vaginal itching
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Hot flashes, including sudden sweating and feelings of warmth (especially common during the first 6 months of treatment)
increased white vaginal discharge
joint or muscle pain
mental depression
problems of stomach or intestines, including passing of gas, upset stomach, or vomiting
swollen joints
trouble in sleeping
weight gain (unexplained)
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Raloxifene (Evista)
Pros
Can take at any time of day, with or without food
Lowers the risk of back fractures
Lowers the risk of invasive breast cancer in certain postmenopausal women
Doesn't have a known risk for uterine (endometrial) cancer
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
Pharmacist tips for Raloxifene (Evista)
Take raloxifene (Evista) every day. You can take the medication at any time of day, with or without food. Staying consistent with when you take raloxifene (Evista) and whether you take it with food can help you remember to take your medication.
Raloxifene (Evista) can cause hot flashes. Avoid eating spicy foods or drinking alcohol or caffeine since they can trigger hot flashes or make you feel worse. Also, keep a fan nearby and your room cool to help you feel more comfortable if you get a hot flash.
When you take a long plane or car trip, consider wearing compression socks or stretching your legs often to help improve blood flow. This helps lower your risk of clots from raloxifene (Evista) and from not moving for a long time.
Tell your healthcare provider as soon as you know of any upcoming situations where you won't be moving for a long time, like bedrest or recovery from major surgery. Both raloxifene (Evista) and not being able to move can put you at risk for blood clots. Your provider will tell you when to stop raloxifene (Evista) and when to restart it to lower your clot risk in these situations.
It's not recommended to take medications that contain estrogen, like certain types of hormonal therapy for menopause, while you're taking raloxifene (Evista). We don't know how safe it is to use these medications together yet.
Tell your healthcare providers about any other medications you're taking, especially warfarin (Coumadin), benzodiazepines, or bile acid sequestrants like cholestyramine (Prevalite). Drug interactions with raloxifene (Evista) can either make your medications work less well or raise the risk of side effects. Your providers can check for interactions.
Frequently asked questions about Raloxifene (Evista)
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What are the risks and warnings for Raloxifene (Evista)?
Raloxifene (Evista) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk for blood clots and stroke
Risk factors: History of blood clots, stroke, or "mini-stroke" | At higher risk for heart disease | Situations where you're not moving for a long period of time | High blood pressure | Atrial fibrillation | Cigarette smoking
Raloxifene (Evista) can raise your risk of blood clots. The risk for clots appears to be greatest during the first 4 months of treatment. Blood clots can lead to life-threatening complications, such as stroke.
Let your healthcare provider know about your medical history, especially if you've had a blood clot or stroke before. Your provider can discuss the risks and benefits of taking raloxifene (Evista). You won't be able to take this medication if you've had any blood clots in the past.
Get emergency help right away if you have pain in your arms or legs, bad headaches, trouble breathing, sudden changes in your speech or vision, or sudden weakness on one side of your body. These can be signs of a blood clot or stroke.
High triglyceride levels
Risk factors: History of high triglyceride levels from previous estrogen use
It's possible for your triglyceride (fat) levels to go up while you're taking raloxifene (Evista) if your triglyceride levels are already high as a side effect of other estrogen medications. Your healthcare provider will order regular blood tests for you to get done while you're taking raloxifene (Evista) if you're at risk for very high triglyceride levels.
Continue to monitor for breast cancer
Raloxifene (Evista) helps prevent breast cancer, but it doesn't completely get rid of the risk. Continue to get breast scans (mammograms) and regularly check your breasts for any lumps or changes. Talk to your healthcare provider if you notice any unusual changes in shape, size, or color of your breast.
Interaction with warfarin (Coumadin)
Taking raloxifene (Evista) with warfarin (Coumadin) might raise the risk for side effects from the blood thinner, most notably bleeding. Let the healthcare provider who's managing your warfarin know that you're taking raloxifene (Evista). You might need to do blood tests when you start or stop taking raloxifene (Evista) to make sure the warfarin levels in your body are safe. Tell your healthcare provider if you notice more bleeding than usual, such as nosebleeds lasting more than 10 minutes or severe bruising.
Raloxifene (Evista) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 60mg | 90 tablets | $40.82 | $0.45 |
Typical dosing for Raloxifene (Evista)
The typical dose is 60 mg by mouth once daily.
Interactions between Raloxifene (Evista) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Raloxifene (Evista) cost?
Raloxifene (Evista) contraindications
Current or history of blood clots
Currently pregnant
What are alternatives to Raloxifene (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
Prevention and treatment of osteoporosis in females
Treatment of osteoporosis in males
Early-stage HR+ breast cancer after surgery to lower the risk of breast cancer coming back
Ductal carcinoma in situ (DCIS) in females after breast surgery and radiation to lower the risk of breast cancer coming back
Lowering the risk of breast cancer in females who are considered high risk
What is the latest news about Raloxifene (Evista)?
Raloxifene (Evista) images
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References
Best studies we foundAmerican Cancer Society. (2021). Invasive breast cancer (IDC/ILC).
American Cancer Society. (2021). Tamoxifen and raloxifene for lowering breast cancer risk.
Camacho, P. M., et al. (2020). American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2020 update. Endocrine Practice.
Centers for Disease Control and Prevention. (2024). Understanding blood clots infographic.
Davis, S. R., et al. (2012). Understanding weight gain at menopause. Climacteric.
Eli Lilly and Company. (2023). Evista- raloxifene hydrochloride tablet [package insert]. DailyMed.
Ganesan, K., et al. (2023). Biphosphonate. StatPearls.
Journal of Clinical Endocrinology and Metabolism. (2014). What does estrogen do?
Lee, H. W., et al. (2022). Pharmacokinetic drug interaction between raloxifenee and cholecalciferol in healthy volunteers. Clinical Pharmacology in Drug Development.
MedlinePlus. (2024). Bone density.
National Cancer Institute. (2010). The study of tamoxifen and raloxifene (STAR): Questions and answers.
Ouellet, D., et al. (2006). Effects of lasofoxifene on the pharmacokinetics and pharmacodynamics of single-dose warfarin. British Journal of Clinical Pharmacology.
Qaseem, A., et al. (2023). Pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults: A living clinical guideline from the American College of Physicians. Annals of Internal Medicine.
Rey, J. R., et al. (2009). Raloxifene: Mechanism of action, effects on bone tissue, and applicability in clinical traumatology practice. The Open Orthopaedics Journal.
Vogel, V. G. (2011). Update on raloxifene: Role in reducing the risk of invasive breast cancer in postmenopausal women. Breast Cancer.
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