Until fairly recently, women at risk of osteoporosis had a difficult choice: taking estrogen strengthened the bones, but increased the risk of breast cancer.

Evista belongs in a new category of drugs, selective estrogen receptor modulators, or SERMs. By tailoring the molecule’s estrogenic action, scientists have been able to create a medicine that has some of the beneficial effects, but not all of the drawbacks.

This compound slows bone breakdown, giving the bone-building cells a chance to catch up and re-establish equilibrium. Evista is prescribed for postmenopausal women to keep their bones from weakening with age. Short slender women, those who have smoked, and those whose mothers had osteoporosis are at the greatest risk of this condition. Unlike estrogen, Evista does not make a woman more vulnerable to breast cancer. In addition, it does not predispose a woman to uterine cancer, as both estrogen and tamoxifen do.

Side Effects and Interactions

The most common side effects of Evista are hot flashes and leg cramps.

Your doctor should be notified immediately of any of the following symptoms: pain in the calf or groin, sudden shortness of breath or sharp chest pain, sudden severe headache, blurred vision or speech, weakness or numbness in an arm or leg. These might indicate a blood clot requiring prompt medical attention.

Other side effects reported with Evista include migraine headaches, sinusitis, joint pain, insomnia, rash, sweating, digestive upset, vaginitis, and infections.

Evista may alter tests of blood fats, lowering total cholesterol, LDL cholesterol, apolipoprotein B and fibrinogen. It raises values of apolipoprotein A1.

Like estrogen, it may increase the levels of certain thyroid tests without changing thyroid function.

Evista may change prothrombin times modestly if given with Coumadin, so monitoring is important.

Medications such as ibuprofen (Advil, Motrin IB), indomethacin and naproxen (Aleve, Naprosyn) may interact with Evista.

Check with your doctor and pharmacist before taking any other medicine while taking Evista.

Special Precautions

Pregnant women should avoid Evista just as they would avoid any estrogen; it could have a negative effect on the fetus. Women with a history of blood clotting disorders such as thrombophlebitis should not take Evista, either.

Like estrogen, this medication raises the possibility of clots and their complications, which can be extremely serious. Because of this danger, women who must be bedridden for several days due to accident, illness or surgery should discontinue Evista (72 hours ahead of time if possible).

Immobility increases the risk of clotting, so on long trips women taking Evista are encouraged to get up and move around whenever they can.

Taking the Medicine

Evista is taken in one daily 60 mg tablet. It does not matter what time of day the pill is swallowed, and it may be taken either with meals or on an empty stomach. Unless the diet is rich in calcium, supplements of this mineral and vitamin D are recommended to get the maximum benefit from Evista.

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  1. EM
    New York USA

    I stopped taking Evista about 4 months ago after 5 years with no side effects on the advice of my doctor and now have pains in my legs. I’m not sure if it’s connected since I also stopped taking vitamins then. I’ve started calcium and fish oil again, but so far still have a significant amount of pain especially when I’m sitting still.

    • Michele

      Doctor prescribed raloxifene when I was in my 50s because my mother died of breast cancer and it was believed to block estrogen from breasts. It must have worked as I took it for 15 years without side effects and no bone problems.
      I stopped taking it believing there couldn’t be much estrogen left. Eighteen months later had lumpectomy for early tumor that was estrogen receptive. Get those mammograms!

      • Gina

        Michele in GA,

        You answered 27 questions I didn’t realize were one. I’ll be 49 my next b-day and knock on wood there’s longevity for a while. I would hope your rationale for coming off raloxifene wasn’t because of the expense in retirement years. Hang in there and thank you, really.

  2. Mah

    I stopped taking evista after five years. Within four weeks I had joint pain in neck. I have a history of osteoarthritis I am seeing dr to go back on it. I believe the estrogen effect of evista helped me with joint pain. During menopause I had a lot of neck pain that went away with hrt

  3. DEL

    I stopped taking Evista 6 months ago, after taking it for 10 years post breast cancer. I had no side effects while on Evista. Within 3 weeks after stopping it, I began having really intense pressure in my head which has continued for 6 months. Additionally, my eyes became extremely dry, to where I cannot wear my contacts. I also now have ringing in my ears.
    I have had extensive blood work, in addition to a neck and brain MRI, plus sinus CT and everything has come out normal. Could it be due to stopping the Evista? Has anyone else had a similar experience?

  4. efn

    I have been taking evista for 3 1/2 yrs. I am 68 and experiencing joint pain but only on the right side. I am active and started playing tennis again about 6 months ago. I am not sure if the joint pain is from arthritis or evista.
    I also have a slight pain in the groin area but most of the pain is in my knee. I want to stop taking evista but I am not sure that it is the cause. other than the joint pain I have had no side effects.
    Should I stop and if so can I resume it at a later time?

  5. Marilyn

    I have been having hot flashes and shortness of breath since taking this drug. I would also like to know how long after stopping this drug I can expect these side effects to stop.

  6. Cindy S

    I am checking to see how long after stopping Evista does it take to get out of your system? Thanks
    I have had leg pain, weight gain and fatigue as well, and lower back pain.

  7. LC

    I was diagnosed with PE last month. Terrible condition to survive and recovery is quite lengthy – up to a year. I read these warnings about Evista and stopped taking it. No clots in my legs, but both lungs have several – 2 Doppler Ultrasounds – so I feel Evista may be my problem? I stopped Evista cold turkey’ and have had no side effects – yet?? I am taking coumadin. Side effects aren’t ‘nice’ on that drug, either!!

  8. DD

    I would also like some information on this subject.

  9. Lbs

    Should you go cold turkey or slowly withdraw? I have taken Evita for more than 7 years. I am experiencing leg and hip pain as well as having sleep issues.

  10. Delores

    I have begin to have severe cramps and pain in both my legs. This started when I started taking Evista. I am going off the medication to see if this medicine is the problem.

  11. BD

    I was diagnosed with ADH and had a surgery to remove the ADH cells. Now my Dr is strongly suggesting I start taking Evista to prevent breast cancer. She remarked several times that she was not guaranteeing I would live longer if I took evista. I thought that was a strange remark to say to me. I wonder if Evista really does help prevent breast cancer cells from occurring or is this just a maybe thing. I have read of many side affects that would be unwelcome including the blood clot issue. Close family members have died of strokes and heart attacks. I am very afraid to start taking this drug.

  12. Malana

    No. There are absolutely no withdrawal symptoms from stopping Evista abruptly. At least not for me. I stopped several times when I went into the hospital and never noticed a thing. I recently went off again to see if it contributed to my chronic migraines. The migraines have been cut in half since I stopped Evista. Every other drug looks like a horror to me, so I don’t know if I will go on any of these drugs anymore (Boniva, Actonel etc) The side effects are insane. I am trying weights and calcium instead!

  13. PA HOLT

    I am 66 years old, my doctor has just taken me off Evista after 17 years of HRT. I have osteoporosis and take calcium and vitamin supplements. Are there any withdrawal symtoms to be aware of and any other products I can take to help the osteoporosis, thank you.

  14. jn


  15. eel

    Has anyone ever commented on whether they think Evista might have changed their alcohol tolerance? I cannot even have one alcoholic drink without getting a headache or stomachache or both since I started taking Evista.

  16. Betty

    I would like to know how long it takes to clear Evista and Actonel from the system. I had side effects from them, particulary lip and mouth, and am still having night time tingling and numbness of the arms.
    Can the withdrawal of Evista simulate going off estrogen for a period of time? Thanks for your response.

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