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Generic Name: Braloxifene
Brand Name(s):
Information updated: April 1, 2000
Overview
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 Estrace.
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.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.
© 2000