The People's Perspective on Medicine



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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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Hi. I’ve been on reloxifine for over two years. Not sure if my symptoms are from it or not but the timing is indicative. I have had increased cracking and popping in my spine. Most of this is not accompanied by pain but overall I am having spinal pain. It started gradually. I have always been able to make my spine crack during yoga and some stretches.

I am active, do yoga, weights, jog, hike, walk and chores comparable to farm chores I am almost 61. I now have pain at he base of my neck like where one or two of the vertebrae are and now is accompanied by collar bone pain. I always wait a good long time with pain to let my body sort it out and heal. Especially at my age. But this is not going away.

My chiropractor adjusts it and also has given me several laser treatments. I am suspecting the reloxifine contributing to connective tissue and possible disk issues. I went thru almost two years of sacriailiac issues that gradually healed. Again laser therapy. I’ve always had good muscles and a strong back but the reloxifine seems to be depleting that in some way. I am too stubborn to not continue my activities and chores but I am very smart and careful too. Not careless at all.

I go slow deliberate and use good posture. Neck vertebrae pain is five months now. Collarbone is about three months. Comments about disks and connective tissue losss?

I too have been on Evista for a couple years. I take it to treat osteoporosis. It’s my understanding that Evista does nothing for osteoporosis in the spine, but is helpful in hip, etc. I am a migraine sufferer and have been for about 20 years. I have seen no improvement or worseneing in my migraines since using Evista. Evista has slightly improved my density readings. I do have some leg cramping, but nothing I can’t handle. I don’t like taking any medications, but feel better about Evista than Fosomax type treatments. Crap shoot either way in terms of safety, I guess.

OMG it is just FREAKING me out Reading all these things… They are the same things that have been going on with me for the last 20 yrs being on Evista !! Some Day’s I just can’t function, And to top it off my Osteoporosis got so bad my spine and neck and hips look like Swiss Cheese . They want me to start a new bone growing drug, but i’m scared it will mess with me causing growths where there should not be…. At A Loss … Just glad to see it is not just me having all these things happening to … I swear my Dr. Thought I was Just making this stuff up !!!! But now i see it is real .. TY all so much for the info…

I have been on Evista at least 16 years for Osteopenia. The studies regarding breast cancer protection were not out yet when I started taking it. However, I was pleased when I heard them, as my mother had breast cancer twice. Doctors have repeatedly tried to switch me over to Fosomax, and I have refused. I wanted the benefit of prevention from both. I have stayed in the osteopenia range until just this year. Now they are pushing me at Fosomax again and I am still refusing. My density numbers are minimally into the osteoporosis range and I have read too many bad things about the bone building medicines. However, I’m wonder how many years it is safe for me to be on Evista. I seem to have more years on the medicine than anyone else on this site. Leg cramps are my only side affect and drinking more water seems to help. I’m still in good health and physically active.

Been on Evista for 2 years. My Ob-gyn swears by it. My primary doctor wants me to switch to a Fosomax type product as she is concerned with the blood clot risk of Evista. I think both products are risky. I wonder if I take a baby aspirin in addition to Evista if I could lessen the blood clotting risk. I am scared to death to start using Fosomax type products.

Off Evista for a month after having taken it for only 3 days.. I still have sore neck and shoulder .
Knee pain, foot, ankle, toe swelling and pain.
Headaches, nausea, exhaustion and
. Depression. Which
comes and goes at varying degrees.
Varying degrees of pain and discomfort which move or disappear and then reappear.
I asked prescribing doc who insisted it was a virus. Was angry that I told him my symptoms.
Took Lyme disease test which was negative.
Any thoughts, my doc doesn’t know.

I forgot to add hot flashes.

Evista has been a terrible drug for me. I took it for five years in spite of leg cramps that were unbearable, hot flashes, and migraines. I stopped taking the drug 3 years ago and I still have the hot flashes and the migraines (very bad migraines, this time lasting the whole month), and foot cramps. I wonder if anyone else has been off of the medication and has migraines. Please let me know. Thanks!

I have been on Evista for about 10 years for Osteopenia. My Bone scans are good. I’m staying out of Osteoporosis. I stopped taking it for about a yr. & my scans went down.
Recently, I have been having weird symptoms. the most concerning is shoulder pain ( got a steroid shot for that) helped some. But also if I excerpt myself, I hurt across my chest & my arms really hurt. It could be my heart, but it occurred to me, it was possibly the Evista. After reading this site, I have had so, so many of the same symptoms all along. Like numb hands, that couId be Raynauds, leg cramps, bloating, diarrhea, trouble sleeping, now the shoulder & arms & sometimes hip. I really don’t remember how it was for the short time I stopped, because it’s been so long. It occurred to me that these problems could be due to the Evista. So, I didn’t take one this morning & I plan on stopping & will see what happens. Also, I take
Questran & I found out today, you’re not supposed to take Evista, if you take that! Duh, why didn’t my GP or GI doctor tell me that. If the shoulder and arm pain & shortness of breath continue when I excerpt myself, I’ll see a Cardiologist, I did just have an EKG it was perfect & I had an Eco Cardio about 6 mos. ago as part of my physical. I read they are doing a 5 yr. study with Evista vs Tamoxifen. I didn’t know they were so much alike. Well, I’m glad I found this site. I wish I knew how long it takes to get it out of your system & I see on here how many people have serious side effects for a long period of time! This is scary. Oh well, I’m stopping it & we shall see.

I stop taking Evista after 10 years by order of my Doctor. I was told when I had my last Bone Density test in January that I have not had any additional bone loss in my Left hip which was the reason I was diagnosed with Osteoporosis and placed on Evista. I have begun in the last 2 months having a lot of pain in my Left hip since the Evista was discontinued by my Doctor.

I stop taking Evista after 10 years by order of my Doctor. I was told when I had my last Bone Density test in January that I have not had any additional bone loss in my Left hip which was the reason I was diagnosed with Osteoporosis and placed on Evista. I had began having a lot of pain in my Left hip after the Evista was discontinued by my Doctor.

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.

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!

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

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?

I am replying to Del’s post on August 10, 2014. I hope that she will see this and respond. I stopped Evista 3 years ago and have been suffering from severe migraine headaches, increasing in length so that I have now had a headache for a month. I also have hot flashes. I had these symptoms while on the drug but to a lesser degree. I also had severe foot and leg cramping which I sometimes still get. I have lately been feeling shaky as well. I do wonder whether all of this is as a result of Evista, which I believe it to be. I will have a brain MRI soon.

Interesting to hear your problems after stopping Evista. I am 72, been on Evista about 10 years and was recently told it did no good after a certain age so should stop taking it. I did, about 2 months ago. I now have leg cramps at night, pressure and a constant humming sound in my head, and feel “down” a lot of the time. I do have an appointment with an endocrinologist coming up soon….. though Prolia and other meds were suggested by my internist, I do not like the information and side effects I read about them. Were you able to resolve your problems?

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?

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.

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.

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!!

I would also like some information on this subject.

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.

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.

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.

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!

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.


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.

I agree – seems shocking to me how little mild wine I can have now and I get wiped out with severe headache & nausea soon after /next day. After just a couple glasses. Definitely not normal – for me or for anyone else I know … I have wondered if it was the raloxifen ?????

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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