The People's Perspective on Medicine

Raloxifene

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.

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.

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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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I’m 53 with osteopenia T scores. I exercise a lot (average 90 minutes per day over 7 days), lift weights, walk 20-30 miles per week, practice yoga and pilates and used to be a runner. I am 5’1″ tall and weigh about 111 now but usually hover about 114. I was on Boniva for about a year and developed jaw pain, spent money on a dentist to check for root canal needs and my tooth was fine. No pain since I went off boniva about 6 months ago. I eat well, take at least 2000mg calcium and 8000 mg D (yes, and my D in the blood is about 107). So…do I need Evista?? I checked out WebMD and there were very few if any positive comments about it. What do you think?

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