Raloxifene
EVISTA
Pronunciation: ral-OX-i-feen (ee-VIS-ta)
“Eve is a Rolex fiend”
Pink ribbon → reduces invasive breast cancer risk
Bone → SERM agonist at bone (osteoporosis)
What it isSelective estrogen receptor modulator; postmenopausal osteoporosis and breast cancer risk reduction.
Why this oneIt builds bone while blocking estrogen in the breast, reducing invasive breast cancer risk — a combination estrogen cannot offer.
What limits itVenous thromboembolism and hot flushes. Vertebral fracture data only, with no hip fracture benefit.
FDA-approved for
- osteoporosis (1997)
- breast cancer prevention (2007)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Osteoporosis (treatment/prevention) and reduction of invasive breast cancer risk | Postmenopausal women | 60 mg QD | 60 mg QD | 60 mg QD |
Renal Undefined
Hepatic Use with caution
Instructions
- May be taken any time of day without regard to meals
- Add supplemental calcium and/or vitamin D if dietary intake is inadequate
- Discontinue 72 hours before and during prolonged immobilization
Available strengths
- tab 60 mg
Contraindications
- Active or past history of venous thromboembolism (DVT, PE, retinal vein thrombosis)
- Pregnancy
Cautions
- Venous thromboembolism; discontinue 72 h before/during prolonged immobilization
- Increased risk of death due to stroke in women at risk for major coronary events
- Not for primary/secondary prevention of cardiovascular disease
- Not recommended in premenopausal women
- Hepatic impairment — use with caution
- Not recommended with systemic estrogens
- Monitor triglycerides if prior estrogen caused hypertriglyceridemia
Adverse reactions
- Hot flashes, leg cramps, peripheral edema, flu syndrome, arthralgia, sweating
Pregnancy Contraindicated — may cause fetal harm; not for females of reproductive potential.
Lactation Undefined
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 60 mg | tab | 30 qd | $6.70 | offered |
Generic entry2014
⚠ BOXED WARNINGS
- Venous thromboembolism
- Death from stroke in women at increased cardiovascular risk
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityVenous thromboembolism and hormone-related adverse effects; estrogen also lowers lamotrigine exposure.
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