Examples

Raloxifene is taken in pill form every day. It can be taken at any time during the day. It is used only for postmenopausal women.

How It Works

Raloxifene is a selective estrogen receptor modulator (SERM), which works like estrogen on bone. It also works like an "anti-estrogen" on breast tissue and the uterus.¹ As a result, raloxifene:

• Prevents and treats osteoporosis by slowing bone thinning and causing some increase in bone thickness.
• Lowers the risk of breast cancer.

Compared to estrogen therapy (used to protect the bones) or tamoxifen (used to treat cancer), raloxifene is less likely to cause uterine cancer.

Why It Is Used

Raloxifene is used to prevent and treat osteoporosis in women.

Raloxifene can also be used to help prevent breast cancer in women who have a high risk for breast cancer.²

How Well It Works

Bone. Studies show that raloxifene increases bone mineral density in the bones of the spine and neck. This lowers the risk for broken spinal bones.³ Although raloxifene works much like estrogen, it may not be as effective on bone.

Breast cancer. Among high-risk women, raloxifene lowers the risk of breast cancer about as much as tamoxifen does.²

Side Effects

Side effects of raloxifene include:

• Hot flashes.
• Vaginal dryness.
• Leg cramps.
• Blood clots in deep veins (deep vein thrombosis). You may or may not have symptoms of deep vein thrombosis. Symptoms that occur in the legs include:
  • Swelling.
  • Warmth.
  • Pain or tenderness.
  • Redness.
  Sometimes life-threatening pulmonary embolism is the first sign that you have deep vein thrombosis. Pulmonary embolism is the sudden blockage of an artery in the lung. Blood clots in the deep veins of the leg are the most common cause of pulmonary embolism. Symptoms of pulmonary embolism include:
  • Sudden shortness of breath.
  • Chest pain that may get worse with a deep breath.
  • A cough that may bring up blood.
  • A fast heart rate.
• Uterine cancer (rare).

Less serious side effects include:

• Muscle and joint aches.
• Weight gain.
• Rash.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Raloxifene raises your risk of dangerous blood clots. So does bed rest. If you plan to have a surgery followed by bed rest, stop taking raloxifene at least 3 days before the surgery. This will lower your risk of blood clots.

Raloxifene should not be used in women who:

• Are pregnant or might become pregnant. If you are nursing, do not take raloxifene, because experts do not know if the drug passes through breast milk.
• Have a history of blood clots in their deep veins (venous thromboembolism, deep vein thrombosis, or pulmonary embolism).
• Are taking certain medicines, such as cholestyramine, to lower the amounts of cholesterol in the blood.
• Have liver disease.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Abramowicz M (2006). Raloxifene (Evista) for breast cancer prevention in postmenopausal women. Medical Letter on Drugs and Therapeutics, 48(1234): 37.

2. Vogel VG, et al. (2006). Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: The NASBP study of tamoxifen and raloxifene (STAR) P-2 trial. JAMA, 295(23): 2727–2741.

3. Drugs for prevention and treatment of postmenopausal osteoporosis (2005). Treatment Guidelines From the Medical Letter, 3(38): 69–74.