COMMON BRAND NAME(S):
Evista

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Uses: Helps prevent osteoporosis in women after menopause; (2) treats osteoporosis after menopause.

Other (unlabeled) generally accepted uses: (1) Because of LDL and homocysteine lowering, may have a role in maintaining heart (cardiovascular) health; (2) may have a role in preventing breast cancer (one study found a 76% lower risk of breast cancer in a group of women who took this drug for 3 years [MORE trial], and is now being studied in the STAR trial); (3) Based on the MORE trial, data accumulated on cardiovascular benefits of this drug. The RUTH trial is under way to further define the benefits of raloxifene on the heart. Appears likely to have a significant role in preventing cardiovascular disease.

How This Drug Works: Works similar to estrogen itself on the bone (increasing bone density) and on LDL cholesterol (lowering it). Because of this. some people in the news media call raloxifene a designer estrogen. May block use (uptake) of estrogen (estradiol) and remove one stimulus for breast cancer. Benefits in preventing cardiovascular disease may involve decreases in fibrinogen, positive changes in endothelial function, decreased LDL and homocysteine. More data are needed.

Available Dosage Forms and Strengths

Tablets - 60 mg

Usual Adult Dosage Ranges:

Prevention of Postmenopausal Osteoporosis: 60 mg once daily. Supplemental calcium and vitamin D are prudent.
Treatment of Postmenopausal Osteoporosis: 60 mg once daily. Supplemental calcium and vitamin D are prudent.
Note: Actual dose and schedule must be determined for each patient
individually.

Conditions Requiring Dosing Adjustments

Liver Function: Extensively changed (metabolized) in the liver. Dose decreases appear prudent, but drug use not studied in this population. Most of the drug removal from the body is via feces.
Kidney Function: Not studied in people with kidney disease or compromise.

Dosing Instructions: The tablet may be crushed and taken without regard to food. If you forget a dose: Take the missed dose as soon as you remember it, unless it's nearly time for your next dose-if that is the case, skip the missed dose and take the next dose right on schedule. Talk with your doctor if you find yourself missing doses. There are beeper-based systems to help you. If a switch is being made from estrogen to raloxifene, some clinicians taper estrogen over at least a month to help decrease the chance of sudden menopause symptoms. It may also be best to have stopped taking estrogen for a month before starting raloxifene-this approach will allow any raloxifene-related problems to be clearly identified.

Usual Duration of Use: Use in clinical trials compared two years of raloxifene use to calcium use alone. The RUTH trial is ongoing. Some trials used measures of bone mineral density (BMD) to check the benefits of this drug. It appears prudent to check BMD before starting this medicine and then to recheck markers of bone turnover (such as N-telopeptides) and BMD once the medicine has been started to make sure that it is working. Long-term use requires physician supervision.

Please Note: The information contained on this page is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs or following any treatment or regimen. Only your doctor, nurse or pharmacist can provide you with advice on what is safe and effective for you.

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