Raloxifene (Evista®)

Raloxifene is a medication that is Food and Drug Administration (FDA)-approved to treat osteoporosis. This medication moderately reduces the activity of bone resorbing cells, so that less mineral is removed from bones. This helps to maintain bone density and bone strength, so they are less likely to fracture with minor trauma such as a fall on ice.

Raloxifene is also under investigation as an agent that may prevent breast cancer. This medication works like estrogen in bone, but opposes estrogen in the breast and uterus. Therefore, unlike estrogen, it is not associated with any increased risk of breast or uterine cancer.

The usual dose of raloxifene is 60 mg taken orally once per day.

Raloxifene is associated with a small increased risk of blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolus). This medication should not be used by those who have a history of these disorders. Hot flashes may occur in women on raloxifene.

In unusual circumstances, headache, stomach upset or blurred vision may occur with use of raloxifene.

Raloxifene prevents further bone loss but causes only small increases in bone density. Raloxifene reduces the risk of spine fractures by 30 percent to 50 percent, but does not appear to reduce the risk of nonvertebral fractures.

No laboratory tests to monitor for side effects are needed. Typically, a repeat bone mineral density test is done two years after stopping raloxifene to be sure that bone density is stable, and that more bone loss is not occurring.

It is very important that those using raloxifene get adequate amounts of calcium and vitamin D through their diet or supplements. Inadequate amounts of daily calcium or vitamin D may blunt the benefit of these medicines.