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Home > Drug Category > Osteoporosis Medications > Evista and Equivalent

Evista Information

Evista (Raloxifene) is a selective estrogen receptor modulator used for both the prevention and treatment of osteoporosis in postmenopausal women. While it significantly reduces the risk of spine fractures, data suggest it is less effective at reducing non-vertebral or hip fractures compared to some other medications like bisphosphonates. It may also be used to lower the risk of invasive breast cancer in postmenopausal women who are at high risk.

Raloxifene works by attaching to estrogen receptors throughout the body, acting like estrogen in some tissues and blocking it in others. In the bones, it mimics the effects of natural estrogen. By binding to bone receptors, it signals the body to slow the cells that break down bone tissue, helping maintain bone density and preventing osteoporosis after menopause. In the breasts and uterus, it does the exact opposite by blocking estrogen. It binds to the receptors in these tissues but turns them off, preventing natural estrogen from attaching. This blocks the signals that cause cells to multiply, which lowers the risk of hormone-sensitive breast cancer from developing.

Evista Side Effects

Common mild side effects of this medication include hot flushes, flu-like symptoms, nausea, vomiting, stomach upset, headache, leg cramps, and swelling of hands and feet. (Unlike traditional hormone therapies, Evista blocks estrogen in the breasts and is not expected to cause breast pain or enlargement; contact your doctor if you notice any unusual breast changes.) Contact your doctor if these common side effects persist or worsen.

There is an increased risk of clotting problems, specifically deep vein thrombosis and pulmonary embolism, especially during the first four months of starting this medication. Hence, why it is important to discontinue this medication at least 72 hours prior to any event that may involve prolonged immobilization (such as upcoming major surgeries or extended travel/flights).

Therefore, stop taking this medication and seek immediate medical attention if you experience serious side effects such as:
• Allergic reactions such as breathing difficulties, body itching, body rash, skin blistering, swelling of the face, mouth, tongue, lips, or throat;
• Leg pain or a feeling of warmth in the lower leg (calf);
• Swelling of the legs, hands, or feet;
• Sudden chest pain, shortness of breath, or coughing up blood;
• Sudden change in your vision, such as loss of vision or blurred vision

Also, inform your doctor about any other side effects you notice that are not listed here.

Evista Precautions

Do not use this medication if you have:
• Active pregnancy or are currently breastfeeding.
• Allergic reactions to raloxifene, other ingredients in Evista, or any other medication;
• Current or past history of blood clot disorders such as deep vein thrombosis, pulmonary embolism

You must inform your doctor about any medical conditions you previously or currently have before starting this medication, as this medication needs to be used with caution in individuals with some medical conditions, such as:
• Cerebrovascular accidents such as stroke;
• High triglycerides in the blood caused by previous estrogen use;
• Immobilized for some time, such as being wheelchair-bound;
• Liver disease, including cirrhosis, mild hepatic impairment, or cholestatic jaundice;
• Severe kidney disease;
• Unexplained vaginal bleeding or active uterine cancer

Cholesterol-lowering medication such as cholestyramine should not be taken with Evista. It binds to raloxifene in the digestive tract, severely disrupting its absorption and circulation, which makes Evista much less effective. Raloxifene can decrease the blood-thinning effect of warfarin, meaning the warfarin dose may need adjustment to maintain safe therapeutic levels. Therefore, it is important to inform your doctor about any other medications you are currently taking, including herbal products and supplements, to determine whether they are safe to use with raloxifene.

Evista is strictly contraindicated during pregnancy because its hormonal effects can cause severe developmental harm to the fetus. It is also not for use while breastfeeding, as it remains unknown whether the drug passes into breast milk, and it could potentially impair milk production or affect infant development. Therefore, women who are pregnant, planning to become pregnant, or nursing must not take this medication. Store this medication at room temperature and keep it out of reach of children and pets.

Do I need a prescription to order Evista?

Yes, a prescription is required from your physician to order Evista.