Evista®(raloxifene) is an osteoporosis medicine that is called a selective estrogen receptor modulator or SERM. You may also see it referred to as an estrogen agonist antagonist (EAA). These names are descriptive of its mechanism of action. Evista acts like estrogen in some tissues and blocks the effect of estrogen in others. Evista is beneficial to the bone without causing stimulation of breast tissue or lining of the uterus (endometrium).
Breast Cancer Reduction
Because of this action on breast tissue, women in clinical trials taking Evista had reduced rates of breast cancer compared with women on placebo. Therefore, Evista is also indicated for reduction of risk of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer and postmenopausal women with osteoporosis.
Effectiveness
If you are at higher risk for breast cancer and have low bone density, this may be a good choice for you. Bone density changes are not as robust as other medicines for osteoporosis. Nevertheless, Evista reduces the risk of fractures at the spine but not other sites. In the pivotal fracture trial, those with spine fractures when starting Evista 60 mg a day had a 30% reduction in risk of another spine fracture. Those with osteoporosis by bone density and no spine fractures has a 50% reduction in spine fracture risk.
Safety
Evista is a tablet taken once a day. No special dosing measures are required.
Evista has a black box warning for clotting problems in the deep vein in the legs. Also women with a history of or at risk for a heart attack have an increased risk for a fatal stroke. Therefore, if you have a history of clotting problems, heart attack or are at risk for a heart attack, you should not take this medicine.
The most common side effects are hot flashes, leg cramps, ankle swelling, joint pain, and flu symptoms. Leg cramps usually decrease with continued use. Hot flashes and sweats did not lead to stopping study medicine in the clinical trials.
Because of the clotting risk, if you are planning a long drive in the car or long plane trip, stop Evista three day ahead of time then resume after your trip. If your have a scheduled hospitalization or surgery that takes you off your feet, you should do the same.
Other Resources:
Evista product website
www.evista.com