Am Fam Physician. 1999;60(4):1139
See related article on raloxifene.
What is osteoporosis?
Osteoporosis is a disease that causes bones to break more easily. It begins in women around the time of menopause. The major cause is lack of estrogen. Osteoporosis can lead to painful fractures (broken bones), most often in the hips, backbone or arms.
How can I keep from getting osteoporosis?
Drink only moderate amounts of alcohol.
Eat a well-balanced diet.
Take extra calcium and vitamin D.
If you have gone through menopause, take estrogen replacement therapy, if you can. If you can't take estrogen, or if you don't want to, you might take raloxifene.
What is raloxifene? What does it do?
Raloxifene (brand name: Evista) is a new medicine that helps prevent osteoporosis. It can only be used after menopause. It slows bone loss and slightly increases normal bone growth. It lowers total and LDL (“bad”) cholesterol levels in the blood. It doesn't raise triglyceride or HDL (“good”) cholesterol levels.
We still need to prove that raloxifene prevents bones fractures or lowers the risk of heart disease.
Raloxifene doesn't seem to increase the risk of cancer of the uterus or breast. It doesn't have some side effects of estrogen, like vaginal spotting (bleeding) and breast tenderness. However, it doesn't make hot flushes go away (a major benefit of estrogen).
How is raloxifene taken?
Raloxifene is taken as a tablet once a day. It can be taken with or without food.
While taking raloxifene, you shouldn't also take medicines that lower cholesterol levels, like cholestyramine (brand name: Questran). And you shouldn't take estrogen at the same time, in injections, pills or patches.
If you're taking warfarin (brand name: Coumadin), your doctor may want to check your prothrombin time more often and adjust your dosage of warfarin.
Does raloxifene have any side effects?
Most side effects are mild. The most common effects are hot flushes and leg cramps.
A rare but serious side effect is blood clots in the veins. Call your doctor as soon as you can if you have pain in the calves (lower part of legs), leg swelling, sudden chest pain, shortness of breath, coughing up blood, changes in vision.
Who shouldn't take raloxifene?
You shouldn't take raloxifene if:
You're pregnant or can become pregnant.
You have or have had blood clots.
You will be immobile (in a cast or in bed) for a long time.
You have liver disease or are allergic to raloxifene or any of its ingredients.