Dr. MJ Bazos MD, Patient Handout

Osteoporosis and Raloxifene (Evista)

What is osteoporosis?

Osteoporosis is a disease that causes bones to break more easily. It is most common in women. 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?

• Exercise regularly.
• Quit smoking.
• Drink only moderate amounts of alcohol.
• Eat a well-balanced diet.
• Take extra calcium and vitamin D.

What is raloxifene and what does it do?

Raloxifene (brand name: Evista) is a new medicine that helps prevent and treat 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.

Raloxifene is being tested to see if it lowers the risk of heart disease.

Raloxifene doesn't cause some side effects that estrogen causes, like vaginal spotting (bleeding) and breast tenderness. Raloxifene also doesn't seem to increase the risk of cancer of the uterus or breast. However, it doesn't make hot flushes go away (a benefit of estrogen replacement therapy).

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 (one brand name: Questran). And you shouldn't take estrogen at the same time, in injections, pills or patches.

If you're taking warfarin (one brand name: Coumadin), your doctor may want to check your prothrombin time (time it takes for your blood to clot) 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 right away if you have pain in the calves (lower part of legs), leg swelling, sudden chest pain, shortness of breath, if you are coughing up blood, or if you notice changes in your 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 have limited mobility (if you are in a cast, in a wheelchair, or in bed) for a long time.
• You have liver disease or are allergic to raloxifene or any of its ingredients.