Raloxifene

Brand names

• Evista

Usage

For the treatment and prevention of osteoporosis in postmenopausal women. Unlike estrogen, raloxifene does not stimulate overgrowth of the endometrium (the tissue lining the uterus) and thus does not increase the risk of uterine cancer.

How it works

Healthy bone tissue is continuously remodeled (broken down and then reformed); the minerals and other components of bone are reabsorbed by certain cells and then replaced by new bone formation. Raloxifene suppresses the activity of the cells that resorb bone; consequently, the breakdown of bone tissue occurs more slowly than the laying down of new bone. This action preserves bone density and strength.

Side effects

Serious

No serious side effects have been reported.

Common

Leg cramps, increased incidence of infections, flu like symptoms, hot flashes, joint pain, sinusitis, unexpected weight gain.

Less common

Mild chest pain, fever, migraine, indigestion, vomiting, flatulence, stomach upset, swelling of the legs and feet, muscle pain, insomnia, sore throat, increased cough, pneumonia, laryngitis, rash, sweating, yeast infection, urinary tract infection, white vaginal discharge.

Possible interactions

Other medicaments:

The following medicaments may decrease the effects of raloxifene:

• ampicillin (Polycillin, Principen).
• ampicillin/sulbactam (Unasyn).
• cholestyramine (Questran).
• corticosteroids such as prednisone (Deltasone, others), as long-term use of those medicines can lead to osteoporosis.

Raloxifene taken concurrently with:

• other highly protein bound medicines, such as diazepam (Valium), indomethacin (Indocin), naproxen (Naprosyn) or others, should be done only with great caution.
• warfarin (Coumadin) may lower benefits of warfarin; increased frequency of INR (prothrombin time or protime) testing is needed.

Herbal medicines or minerals:

Make certain that you are getting adequate calcium in your diet. The average American diet has about 200 mg. Most people need 1,000 to 1,500 mg per day. Effervescent calcium (resulting in solution) may be absorbed more rapidly than other forms of calcium and can help prevent osteoporosis. Vitamin D and adequate sunlight are also needed. Soy or other plant-derived phytoestrogens may work to complement raloxifene. Ipriflavone is a synthetic flavonoid currently investigational for osteoporosis (which both inhibits bone resorption by reducing osteoclast recruitment and encourages osteoblast function).

Beverages:

Watch intake of phosphorous from soda.

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