Evista (raloxifene hydrochloride) is a selective estrogen receptor modulator (SERM) specifically engineered for postmenopausal women to combat osteoporosis and reduce the risk of invasive breast cancer. It offers a targeted therapeutic approach by mimicking estrogen’s beneficial effects on bone density without stimulating uterine or breast tissue, providing a favorable safety profile for long-term use. Clinically proven to significantly decrease vertebral fractures, Evista represents a cornerstone in preventive women’s health, combining efficacy with well-tolerated management for at-risk populations.

Features

• Contains 60 mg raloxifene hydrochloride per tablet
• Administered as a once-daily oral medication
• Selective estrogen receptor modulator (SERM) class
• Non-hormonal mechanism of action
• Available in blister packs of 28 tablets
• Requires no dosage titration for most patients

Benefits

• Significantly increases bone mineral density, reducing fracture risk
• Lowers incidence of invasive breast cancer in postmenopausal women with osteoporosis
• Avoids estrogen-related stimulation of endometrial tissue
• Provides a convenient, once-daily dosing regimen
• Demonstrates a favorable long-term safety profile in clinical trials
• Offers an alternative for patients contraindicated for traditional hormone therapy

Common use

Evista is primarily prescribed for the prevention and treatment of osteoporosis in postmenopausal women. It is also indicated for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis or those at high risk for invasive breast cancer. Healthcare providers may consider Evista for women who cannot or prefer not to take estrogen-based therapies but require bone protection.

Dosage and direction

The recommended dosage is one 60 mg tablet taken orally once daily, with or without food. Patients should swallow the tablet whole with water and not crush or chew it. Evista may be taken at any time of day, though consistency in timing is recommended to maintain steady blood levels. Treatment should be combined with adequate calcium and vitamin D intake through diet or supplements as directed by a healthcare provider.

Precautions

Patients should undergo baseline bone density testing before initiation. Regular mammograms and gynecological examinations are recommended during treatment. Use with caution in patients with a history of venous thromboembolism (VTE), as SERMs increase VTE risk. Liver function should be monitored periodically. Patients should avoid prolonged immobilization during therapy. Not recommended for premenopausal women or those with childbearing potential.

Contraindications

Evista is contraindicated in women with active or past history of venous thromboembolic events, including deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis. Additional contraindications include pregnancy, lactation, known hypersensitivity to raloxifene or any component of the formulation, and women who may become pregnant. Concurrent use with systemic estrogen therapy is not recommended.

Possible side effects

Common side effects include hot flashes, leg cramps, peripheral edema, and arthralgia. Serious side effects may include venous thromboembolism, stroke, and fatal myocardial infarction (observed in clinical trials). Less frequently reported effects include gastrointestinal disturbances, rash, and increased blood pressure. Patients should report any unusual symptoms, particularly leg pain or swelling, chest pain, or neurological changes, immediately to their healthcare provider.

Drug interaction

Evista may interact with cholestyramine and other anion exchange resins, reducing its absorption. Concurrent use with warfarin may require monitoring of prothrombin time. Highly protein-bound drugs such as diazepam, diazoxide, and NSAIDs may theoretically interact, though clinical significance is uncertain. Avoid concomitant systemic estrogen therapy.

Missed dose

If a dose is missed, patients should take it as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Consistent daily administration is important for optimal therapeutic effect.

Overdose

Limited data exist on Evista overdose. In clinical trials, single doses up to 600 mg were administered without serious adverse effects. There is no specific antidote for raloxifene overdose. Treatment should be symptomatic and supportive. Hemodialysis is unlikely to be beneficial due to high protein binding. In case of suspected overdose, contact poison control or seek immediate medical attention.

Storage

Store at room temperature (20-25°C or 68-77°F) in the original container. Keep tightly closed and protect from light and moisture. Do not store in bathrooms or other areas with high humidity. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual patient needs may vary, and only a licensed physician can determine appropriate treatment based on specific health circumstances and medical history.

Reviews

Clinical studies demonstrate Evista’s efficacy in reducing vertebral fractures by approximately 30-50% over three years. The MORE trial showed a 72% reduction in invasive breast cancer incidence among osteoporotic postmenopausal women. Most patients tolerate therapy well, with hot flashes being the most frequently reported adverse effect. Long-term follow-up data from the CORE and RUTH trials support maintained efficacy and safety profiles over extended treatment periods.