Evista (raloxifene) is a non-estrogen treatment used to prevent osteoporosis in post-menopausal women, and may also be used to prevent breast cancer in post-menopausal women at high risk of developing it. This medication is only rarely used in women before menopause.

The medication is only available in tablets of 60 mg. It is taken once per day, with or without food. Duration of treatment is typically long-term, spanning years, though individuals who develop serious side effects may be taken off of it.

How It Works

Evista is a Selective Estrogen Receptor Modulator, or SERM. It is not an estrogen, but can replace estrogen when it comes to bone health, strengthening bones, while blocking estrogen receptors in the breasts. This has obvious benefits with regard to osteoporosis and preventing breast cancers, many of which acquire the fuel needed to thrive and spread from estrogen.

Unlike another commonly used SERM, tamoxifen, Evista is less likely to cause uterine cancer, but it is more likely than tamoxifen to cause blood clots. These are both very rare events, but regardless women at high risk of blood clots or uterine cancer may wish to take this into account when choosing a medication.

A side-benefit of Evista is that it lowers low-density lipoprotein (LDL) cholesterol in the blood. However, the medication does nothing to raise high-density lipoprotein (HDL) cholesterol. Due to the other actions of Evista, it is not prescribed as a cholesterol treatment.

Patients are prescribed Evista to:

• Reduce risk of osteoporosis in postmenopausal women;
• Reduce risk of breast cancer in postmenopausal women who have osteoporosis;
• Reduce risk of breast cancer in postmenopausal women who are high risk.

Evista is usually not used to:

• Treat existing breast cancer;
• Treat men or pre-menopausal women for any condition;
• Address menopausal symptoms, such as hot flashes.

Women taking Evista to treat osteoporosis should also make sure enough calcium and vitamin D are being consumed. Supplements can be very helpful in these cases, as it can be difficult to acquire enough through diet alone. The exact amounts will vary according to weight, other medical conditions, and so forth, but in general postmenopausal women need 1500 mg per day of calcium and 400 to 800 IU (10 to 20 mcg) of Vitamin D per day. A doctor can give more personalized recommendations.

How It's Taken

As mentioned above, Evista is only available in 60 mg tablets. One of these per day is the standard dose. A doctor may recommend a different dose, but this is fairly unusual.

Doses can be taken with or without food as desired, unless a doctor instructs otherwise.

If a dose is missed, it should be skipped entirely. Do not take a double dose to compensate for a skipped dose.

Side Effects & Other Considerations

Most side effects from Evista, though relatively common---experienced by 10 to 30% of patients---are mild and not cause for concern, including:

• Dry skin
• Hot flashes
• Sweating
• Cold-like symptoms
• Difficulty sleeping
• Leg cramps
• Joint pain

In many cases---unfortunately not all---the above side effects will stop occuring after the medication is taken for a few weeks.

Rarely more serious side effects will develop, which are cause for concern. Seek immediate medical attention if experiencing:

• Blood clots - often first noticeable by swelling, warmth, or pain in the calf
• Swelling of the legs, feet, or hands
• Vision changes
• Severe weakness or fatigue
• Difficulty speaking or understanding
• Confusion or disorientation
• Severe headache

While Evista is only very rarely prescribed to pre-menopausal women or to men, these patients should be aware that it is very likely to cause birth defects. At least two birth control methods should be utilized if pregnancy is a possibility. Women who discover they're pregnant while taking Evista should speak with a doctor about the best course of action.

All patients taking Evista should expect routine doctor visits to be scheduled, to make sure the medication is working as intended as well as to monitor for developing side effects. Bone density tests will also be performed at least every 2 years.