Evista

How it works

     * Evista is a brand (trade) name for raloxifene. Raloxifene decreases
       bone resorption and turnover. It is not a hormone; however, it
       mimics the action of estrogen on bones while at the same time
       blocking the effect of estrogen on other tissues.
     * Evista belongs to the class of medicines known as estrogen
       agonist/antagonists (also called selective estrogen receptor
       modulators [SERMs]).

Upsides

     * May be used for the treatment or prevention of osteoporosis in
       postmenopausal women.
     * May also be given to lower the risk of invasive breast cancer in
       postmenopausal women with osteoporosis, or other postmenopausal
       women at risk of invasive breast cancer.
     * Long-term use of Evista does not carry the same risk to breast and
       womb tissue associated with estrogen-based hormone therapies.
     * Evista is usually taken as a once-daily dose.
     * Evista is available as a generic under the name raloxifene.

Downsides

   If you are between the ages of 18 and 60, take no other medication or
   have no other medical conditions, side effects you are more likely to
   experience include:
     * Hot flashes, joint or muscle pain, difficulty sleeping, weight
       gain, increased vaginal discharge, gastrointestinal complaints
       (such as indigestion, bloating, gas, nausea), flu-like syndromes,
       infection, sinusitis, and a rash.
     * Evista has only been tested in postmenopausal women.
     * May increase the risk of blood clots that occur in the leg (deep
       vein thrombosis), lung (pulmonary embolism) or eye. May also
       increase the risk of stroke; the risk is higher in women with
       coronary heart disease, diabetes, high blood pressure, high
       cholesterol, going through menopause, who smoke, or who are
       overweight.
     * Evista may increase the incidence of hot flushes and leg cramps.
     * May not be as effective as bisphosphonates or estrogen at
       preventing bone loss.
     * Although Evista may be used to reduce the risk of invasive breast
       cancer in postmenopausal women, it does not treat breast cancer and
       is not a cancer medicine.
     * May not be suitable for some people, including those with a history
       of blood clots, cardiovascular disease, liver or kidney disease,
       high triglycerides, with a history of breast cancer, or who take
       certain medications (such as warfarin, statins, or estrogen
       replacement therapy). Avoid Evista in women who are pregnant or
       breastfeeding.

   Notes: In general, seniors or children, people with certain medical
   conditions (such as liver or kidney problems, heart disease, diabetes,
   seizures) or people who take other medications are more at risk of
   developing a wider range of side effects. For a complete list of all
   side effects, [84]click here.

Bottom Line

   Evista is not a hormone, but it mimics estrogen, and may be used to
   treat osteoporosis in postmenopausal women or to lower the risk of
   invasive breast cancer in women with osteoporosis. Hot flashes are a
   common side effect.

Tips

     * May be taken with or without food.
     * Your doctor may advise you to take supplements such as calcium or
       vitamin D while you are taking Evista. Take them as directed.
     * Keep your appointments with your doctor, even if you feel well. An
       appointment is how your doctor can check that Evista is effective
       for you and how you are tolerating Evista.
     * If you have surgery scheduled, tell your doctor you are taking
       Evista because it may need to be temporarily discontinued about
       three days prior to surgery if you will be experiencing periods of
       inactivity or bed rest. Also, tell your doctor if you are planning
       to go on a long trip or plane flight and will be inactive for long
       periods of time.
     * Tell your doctor if you experience any vaginal bleeding, breast
       pain or enlargement, or swelling of the hands or feet. Seek urgent
       medical help if you experience any shortness of breath, calf pain,
       or chest pain.
     * Weight-bearing exercise can help osteoporosis and you should talk
       to your doctor about exercises that are recommended.

Response and Effectiveness

     * Research has shown that Evista significantly and consistently
       suppressed bone turnover within three months and this persisted for
       the duration of the trial (24 or 36 months).
     * Decreases in levels of other minerals, such as total calcium, total
       protein, albumin, and inorganic phosphate were small and less than
       that typically seen with estrogen or hormone therapy.
     * Spine and hip bone mineral density increased by 2-3% with Evista
       administration.

References