Raloxifene for osteoporosis (Evista)

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Raloxifene is prescribed to help strengthen bones. It is only suitable for women who have been through the menopause.

Take one tablet each day. It can be taken either before or after a meal.

The most common side-effects are hot flushes and flu-like symptoms.

Type of medicineA non-hormonal selective oestrogen receptor modulator
Used forOsteoporosis
Also calledEvista®
Available asTablets

If you have osteoporosis, it means that you have lost some bone material and your bones have become less dense. This makes them more prone to break (fracture). The female hormone oestrogen helps to protect a woman against bone loss. When the level of oestrogen falls after the menopause, a woman can rapidly lose bone material, making her at risk of developing osteoporosis. Osteoporosis can develop over several years, often without any symptoms.

Raloxifene works by mimicking the natural effects of oestrogen. This gradually reverses the excessive breakdown of bone that happens at menopause and makes bones stronger. It is usually only prescribed for a woman who has had a bone fracture in the spine.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking raloxifene it is important that your doctor knows:

  • If you have ever been treated for an unwanted blood clot in your legs or lungs.
  • If you have had a stroke, or if your doctor has told you that you may be at risk of having one.
  • If you have been told you have high levels of fat called triglyceride in your blood.
  • If you have any problems with the way your liver works, or if you have been told you have a problem with the flow of bile from your liver (cholestasis).
  • If you have any problems with the way your kidneys work.
  • If you are not fully mobile (such as if you have been advised to rest in bed for any reason).
  • If you have noticed any vaginal bleeding.
  • If you have breast cancer or endometrial cancer.
  • If you have a rare inherited blood condition called porphyria.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about raloxifene and will provide you with a full list of the side-effects which you may experience from taking it.
  • Take raloxifene exactly as your doctor tells you to. Take one 60 mg tablet each day.
  • You can take raloxifene at whatever time of day you find easiest to remember but try to take your doses at the same time of day, each day. This will help you to remember to take your doses regularly. You can take the tablet either before or after a meal.
  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses on the same day to make up for a forgotten dose.
  • Treatment with raloxifene is usually long-term unless you experience an adverse event. Continue to take the tablets unless you are advised otherwise by your doctor.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • Your body needs plenty of calcium and vitamin D for healthy bones. Vitamin D is needed in order to absorb the calcium that you eat or drink from your diet. If your doctor suspects that you may not be getting enough calcium or vitamin D, you may be prescribed supplements to take in addition to raloxifene.
  • Remember to follow any exercise or dietary advice that your doctor gives to you. Eating a well-balanced diet and taking some regular exercise can help your bones stay strong. Exercise (such as brisk walking, dancing or aerobics) stimulates bone-making cells and this helps strengthen your bones. 
  • Chemicals from tobacco can get into your bloodstream and can affect your bones, making bone loss worse. If you are a smoker, you should try to quit if possible. Ask your doctor or pharmacist for advice on how to stop smoking.
  • As osteoporosis makes your bones weaker, they may break more easily if you fall. You can try to reduce the risk of falls by wearing well-fitting shoes or slippers, having hand rails fitted near any steps and checking your home for hazards such as uneven rugs, trailing wires and slippery floors.
  • If you are due to have an operation and are likely to be advised to rest in bed for a while, please tell the person carrying out the treatment that you are taking raloxifene.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with raloxifene. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common raloxifene side-effects (these affect more than 1 in 10 women)What can I do if I experience this?
Flu-like symptoms, hot flushesSpeak with your doctor if either of these become troublesome
Common raloxifene side-effects (these affect less than 1 in 10 women)What can I do if I experience this?
Leg crampsTry gentle stretching exercises to ease the pain
Swollen feet or anklesRest your feet on a low stool whenever possible

Important: there may be a small increased risk of you developing an unwanted blood clot (deep vein thrombosis) while you are taking raloxifene. Your doctor will advise you about this. If you develop any swelling in a leg, or if you have difficulties with your breathing, or if you get chest pains, you should let your doctor know straightaway so that it can be investigated.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Do not give it to other people even if their condition appears to be the same as yours.

If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Evista® 60 mg film-coated tablets; Daiichi Sankyo UK Limited, The electronic Medicines Compendium. Dated September 2013.
  • British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Prof Cathy Jackson
Document ID:
3282 (v25)
Last Checked:
24/06/2015
Next Review:
23/06/2018
The Information Standard - certified member

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