Raloxifene

EVISTA

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Pronunciation: ral-OX-i-feen (ee-VIS-ta)

Raloxifene ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Raloxifene ballicule

Raloxifene EVISTA mascot mnemonic cartoon — Visual mnemonic: Raloxifene mascot
**“Eve is a Rolex fiend”**
Pink ribbon → reduces invasive breast cancer risk
Bone → SERM agonist at bone (osteoporosis)

What it isSelective estrogen receptor modulator; postmenopausal osteoporosis and breast cancer risk reduction.

Why this oneIt builds bone while blocking estrogen in the breast, reducing invasive breast cancer risk — a combination estrogen cannot offer.

What limits itPrevents vertebral fractures only, with no hip or nonvertebral benefit; worsens hot flashes and leg cramps.

Pearls

Reasonable bisphosphonate alternative when breast cancer risk is high.

Raloxifene molecular structure (skeletal formula) — Molecular structure: Raloxifene

Raloxifene prescription history

Animated chart of estimated U.S. prescriptions per year, Osteoporosis meds (1975–2026). Raloxifene enters in 1998 (estimated).

FDA-approved for

osteoporosis (1997)
breast cancer prevention (2007)

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryX

Defining liabilityVenous thromboembolism and hormone-related adverse effects; estrogen also lowers lamotrigine exposure.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Increased risk of venous thromboembolism (DVT/PE) and death from stroke.

FDA dosing	Population	Start	Target	Max
Osteoporosis (treatment/prevention) and reduction of invasive breast cancer risk	Postmenopausal women	60 mg QD	60 mg QD	60 mg QD

Renal Undefined

Hepatic Use with caution

Instructions

May be taken any time of day with or without meals
Add supplemental calcium and/or vitamin D if dietary intake is inadequate
Discontinue 72 hours before and during prolonged immobilization

Available strengths

tab 60 mg

Contraindications

Active or past history of venous thromboembolism (DVT, PE, retinal vein thrombosis)
Pregnancy

Cautions

Venous thromboembolism; discontinue 72 h before/during prolonged immobilization
Increased risk of death due to stroke in women at risk for major coronary events
Not for primary/secondary prevention of cardiovascular disease
Not recommended in premenopausal women
Hepatic impairment — use with caution
Not recommended with systemic estrogens
Monitor triglycerides if prior estrogen caused hypertriglyceridemia

Adverse reactions

Hot flashes, leg cramps, peripheral edema, flu syndrome, arthralgia, sweating

Pregnancy Contraindicated — may cause fetal harm; not for females of reproductive potential.

Lactation Undefined

Cost

Raloxifene (EVISTA)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
60 mg	tab	30 qd	$6.70	offered

Generic entry2014

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Memory aids: interaction avatars

Box: minimal PK interactions

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Self-check

Raloxifene: What does it do to estrogen action in the breast?
Blocks it.
Raloxifene: Is hip-fracture benefit established in this source?
No; vertebral-fracture data only.