If you and your doctor are considering evista as part of your treatment plan, tell your doctor if you smoke or have a history of blood clots or heart attack.
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You also should not use Evista if you are allergic to raloxifeneif you are pregnant or breast-feeding.
Uterine fibroids that remain small and do not grow usually do not need treatmenthoweversurgery to remove the fibroid may be necessaryUterine fibroids do not cause cancerhoweverthere is a rarefast-growing cancerous called leiomyosarcoma.
What to doRaloxifene should not be used to reduce a woman’s risk of cardiovascular diseaseWomen prescribed the drug should be warned about the potential risk of strokeStroke risk calculatorse.gFramingham calculatorsallow women at high risk of stroke to be identifiedIn such womenas well as those with characteristics that would have allowed them entry into the trialBox 1and those with a prior history of cerebrovascular eventsincluding transient ischemic attacksor atrial fibrillationthe choice of alternate therapies for osteoporosis seems wise.
The drugRaloxifene is a benzothiophene compound taken orally once a dayIt undergoes significant first-pass metabolism to glucuronide conjugatesNinety-five percent of the drug circulates protein-boundand it is mostly excreted in the fecesAs with estrogenraloxifene’s effects occur when the drug binds tightly to estrogen receptorswhich alters gene transcription in susceptible cellsRaloxifene’s bone effects appear to be mediated through osteoblastswhich results in the promotion of bone deposition in a manner similar to that of estrogenrather than the osteoclast inhibition seen with other therapies such as bisphosphonatesRaloxifene is less effective than estrogen at promoting bone deposition but is more effective than placebo at increasing bone mineral densityand it is used to both treat and prevent osteoporosis in postmenopausal women.
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