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Generic name: Raloxifene hydrochloride
Brand names: Evista

Why is Evista prescribed?

Evista is prescribed to treat and prevent osteoporosis, the brittle-bone disease that strikes some women after menopause. A variety of factors promote osteoporosis. The more factors that apply to you, the greater your chances of developing the disease. These factors include:

Caucasian or Asian descent
Slender build
Early menopause
Smoking
Drinking
A diet low in calcium
An inactive lifestyle
Osteoporosis in the family

Most important fact about Evista

Like estrogen, Evista reduces bone loss and increases bone density. However, Evista does not have estrogen-like effects on the uterus and breasts, and therefore is unlikely to increase the risk of cancer, as estrogen therapy sometimes can do.

Although Evista has been shown to increase bone density over the course of a two-year study, its longer-term ability to prevent bone fractures has not yet been proven.

How should you use Evista?

Take Evista once daily, at any time, with or without food. Take calcium and vitamin D supplements as well, if you do not get enough in your diet. Avoid alcohol and tobacco. Do weight-bearing exercises to strengthen your bones.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take a double dose.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Evista has one very positive side effect: It lowers total cholesterol and LDL ("bad") cholesterol. It does not affect HDL ("good") cholesterol or triglyceride levels.

The unwanted side effects of Evista cannot be predicted. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Evista.

• More common side effects may include:
  Abdominal pain, arthritis, breast pain, bronchitis, chest pain, depression, diarrhea, dizziness, fever, flu symptoms, gas, gynecological problems, headache, hot flashes, increased cough, indigestion, infection, insomnia, joint pain, leg cramps, muscle ache, nasal inflammation, nausea, rash, sinusitis, sore throat, stomach and intestinal problems, sweating, swelling, tendon soreness, uterine discharge, urinary tract infection, vomiting, weight gain

Why should Evista not be prescribed?

Evista is not for use by women who are--or could become--pregnant. You should also avoid Evista if you have a history of blood clot formation, including deep vein thrombosis (blood clot in the legs), pulmonary embolism (blood clot in the lungs), and retinal vein thrombosis (blood clot in the retina of the eye), since Evista increases the risk of clots. Avoid the drug, too, if it gives you an allergic reaction.

Special warnings about Evista

Because of Evista's tendency to promote clots, you should not take it during long periods of immobilization such as recovery from surgery or prolonged bed rest, or for 72 hours beforehand. If you are scheduled for surgery, make sure the doctor is aware that you are taking Evista.

For the same reason, if you are going on a trip where your movement will be restricted, make a point of periodically getting up and walking around.

Evista is not needed prior to menopause and shouldn't be taken until menopause has passed. It has not been studied in premenopausal women and its use is not recommended.

Use Evista with caution if you have congestive heart failure, a liver condition, or cancer. Be cautious, too, if you've had breast cancer in the past; the drug's effect in this situation is unknown.

If you develop unusual uterine bleeding or breast problems while taking Evista, tell your doctor immediately.

Evista will not cure hot flashes. (In fact, it may cause them.) Nevertheless, never combine Evista with estrogen hormones.

If you've had a problem with high blood triglyceride levels when taking estrogen, Evista may cause the same problem. However, it tends to lower cholesterol levels by 6 to 11 percent.

Possible food and drug interactions when taking Evista

If Evista is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Evista with the following:

Cholestyramine (Questran)
Clofibrate (Atromid-S)
Diazepam (Valium)
Diazoxide (Proglycem)
Ibuprofen (Advil, Motrin, Nuprin)
Indomethacin (Indocin)
Naproxen (Aleve, Anaprox, Naprosyn)
Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding

Evista can harm a developing baby. Do not use if you are or may become pregnant. Also avoid breastfeeding while taking Evista.

Recommended dosage

POSTMENOPAUSAL WOMEN

The recommended dosage is one 60-milligram tablet once a day.

Overdosage

There have not been any reports of overdose with Evista. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.