Raloxifene (Evista) is a Selective Estrogen Receptor Modulator (SERM). It is mainly used for the treatment and prevention of osteoporosis in postmenopausal women, as well as reducing the risk of invasive breast cancer in postmenopausal women at high risk. Although this medication has shown good efficacy in clinical application, patients need to fully understand its potential side effects and medication precautions.

What are the Side Effects of Raloxifene (Evista)?

Systemic Reactions

Flu-like symptoms: Approximately 13.5% of patients may experience flu-like symptoms.

Headache: The incidence rate is about 9.2%.

Fever: Approximately 3.9% of patients have reported fever.

Peripheral edema: The incidence rate is 5.2%, manifested as swelling of the limbs.

Cardiovascular System Reactions

Hot flashes: Approximately 9.7% of patients receiving therapeutic treatment experience this symptom, and the incidence rate is higher (24.6%) when used for preventive purposes.

Varicose veins: The incidence rate is about 2.2%.

Gastrointestinal Discomfort

Nausea: Approximately 8.3% of patients may experience nausea.

Diarrhea: The incidence rate is about 7.2%.

Vomiting: Approximately 4.8% of patients have reported this symptom.

Musculoskeletal Symptoms

Arthralgia (joint pain): Approximately 15.5% of patients experience joint pain.

Muscle spasms: Approximately 7.0% of patients have reported leg cramps, and the incidence rate is 5.9% when used for preventive purposes.

Other Common Reactions

Hyperhidrosis (excessive sweating): Approximately 2.5% of patients experience excessive sweating.

Skin rash: The incidence rate is about 5.5% when used for preventive purposes.

Severe Side Effects of Raloxifene (Evista) That Require Vigilance

Venous Thromboembolism (VTE)

It includes deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis, with an incidence rate of 1-2 cases per 1,000 patient-years. The risk is highest in the first 4 months of treatment.

The medication should be discontinued 72 hours before prolonged immobilization (e.g., after surgery).

Endometrial and Ovarian Abnormalities

Although it does not increase the risk of endometrial cancer, attention should be paid to unexplained uterine bleeding (incidence rate: 2.5%) and ovarian cancer (incidence rate: 0.34%-0.70%).

Hypertriglyceridemia

Patients who developed hypertriglyceridemia (>500 mg/dL) due to previous estrogen therapy need to have their blood lipids monitored.

Precautions for Taking Raloxifene (Evista)

Contraindicated Populations

Patients with active or a history of venous thromboembolism: Including deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis.

Pregnant women: This medication may cause fetal harm. Women of childbearing age should take effective contraceptive measures during treatment.

Medication Use in Special Populations

Renal impairment: Patients with moderate to severe renal impairment should use this medication with caution.

Hepatic impairment: The plasma concentration of raloxifene may increase by 150% in patients with mild hepatic impairment, requiring close monitoring.

Elderly patients: No dosage adjustment is required, but individual sensitivity may increase.

Drug Interactions

Cholestyramine: Significantly reduces the absorption of raloxifene; concurrent use is not recommended.

Warfarin: The prothrombin time needs to be closely monitored.

Highly protein-bound drugs: Such as diazepam, diltiazem, and lidocaine. Concurrent use should be done with caution.