Evista (Raloxifene) – Oral


Evista (raloxifene) is associated with the increased risk of deep vein thrombosis and pulmonary embolism. If you have an active or past history of venous thromboembolism, do not take Evista. 

A clinical trial of postmenopausal individuals with coronary heart disease or at high risk for major coronary events showed an increased risk of death due to stroke with Evista use.

What Is Evista?

Evista (raloxifene) is an oral medication used to prevent and treat a bone condition called osteoporosis in postmenopausal people. It is also used to reduce the risk of breast cancer in postmenopausal people at high risk. 

Evista is a selective estrogen receptor modulator. These medications chemically resemble the hormone estrogen and bind to estrogen receptors in different parts of the body. Estrogen receptors are found in tissues like the uterus, breast, or bone. The specific effect of the drug depends on the type of tissue. 

Evista is available in tablet form.

Drug Facts

Generic Name: Raloxifene

Brand Name(s): Evista

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Endocrine-metabolic agent

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Raloxifene hydrochloride

Dosage Form(s): Tablet

What Is Evista Used For?

When Evista binds to an estrogen receptor, it can have effects that mimic estrogen (like in bone, where it helps maintain bone strength) or oppose estrogen (like in the breast).

The Food and Drug Administration (FDA) approved Evista to prevent and treat and prevent osteoporosis in post-menopause. It has been shown to reduce the bone loss associated with menopause and lower the risk of vertebral (spine) fractures.

Evista is also approved to prevent breast cancer in people at high risk for developing the disease. Your risk of breast cancer depends on your age, family history, and personal history of breast disease. Talk to your healthcare provider about how your breast cancer risk is determined and whether you would benefit from this medication.

Evista should not be used in pre-menopause.

Evista ( Raloxifene ) Drug Information - Showing a body with the areas affected

Verywell / Dennis Madamba

How to Take Evista

Take Evista exactly as prescribed by your healthcare provider. It can be taken at any time of the day, with or without food. Evista is supplied as 60-milligram tablets, usually taken once a day. If you are taking Evista for osteoporosis, your healthcare provider may also prescribe calcium and vitamin D supplementation. These can be taken at the same time as your medication.

Because Evista can increase the risk of developing blood clots, try not to stay seated the whole time during long car or plane trips. Remember to move around periodically.

If you need major surgery or will be on long-term bed rest, you will need to stop taking Evista at least three days ahead of time. Tell your healthcare provider who treats you that you take this medication. You may not be able to restart the medicine until you are active again.


Store your Evista tablet at room temperature (between 68 degrees and 77 degrees F). Like all medications, keep them out of reach of children and pets. Do not store your medication in the bathroom.

Off-Label Uses

Sometimes, healthcare providers prescribe drugs “off-label” for conditions not specifically mentioned in the product label.

Evista is only FDA-approved for postmenopausal people who have never had breast cancer. However, some with a history of having breast cancer may be prescribed Evista to prevent their tumor from returning. People with osteoporosis may be prescribed Evista after receiving androgen deprivation therapy (most often given for prostate cancer).

What Are the Side Effects of Evista?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Evista include: 

  • Hot flashes
  • Leg cramps or swelling in your hands, feet, or ankles
  • Flu-like symptoms
  • Joint pain
  • Sweating

Hot flashes are most common in the first six months of treatment.

Severe Side Effects

There are a few serious safety risks associated with Evista that you should know about.

Evista increases the chances for blood clots to form in your body. This can take the form of clots in the veins of the legs (deep vein thrombosis, or DVT) or lungs (pulmonary embolism, or PE). People who have a history of heart attacks or are at increased risk of heart attack have an increased risk of dying of stroke while on Evista.

For this reason, people with a history of blood clots (in the legs, lungs, or eyes) should not take Evista.

Report Side Effects


Evista may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or phone at 800-332-1088.


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It is very important that you keep your appointments with your doctor even if you feel well.

Before you have any kind of surgery, tell the medical doctor in charge that you are using this medicine. Discuss discontinuing use of raloxifene 3 days before you think you will have a long period of inactivity, sitting, or bed rest, such as after having surgery or going on a long trip. The doctor may have you start the medicine again after you are back on your feet and fully mobile. If you are going on a trip and stay on raloxifene, you should walk regularly or move about when possible. Remaining still for long periods may cause blood clots for some people, and raloxifene may rarely worsen their condition.

If you are able to become pregnant, stop using the medicine immediately if you think you have become pregnant and check with your doctor. Raloxifene is recommended for women who are past menopause.

Raloxifene does not act like an estrogen to stimulate the uterus or breast. If you experience vaginal bleeding, breast pain or enlargement, or swelling of hands or feet while on raloxifene, you should report it to your doctor.

Other ways that may be used with raloxifene to help prevent or treat bone loss are taking calcium plus vitamin D supplements and getting weight-bearing exercise. You may want to discuss these options with your doctor.


Evista should be used with caution if you have liver or kidney disease, as this can affect how the drug is metabolized (processed) by the body. Make sure your healthcare provider knows your medical history before starting therapy with Evista.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Don’t take an extra dose to make up for the missed one.

Overdose: What Happens If I Use Too Much Evista?

Evista overdoses are rare, and no deaths have been reported due to taking too much of this medication. If you take too much Evista, you may experience side effects like leg cramps and dizziness.

What Happens If Overdose on Evista?

If you think you or someone else may have overdosed on Evista, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Evista, call 911 immediately.

What Are Reasons I Shouldn’t Take Evista?

You should not take Evista if:

  • You are allergic to Evista or any of its ingredients.
  • You have a history of blood clots since the medication can further increase your risk.
  • You are pregnant or can become pregnant.
  • You are breastfeeding.

What Medications Interact With Evista?

Evista has important drug interactions, so make sure your prescribing healthcare provider knows all the medications, herbs, and supplements you are taking.

Evista may interact with the following:

  • Other estrogen-containing medications: Evista mimics some of estrogen’s actions in the body.
  • Warfarin: Evista can affect the activity of warfarin, so your blood clotting should be monitored closely.
  • Prevalite or Questran (cholestyramine): Cholestyramine can affect your ability to absorb Evista, reducing its therapeutic effect. It is not recommended to use these medications together.
  • Synthroid (levothyroxine): Evista can interfere with your body’s ability to absorb Synthroid, which is used to treat hypothyroidism.

What Medications Are Similar?

Evista belongs to a drug class called selective estrogen receptor modulators, or SERMS. These drugs can both mimic and oppose the effects of estrogen. For example, Evista acts like estrogen to increase bone strength. However, its anti-estrogen effects can help treat breast cancer.

Other SERMS are tamoxifen (the oldest member of this drug class) and Fareston (toremifene), both used to treat breast cancer.

Frequently Asked Questions

  • What is Evista used for?

    Evista is used in postmenopausal people to prevent and treat osteoporosis. It has been shown to reduce the bone loss associated with menopause and lower the risk of vertebral (spine) fractures.

    Evista is also approved to prevent breast cancer in people at high risk for developing the disease. Breast cancer risk can depend on your age, family history, and personal history of breast disease.

  • How does Evista work?

    Evista is a type of medicine called a selective estrogen receptor modulator.  These are medications that bind to estrogen receptors in different parts of the body, acting like estrogen in some tissues but opposing the effects of estrogen in others. 

  • What are the side effects of Evista?

    Evista’s common side effects include hot flashes, leg cramps or swelling, flu-like symptoms, joint pain, and sweating. Hot flashes are most common in the first six months of treatment.

    There are also a few serious safety risks associated with Evista. Evista increases the chances for blood clots to form in your legs (deep vein thrombosis, or DVT) or lungs (pulmonary embolus, or PE). People who have a history of heart attacks, or are at increased risk of heart attack, have an increased risk of dying of stroke while on Evista.

How Can I Stay Healthy While Taking Evista?

Remember that Evista can increase your risk for blood clots in your lungs or legs. Staying still for a long time (like during a long trip or in bed during an illness) can further increase this risk. Talk to your healthcare provider about how to stay healthy and prevent any complications of Evista. Some recommendations may include temporarily stopping your medication before having surgery and trying to move around periodically while on long plane or car rides.

Keep an eye out for blood clot symptoms, including leg pain, swelling, chest pain, or shortness of breath. Get medical attention immediately if you experience these symptoms while being treated with Evista.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. An KC. Selective estrogen receptor modulators. Asian Spine Journal. 2016;10(4):787-791. doi:10.4184/asj.2016.10.4.787

  2. Food and Drug Administration. Evista label.

  3. Waters EA, McNeel TS, McCaskill Stevens W, Freedman AN. Use of tamoxifen and raloxifene for breast cancer chemoprevention in 2010. Breast Cancer Res Treat. 2012;134(2):875-880. doi:10.1007/s10549-012-2089-2

  4. Adler RA. Management of osteoporosis in men on androgen deprivation therapy. Maturitas. 2011;68(2):143-147. doi:10.1016/j.maturitas.2010.11.003

  5. Siraj ES, Gupta MK, Reddy SS. Raloxifene causing malabsorption of levothyroxine. Arch Intern Med. 2003;163(11):1367-1370. doi:10.1001/archinte.163.11.1367

By Rony Kampalath, MD
Rony Kampalath, MD, is board-certified in diagnostic radiology and previously worked as a primary care physician. He is an assistant professor at the University of California at Irvine Medical Center, where he also practices. Within the practice of radiology, he specializes in abdominal imaging.