Evista (Raloxifene HCI) Lowers Risk of Invasive Breast Cancer

What is Evista?

Evista (raloxifene hydrochloride) is a selective estrogen receptor modulator (SERM). It is used to treat osteoporosis and is not a hormone.


Evista Treats Thin Bones and Lowers Risk of Invasive Breast Cancer

Evista is used for the prevention and treatment of osteoporosis (bone thinning) in postmenopausal women. In 2007, it was approved for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer. Evista is not a breast cancer treatment drug, but it can be used to help prevent cases of invasive estrogen-receptor positive breast cancer. It does not reduce your risk of recurrence for invasive breast cancer. Women who have hereditary breast cancer due to genetic mutations (BRCA1, BRCA2) will not benefit from taking Evista.

How Evista Works

Evista binds to estrogen receptors on cells, creating a blockade and causing circulating estrogen to take other routes through your body. It slows down normal postmenopausal bone-thinning and increases bone mineral density (BMD). This results in stronger bones and less risk of fractures. An additional benefit of Evista is that it decreases total and LDL cholesterol levels. In breast and uterine tissues, it acts as an estrogen antagonist.

Bones Thin During and After Menopause

During and after menopause, your body produces less estrogen, which contributes to bone thinning. Many women take osteoporosis drugs to protect and strengthen their bones after menopause. Fosamax, Boniva, and Evista are prescribed for postmenopausal women, along with Vitamin D and calcium supplements and weight-bearing exercise, to maintain bone health and prevent fractures and breaks. If your bones are thinning, you are at risk for fractures in your spine, hips, and wrists.

Evista Compared to Tamoxifen

Evista was compared to Tamoxifen in the 5-year STAR study, and wasn't found to be more effective in lowering the incidence of invasive breast cancer. However, Evista treatment caused fewer cases of deep vein thrombosis, pulmonary embolism, cataracts and endometrial cancer (common side effects) than Tamoxifen.

Recommendations While Taking Evista

Women who are going to be immobile for a prolonged time (recovering from surgery, taking bed rest, traveling with restricted movement) should stop taking Evista at least 72 hours before, and during, sedentary periods. This is because Evista can increase blood clot risk. If you are taking Evista, be sure to take calcium and vitamin D supplements, and engage in regular weight-bearing exercise, in order to get the most benefit for your bone health. Quit or cut back on smoking, caffeine, and alcohol while you're on Evista, as those things contribute to brittle bones.

Who Should Not Take Evista

Do not take Evista if:

  • you are pregnant or breastfeeding, as it may cause harm to your baby
  • you have circulatory problems
  • you have a history of deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis
  • you are using hormone replacement therapy (HRT)
  • you have severe liver problems

Available As

Evista is available in 60 mg tablets, by prescription only. It is taken once daily, with or without food.

Side Effects

Evista may cause these common side effects:

  • hot flashes
  • increased perspiration
  • nausea
  • diarrhea
  • headaches (not migraine)
  • joint pain

Not everyone should take Evista, as it can increase risk for blood clots in the legs (deep vein thrombosis), heart (pulmonary embolism), and eyes (retinal vein thrombosis).

See your doctor if you have these symptoms while taking Evista

  • pain or warmth in your legs or calves
  • swelling of your hands, feet, or legs
  • sudden pain in your chest; shortness of breath
  • sudden change in your vision (vision blurred or loss)

Evista almost never causes breast pain or tenderness, and rarely causes vaginal bleeding.

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Article Sources
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  2. Cox DA, Sarkar S, Harper K, Barrett-connor E. Effect of raloxifene on the incidence of elevated low density lipoprotein (LDL) and achievement of LDL target goals in postmenopausal women. Curr Med Res Opin. 2004;20(7):1049-55. doi:10.1185/030079904125004187

  3. InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Menopause: Overview. 2006 Feb 14.

  4. Vogel VG. The NSABP Study of Tamoxifen and Raloxifene (STAR) trial. Expert Rev Anticancer Ther. 2009;9(1):51-60. doi:10.1586/14737140.9.1.51

  5. Eli Lilly Canada Inc. Evista. Product Monograph. October 10, 2008.

Additional Reading
  • Sources:
    Evista.com. Osteoporosis and Invasive Breast Cancer. © 2008.
  • FDA. Center for Drug Evaluation and Research. FDA Approves New Uses for Evista (raloxifene hydrochloride). Date created: September 17, 2007.
  • FDA News. Raloxifene hydrochloride. September 17, 2007.