Raloxifene (Evista) is a selective estrogen receptor modulator (SERM), mainly used for the treatment and prevention of postmenopausal osteoporosis, and to reduce the incidence of invasive breast cancer in women at high risk.
How to Use Raloxifene (Evista)
Administration Regimen
Standard Dosage: Take 60 mg orally once daily, without the need for divided doses. It can be taken with or without food.
Treatment Course: For osteoporosis treatment, continuous administration for at least 3 years is required to evaluate the therapeutic effect. The treatment course for reducing breast cancer risk is recommended to be individualized, and data up to 5 years supports its safety.
Adjuvant Measures: It is recommended to supplement 500 mg of calcium and 400-800 IU of vitamin D daily, especially for those with insufficient intake.
Precautions for Medication Use
Management of Missed Dose: If a dose is missed, take it as soon as possible on the same day. If it is close to the time for the next dose, skip the missed dose and do not take a double dose.
Contraindications: It is contraindicated in patients with active or previous history of venous thromboembolism (such as deep vein thrombosis, pulmonary embolism) and pregnant women.
Dosage Adjustment of Raloxifene (Evista)
Adjustment Based on Adverse Reactions
Venous Thromboembolism Risk: The risk is highest in the first 4 months of treatment. Medication should be suspended for more than 72 hours before and during long-term immobilization (such as post-operative recovery).
Liver Function Abnormalities: No dosage adjustment is needed for patients with mild to moderate liver impairment, but close monitoring is required. There is insufficient data for patients with severe liver impairment, so use with caution.
Renal Function Abnormalities: Use with caution in patients with moderate to severe renal impairment (CrCl < 30 mL/min), and there is a lack of clear dosage guidelines.
Adjustment Due to Drug Interactions
Cholestyramine: Concomitant use is prohibited, as it significantly reduces the absorption of raloxifene.
Warfarin: The prothrombin time should be monitored, and the anticoagulant dosage should be adjusted accordingly.
Highly Protein-Bound Drugs (e.g., diazepam, lidocaine): These drugs may compete for binding sites, so attention should be paid to potential interactions.
Medication Use in Special Populations for Raloxifene (Evista)
Patients with Hepatic Impairment
No dosage adjustment is needed for patients with mild to moderate hepatic impairment, but liver function should be monitored. Use should be avoided in patients with severe hepatic impairment.
Patients with Renal Impairment
Mild to Moderate Impairment: No dosage adjustment is required.
Severe Impairment or Dialysis Patients: There is insufficient data, so individualized evaluation is recommended.
Pregnant and Lactating Women
Pregnancy: It is absolutely contraindicated, as it may cause fetal malformations. Women of childbearing age must use strict contraception during medication administration until 6 months after discontinuing the drug.
Lactation: There is insufficient data on whether the drug is excreted into breast milk, but its mechanism suggests that it may inhibit lactation, so it is contraindicated during lactation.
