Evista (Raloxifene)
Medication To Prevent Osteoporosis And Breast Cancer

Breast Cancer Guide

evista drugs

Evista Drug


What Is Evista?
How Does It Prevent Osteoporosis?
How Does It Prevent Breast Cancer?
Bottom Line: Who Should Take Evista?
What Is The Dosage?
How Long Should I Take It For?
What Are The Side Effects?
How Much Does Evista Cost?
Is It Covered By Health Insurance?

Related Articles:

Treatment For Osteoporosis
Hormone Therapy
What Is Evista?

Evista (raloxifene) is a medication marketed by the drug company Eli Lilly. It is one of a new class of drugs called selective estrogen receptor modulators (SERMs). SERMs are designer estrogens that have an effect on bones but do not interfere with the breast or uterus. Evista is only prescribed to women after menopause and has several different uses:

1. Osteoporosis: It is used both to prevent and treat osteoporosis in postmenopausal women.
2. Breast cancer: It is used to help prevent breast cancer in postmenopausal women at high risk of the disease. It is not approved for the treatment of breast cancer.

How Does It Prevent Osteoporosis?

Evista works by making your bones stronger, so they are less likely to fracture (break). As women age, their natural supply of estrogen declines and levels drop rapidly after menopause. Estrogen is instrumental in building healthy bone tissue because it helps the body absorb calcium and phosphates, both essential bone making ingredients. Evista works like a designer estrogen - it cleverly provides estrogen to the bones, so they become stronger but at the same time avoids producing an estrogen effect on the breasts and uterus. This is important because excessive estrogen may be one of the causes of breast cancer and uterine cancer. Studies show that evista can reduce the risk of spinal fractures by 50 percent and fewer women progress from osteopenia to osteoporosis. However it does not appear to prevent any other bone fractures, including hip ones. For this reason, bisphosphonates are still the first drug of choice for osteoporosis. So why take it? Because of its combined effects: it may be a suitable choice if you are high risk for both osteoporosis and breast cancer, but have not developed either disease.

When taking Evista to prevent or treat osteoporosis, you should also take a calcium and vitamin D supplement. The recommended dose for women after menopause is 1500 mg of calcium and 400-800 IU of vitamin D daily. Women over 70 years of age may need slightly higher doses of vitamin D. If you suffer from gastrointestinal malabsorption consider additionally taking 25-hydroxyvitamin D.

Related articles:
• Read about the effects of estrogen on the body.
The effects of menopause on the body.

How Does It Prevent Breast Cancer?

Evista is not approved for the treatment of breast cancer. It is only FDA approved for the prevention of invasive breast cancer in postmenopausal women at high risk of the disease. Tamoxifen in comparison (which has the benefit of being on the market much longer and has been studied more extensively) is approved both for the prevention and treatment of the disease at all stages and for women of all ages. Like all SERMs, evista has an anti-estrogen effect on the breast. While scientists are still not sure what causes breast cancer, controlling the effects of estrogen in women at high risk of the disease, appears to reduce the risk of the disease developing. One of the major benefits of evista over tamoxifen (and other SERMs) is that it does not stimulate the uterus, so it does not increase the risk of endometrial (uterus) cancer, endometrial hyperplasia or postmenopausal bleeding. It should also be noted that clinical trials show that evista is just as effective as tamoxifen in preventing invasive cancer in women at high risk.

Important limitations of evista for reducing breast cancer risks:

• Evista does not eliminate the risk of breast cancer completely (no current medication can do this). If you are taking it, you will still need to have regular mammograms and breast examinations. You should also perform regular breast self examination.
• No data is available regarding the effectiveness of evista in preventing invasive breast cancer in women with inherited genetic mutations BRCA1 and BRCA2. For more about these mutations see, genetic testing for breast cancer.
• It is not approved for the treatment of invasive breast cancer.
• It is not approved for reducing the risk of a breast cancer recurrence.
• It is not approved for the reduction in risk of noninvasive breast cancer (tamoxifen in comparison reduces the risk by 50 percent). Noninvasive cancer is considered stage 0 breast cancer, with the presence of ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS). The majority of LCIS or DCIS do not develop into invasive cancer.

Bottom Line: Who Should Take Evista?

Evista is considered a multi-functional drug that may be beneficial to a specific group of women. Overall, the evidence supports that the risk-benefit ratio of evista is most favorable for women who:
1. Are postmenopausal (has already gone through menopause).
2. Are at risk of osteoporosis or has already been diagnosed with osteoporosis.
3. May or may not have suffered fractures.
4. Are considered high risk for invasive breast cancer.
5. Are considered low risk for blood clots (venous thromboembolism).

What Is The Dosage?

Evista is taken in pill form (60 mg, raloxifene hydrochloride tablet), once a day. It can be taken at any time of the day, regardless of meal times. If you forget to take your pill and it is almost time for the next one, skip the tablet you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember and continue taking the medicine as normal. Never take 2 pills together to make up for the dose you missed.

How Long Should I Take It For?

As the drug is still relatively new, the long-term effects and recommended length of treatment are not yet known. Your doctor will probably recommend taking it for 5 years.

What Are The Side Effects?

Common Side Effects

Menopause-like symptoms are a common side effect of hormone therapy. These include:

Hot flashes.
• Sleep problems.
• Sweating and night sweats.
• Dry skin (read about menopause skin changes for solutions).
• Leg cramps.
• Flu-like symptoms.
• Joint and bone pain.

Less Common But Serious Side Effects

Blood Clots: Increased risks of blood clots in the leg, lungs and eyes (deep vein thrombosis, pulmonary embolism and retinal vein thrombosis).
Stroke: There is an increased risk of dying from a stroke and women with coronary heart disease are more likely to suffer a major coronary event like a heart attack.

Contact your doctor immediately if you experience any of these symptoms:

• Sudden and severe headache.
• Vision problems.
• Chest pain.
• Warmth and pain in the legs.
• Swelling of the hands, feet or legs.
• Shortness of breath.
• Weakness in the body.
• Difficulty speaking or understanding.

Educate yourself:
Symptoms of stroke.
Symptoms of a heart attack.

How Much Does Evista Cost?

The brand evista produced by Eli Lilly costs about $140 a month. Generic versions (Ralista) cost about $80 a month. If you do not have insurance coverage, ask your doctor about programs in your area that may be able to help with the cost. Also check Eli Lilly's website, sometimes they offer evista coupons. You should also check the breastcancer.org website - go to the Paying For Your Care Section for advice on financial assistance.

Is It Covered By Health Insurance?

Some insurance companies will cover the cost of evista. If you have health insurance, check with your provider.

Related Articles on Evista (raloxifene)

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