Raloxifene

How it works

Raloxifene (Evista) is another drug in the class known as SERMs. It's also prescribed in pill form, to be taken by mouth once a day for five years.

Like tamoxifen, raloxifene works by blocking estrogen's effects in the breast and other tissues. Unlike tamoxifen, raloxifene doesn't exert estrogen-like effects on the uterus.

Who it's for

Raloxifene is used to reduce the risk of invasive breast cancer if you're at high risk and you've undergone menopause (postmenopausal). You're considered at high risk if you score greater than 1.7% on the Gail model.

Raloxifene is also used for prevention and treatment of the bone-thinning disease osteoporosis in those who've undergone menopause.

Common side effects

Common side effects of raloxifene include:

• Hot flashes
• Vaginal dryness or irritation
• Joint and muscle pain
• Weight gain

Risks

Health risks associated with raloxifene are similar to those associated with tamoxifen.

Both drugs carry an increased risk of blood clots, though the risk may be lower with raloxifene. Raloxifene may be associated with fewer instances of endometrial and uterine cancers than is tamoxifen.

Raloxifene may also be linked to fewer strokes than tamoxifen in people at average risk of heart disease. But if you have heart disease or you have multiple risk factors for heart disease, raloxifene may increase your risk of strokes.

Although tamoxifen may be slightly better than raloxifene at reducing the risk of breast cancer, the risk of blood clots and uterine cancer are lower with raloxifene. For this reason, raloxifene may be a preferred option if you've undergone menopause and haven't had a hysterectomy or have osteoporosis.