Understanding Osteoporosis Medications (cont.)
Francisco Talavera, PharmD, PhD
Selective Estrogen Receptor Modulators
Raloxifene (Evista) is a selective estrogen receptor modulator (SERM). Unlike estrogen, the SERM raloxifene is not associated with an increased risk of uterine cancer and reduces invasive breast cancer.
- How SERMs work: SERMs have been specifically tailored to provide the particular estrogen effects. Raloxifene is a SERM that preserves bone density but is not associated with estrogen risk factors such as uterine or breast cancer.
- Who should not use these medications: Persons with the following conditions should not use SERMS:
- Allergy to SERMs
- Active or past history of venous thrombosis (blood clots in veins)
- Use: SERMS are taken orally as a tablet every day for prevention or treatment of osteoporosis.
- Drug or food interactions: Cholestyramine (Questran, Cholybar) decreases raloxifene blood concentrations. The time of administration of each drug should be as far apart as possible.
- Side effects: These drugs may cause hot flushes and blood clots at a risk comparable to that of estrogen. Raloxifene should be discontinued 3 days before surgery and throughout the recovery period following surgery. Call your doctor immediately if you experience any of the following side effects:
- Chest pain
- Trouble breathing
- Coughing up blood
- Pain, swelling, or redness in your leg, particularly if below the knee
- Severe headache
- Blurred vision or vision changes
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