Osteopenia Medication: Evista

Another osteopenia medication is Evista. This drug is made by Eli Lilly. Its chemical name is Raloxifene. And it belong to a group of drugs called Selective Estrogen Receptor Modulators or SERMS.

No, you do not need to remember all that. But I think it helps to know the words you may find used in medical articles or words that you health care provider might use.

How they discovered Evista as an Osteopenia Medication

They discovered Evista could be useful because someone noticed something odd during study of a breast cancer drug!

They were studying another SERMS, drug called Tamoxifin. Someone noticed that Tamoxifin seemed to have some positive effect on the bones of those taking it. This led researches to look at

all the SERMS to see if any would be more effective than Tamoxifin as an osteoporosis or osteopenia medication. Raloxifne (Evista) was found to be have the most effect on bone density.

As they tested Evista they learned that it was not as effective as Alendronate (Fosamx) but it appeared to be very useful. That is how we got this new osteoporosis and osteopenia medication.

The FDA approved raloxifene (Evista) for preventing osteoporosis in 1998 and in then 1999 extended that approval to osteoporosis treatment. Canada gave approval for the drug in the same year.

Frequently asked questions

1. So how does Evista work?All the SERMS drugs work by attaching to estrogen receptors on tissues and they have mild estrogen like effect. Since estrogen has a positive effect on bone building, Evista is a useful osteoporosis and osteopenia medication.

2. Does Evista have any other beneficial effects? Yes, studies show that Evista lowers cholesterol. It lowers total cholesterol by about 7%. It lowers and LDL (bad) cholesterol by about 11%. It does not change HDL (good) cholesterol. (The effect of EVISTA on risk for cardiovascular events is now under study.)

Also, unlike hormone replacement therapy, this osteoporosis and osteopenia medication does not increase the risk of breast or uterine cancer. Women taking Evista had no increased risk of breast or uterine cancer in clinical studies.

3. What about side effects?

Side effects are usually mild. The most commonly reported side effects are hot flashes and leg cramps.

This drug does not cause breast tenderness or vaginal bleeding. Women taking Evista and women taking placebo (sugar pills) experienced no difference in breast tenderness or vaginal bleeding in clinical studies.

If you've had a problem with high blood triglyceride levels when taking estrogen, Evista may cause the same problem. However, as noted above the drugs tends to lower cholesterol levels by 6-11%.

Finally, they do not know long term effects of Evista. We also do not know what happens when a person stops taking the drug whether bone gain will continue or if will bone be lost more quickly after stopping the drug.

4. Is there anyone who should not take this drug? Some people should not use Evista.

If you are premenopausal you can not use Evista as an osteoporosis or osteopenia medication. Also, if you are taking hormone replacement therapy you can not use Evista.

If you have liver disease or at risk for blood clots you should not take this medication. (1% of those taking Evista developed blood clots.)

If you have congestive heart failure or cancer you need to discuss the risks of taking this drug with your health care provider. Be cautious, too, if you've had breast cancer in the past. The drug's effect in this situation is unknown.

If you are someone who sits for long periods of time, this may not be the drug of choice for you. Also, if you will be traveling and confined to a seat long periods of time, do speak with your health care provider about your use of the drug. Blood clots are a serious health hazard and you do not want to risk getting one.

You should not take it during long periods of immobilization or prolonged bed rest, or for 72 hours before surgery. If you are scheduled for surgery, make sure the doctor is aware that you are taking Evista as an osteoporosis or osteopenia medication. 5. Does this osteoporosis or osteopenia medication interact with any other drugs? Yes. Evista can increase, decrease, or change the effects of:

  • Cholestyramine (Questran)
  • Clofibrate (Atromid-S)
  • Diazepam (Valium)
  • Diazoxide (Proglycem)
  • Ibuprofen (Advil, Motrin, Nuprin)
  • Indomethacin (Indocin)
  • Naproxen (Aleve, Anaprox, Naprosyn)
  • Warfarin (Coumadin)
It is very important to check with your health care provider before combining Evista with any of these drugs.

6. If I am using Evista as an osteoporosis or osteopenia medication, are there any things I should watch out for? Yes. If you are taking this drug and have any of the symptoms listed below, call your health care provider right away. Do not wait thinking that "maybe it will just go away". These are common signs of blood clots in the veins of the legs, lungs, or eyes:

  • leg pain or a feeling of warmth in the calves
  • swelling of the legs, hands or feet
  • sudden chest pain, shortness of breath or coughing up blood
  • sudden change in your vision, such as loss of vision or blurred vision
Remember, if you have one of these symptoms while you are on Evista you need to call your health care provider right away.

Also, If you develop unusual uterine bleeding or breast problems while taking this osteoporosis, osteopenia medication, tell your doctor immediately.

7. Does Evista have any GOOD side effects? Yes. It appears to prevent some cancers. This is really good news for women concerned about breast cancer or uternine cancer.

Evista (Raloxifene) has been found to be as good as Tamoxifin in preventing breast cancer. The results of a 5 years study showed that Raloxifene is as effective as Tamoxifen in reducing breast cancer. Also women assigned to the raloxifene group had 36% fewer uterine cancers and 29% fewer blood clots than those taking tamoxifen.

If you or your family has a history of breast or uterine cancer, it might be worth discussing Evista for your Osteoporosis or Osteopenai with your physician.

References:

  1. Nelson, Miriam E. and Wernick, Sarah. Strong Women, Strong Bones. G. P. Putnam. 2000.
  2. Eli Lilly - Evista web site.
  3. National Center for Biotechnology Information

Research abstracts and articles

You can read a study about the safety of Evista at the same site. Go to Osteopenia medication; Evista Safety .

To read about other Treatments for Osteopenia, go to Osteopenia treatments .

Special note: Cheaper drugs

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