The Food and Drug Administration (FDA) has approved raloxifene (Evista) for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis or a high risk of invasive breast cancer. The drug is a selective estrogen receptor modulator (commonly called a SERM), which probably acts by blocking estrogen receptors in the breast.
   Clinical trials involving more than 15,000 postmenopausal women compared raloxifene to placebo and found the risk of invasive breast cancer reduced by 44% to 71% in those who received the drug. Another trial involving nearly 20,000 patients compared raloxifene with tamoxifen and found that they had similar effects.
   Because raloxifene can cause serious adverse effects--particularly blood clots in legs and lungs and possible stroke--FDA officials caution that each patient must be carefully evaluated before starting therapy. Women with a history of blood clots shouldn't take raloxifene. Other possible adverse effects include hot flashes, leg cramps, edema of legs and feet, flulike symptoms, joint pain, and sweating. Raloxifene shouldn't be taken by women of child-bearing potential. It also shouldn't be taken with cholestyramine or estrogens.
   Breast cancer is the second leading cause of cancer deaths in American women and accounts for 26% of all cancers in women. Nearly 180,000 cases of invasive breast cancer will be diagnosed in 2007. Raloxifene was previously approved for preventing and treating osteoporosis in postmenopausal women.

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