Evista (Raloxifene)
Evista is the brand of raloxifene 60mg, a selective estrogen receptor modulator (SERM) used for prevention and treatment of postmenopausal osteoporosis and reduction of invasive breast cancer risk. Authorised generic raloxifene is widely available since 2014.
- Active ingredients
- Raloxifene
- Manufacturer
- Eli Lilly
- Dosage forms
- tablet
- Available dosages
- 60mg
- Category
- Hormones and Birth Control
What is it?
Evista is the brand name under which Eli Lilly markets raloxifene 60mg tablets, FDA-approved in 1997 for prevention of postmenopausal osteoporosis, with treatment indication added in 1999 and reduction of invasive breast cancer risk in 2007. It is on the WHO Essential Medicines List for breast cancer prevention. Authorised generic raloxifene has been widely available since 2014 and dominates current prescribing; Evista-branded tablets remain a recognisable name in postmenopausal care.
Active ingredients
Each Evista tablet contains 60mg of raloxifene hydrochloride. The active substance is identical between branded Evista and authorised generic raloxifene tablets, with bioequivalence required by the regulator. Raloxifene is a benzothiophene SERM developed from the SERM scaffold that gave rise to tamoxifen and toremifene, but with a different tissue-selective profile.
Forms and dosages
Evista is supplied as 60mg oral tablets. The standard dose is 60mg once daily, taken with or without food at any time of day. There is no need to adjust the dose for renal or hepatic impairment unless severe. Calcium and vitamin D supplementation is typically recommended alongside Evista for women at risk of inadequate intake, since the drug works through preserving bone mineral density that requires substrate.
Indications
Evista is approved for prevention and treatment of postmenopausal osteoporosis and for reduction of invasive breast cancer risk in postmenopausal women at increased risk. According to current osteoporosis guidelines, raloxifene is a reasonable option for postmenopausal women with osteoporosis who also have elevated breast cancer risk, though bisphosphonates remain first-line for most patients due to greater non-vertebral fracture reduction.
How it works
Raloxifene binds estrogen receptors and produces tissue-selective effects: estrogen-agonist activity in bone (preserving bone mineral density) and on lipid metabolism (lowering LDL cholesterol), while exhibiting estrogen-antagonist activity in breast and uterine tissue (reducing breast cancer risk and not stimulating the endometrium). This selectivity is the basis of SERM positioning — capturing the bone benefits of estrogen without breast cancer or endometrial risks.
Frequently asked questions
How does Evista compare with bisphosphonates for osteoporosis? ▾
Bisphosphonates (alendronate, risedronate) reduce both vertebral and non-vertebral fractures by ~50%, while Evista reduces vertebral fractures by ~30% with less effect on hip and other non-vertebral fractures. According to current osteoporosis guidelines, bisphosphonates are first-line for most patients; Evista is preferred when concomitant breast cancer risk reduction is desired or when bisphosphonates are not tolerated.
Is Evista the same as HRT? ▾
No. Evista is a SERM with tissue-selective activity — agonist in bone, antagonist in breast and uterus. HRT (estradiol or conjugated estrogens) is full estrogen agonist activity in all tissues. Evista therefore prevents bone loss and reduces breast cancer risk but does not relieve hot flashes or genitourinary symptoms, and may worsen hot flashes. According to current menopause guidelines, Evista is not used for symptom-driven HRT.
What is the VTE risk with Evista? ▾
Evista approximately doubles VTE risk compared with placebo, similar to oral estrogen HRT. According to the prescribing information, Evista is contraindicated in women with active or prior VTE, prolonged immobilisation, or elevated thrombophilic risk factors. The drug is held during prolonged immobilisation (e.g. surgical recovery) and discontinued in women with new VTE risk factors.
Does Evista help with hot flashes? ▾
No — Evista does not relieve hot flashes and may actually cause or worsen them in some women. The drug is an estrogen receptor antagonist in vasomotor tissue, which is opposite to the agonist effect that estrogen-based HRT provides. According to clinical practice, women whose primary concern is hot flashes should consider HRT or non-hormonal vasomotor agents rather than Evista; women whose primary concern is bone or breast cancer risk are reasonable candidates for Evista.
Is Evista the same as generic raloxifene? ▾
Yes — Evista and authorised generic raloxifene 60mg tablets contain the same active ingredient at the same strength and have demonstrated bioequivalence. The generic is significantly cheaper and clinically equivalent in nearly all cases. Most current prescribing in the United States is on the authorised generic; the Evista brand remains a recognisable name in postmenopausal osteoporosis care.
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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.