Evista with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Evista (Raloxifene). Most antibiotics do not interfere meaningfully with Raloxifene at 60mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Hormones and Birth Control agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Raloxifene at 60mg.

Practical guidance

According to the prescribing information for Raloxifene, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Evista is co-administered. Adjusted 60mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Evista during an antibiotic course? ▾

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Raloxifene is metabolised and may need a temporary 60mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Evista regimen.

Will antibiotics make Evista stop working? ▾

Most antibiotics do not affect Evista efficacy. Rifampicin and a few others can lower Raloxifene levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Evista

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