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Selective oestrogen receptor modulator (SERM)

Raloxifene hydrochloride

Brand names: Evista

Adult dose

Dose: 60mg PO OD
Route: PO
Frequency: OD

Clinical pearls

  • Postmenopausal osteoporosis (vertebral fractures); reduces invasive breast cancer risk
  • Stop ≥3 days before prolonged immobility

Contraindications

  • VTE history
  • Active oestrogen-dependent cancer
  • Undiagnosed vaginal bleeding
  • Severe hepatic impairment
  • Pregnancy
  • Premenopausal women

Side effects

  • Hot flushes
  • Leg cramps
  • VTE (esp. first 4 months)
  • Stroke (in women at high CV risk)
  • Endometrial benign effects
  • Influenza-like symptoms

Interactions

  • Cholestyramine (reduces absorption)
  • Warfarin
  • Levothyroxine

Monitoring

  • BMD

Reference: BNF; NICE TA161; https://bnf.nice.org.uk/drugs/raloxifene-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.