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Description
Evista tablets contain the active ingredient raloxifene hydrochloride, which is a type of medicine called a selective oestrogen receptor modulator (SERM).
Oestrogen, the main female sex hormone, has many actions throughout the body. Bone tissue, cholesterol metabolism, breast tissue and uterine tissue are all affected by this hormone. At the menopause, blood levels of oestrogen start to decrease and this affects the tissues that are normally responsive to oestrogen.
In terms of bone tissue, declining levels of oestrogen result in an increase in bone breakdown, which can lead to a loss of bone density. Bone loss is particularly rapid for the first ten years after the menopause and it may lead to the development of osteoporosis - a condition in which the bones are weak and break more easily.
Raloxifene is used to both prevent and treat osteoporosis in postmenopausal women. It works by acting on oestrogen receptors in the bone tissue, where it mimicks the natural effects of oestrogen. This gradually reverses the excessive breakdown of bone that happens at menopause and causes an increase in bone mineral density, making bones stronger. Raloxifene has been shown to significantly reduce the risk of spinal fractures, but not hip fractures.
Raloxifene selectively mimicks the effects of oestrogen on bone tissue, but does not affect breast tissue or uterine tissue. This means that long-term use does not carry the increased risk of cancer of the lining of the womb (endometrial cancer) or breast cancer that is associated with long-term use of oestrogen-based hormone replacement therapy (HRT). However, raloxifene is associated with an increased risk of developing blood clots in the veins (venous thromboembolism). This risk is similar to that associated with hormone replacement therapy (HRT).
Due to its selective activity, raloxifene is not effective at relieving other symptoms of oestrogen deficiency that occur during the menopause, for example hot flushes.
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