Raloxifene

It is a Selective Estrogen Receptor Modulator (SERM), a new form of antiresorptive therapy that reduces the risks of osteroporosis and also improves the cardiovascular profile in postmenopausal women.

Indications

-Prevention and treatment of osteoporosis in postmenopausal women -Reduction in the risk of invasive breast cancer in postmenopausal women with osteoporosis -Reduction in the risk of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer

Dosage

-Osteoporosis: 60 mg orally once daily, with or without food. -Breast Cancer Risk Reduction: 60 mg orally once daily.

Contra-Indications

-Hypersensitivity to raloxifene or any component of the formulation -Active or past history of venous thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism) -Pregnancy or women who may become pregnant -Lactation

Special Precautions

It should be used with caution in patients taking highly protein bound drugs such as diazepam, diazoxide and lidocaine. In patients taking concomitant warfarin or other coumarin derivatives, prothrombin times should be closely monitored when starting or stopping raloxifene treatment. Concomitant use of raloxifene with systemic estrogens or cholestyramine is not recommended.

Side Effects

Hot flushes, leg cramps, sweating, sleep disorders, peripheral oedema, vaginal bleeding, endometrail carcinoma and thromboembolic events.

Drug Interactions

Cholestyramine reduces the absorption and enterohepatic recycling of raloxifene. Ampicillin reduces peak concentration and absorption of raloxifene. Coadministration with warfarin reduces the prothrombin response and time.