RaloxifeneRaloxifene Hydrochloride

About Raloxifene

Raloxifene is a selective estrogen receptor modulator: it acts like estrogen on bone, slowing the bone loss that follows menopause, while blocking estrogen in breast tissue. The label approves it for treating and preventing osteoporosis in postmenopausal women and for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis or at high risk. It does not treat breast cancer or stop it coming back, and it is not for premenopausal women. Calcium and vitamin D are added if the diet falls short.

The boxed warning covers two risks. Raloxifene increases the chance of deep vein thrombosis and pulmonary embolism, so it is not used by anyone who has had a clot in a leg, lung or eye vein, and it is stopped at least 72 hours before surgery or any long period of immobility and restarted only once fully up and about; MedlinePlus adds avoiding long spells of sitting still when traveling. In a trial of postmenopausal women with coronary heart disease or at high risk of a coronary event, more women on raloxifene died from stroke, so the prescriber weighs that risk in any woman at risk of stroke.

Hot flashes, leg cramps, swelling of the feet and ankles, flu-like symptoms, joint pain and sweating are common; it does not relieve the hot flashes of menopause and can cause them. It is not taken with estrogen tablets or patches, which the label does not recommend. Pregnancy is a contraindication, and liver impairment calls for caution.

Taking Raloxifene

How to take it

One 60 mg tablet once a day, at about the same time, with or without food. Keep taking it even when you feel well, and do not stop it without talking to the prescriber.

If you miss a dose

Take it as soon as you remember unless it is almost time for the next dose; then skip it. Do not take a double dose.

Storage

At room temperature in the original container, tightly closed, away from heat and moisture, out of reach of children.

Interactions to know about

Cholestyramine cuts its absorption and is not recommended with it. With warfarin, clotting time is checked. Estrogens by mouth or patch are not used with it, and drugs that bind tightly to blood proteins, such as diazepam, diazoxide and lidocaine, need care. Tell the prescriber about liver disease or past blood clots.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Raloxifene differs from pharmacy to pharmacy

With one strength, one daily dose and many generic makers, raloxifene quotes are easy to compare like for like, and the spread between pharmacies comes from each pharmacy’s dispensing fee and markup rather than from the drug itself. A prescription that names Evista and blocks substitution is quoted at brand price.

It is a long-term medicine, so a ninety-day fill with one dispensing fee usually costs less per month than three monthly fills, and a pharmacy with a flat-price generic list may quote far less than one that prices from the list price.

Ways to pay less for Raloxifene without insurance

• Make sure the prescription is written for raloxifene or allows substitution, so the quote is for the generic.
• Ask for a ninety-day supply, since treatment usually continues for years.
• If cost is a barrier and it was prescribed for bone alone, ask the prescriber whether a generic bisphosphonate such as alendronate would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Raloxifene

1. 1.Which clot or stroke symptoms mean I should stop and get help?
2. 2.When should I stop it before surgery or a long journey?
3. 3.Should I take calcium and vitamin D with it?
4. 4.Does it interact with warfarin or cholestyramine?
5. 5.Will it help my hot flashes or make them worse?

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