Raloxifene Hydrochloride

Also known as: raloxifene, Evista (branded), SERM

Hormone Restoration

In plain English

Raloxifene is a pill that acts like estrogen in bone (helping prevent osteoporosis) but blocks estrogen in breast tissue. It is FDA-approved to prevent and treat osteoporosis after menopause and to lower breast-cancer risk in some women. It is taken once daily as a tablet.

The science

Raloxifene is a second-generation selective estrogen receptor modulator with estrogen-agonist activity in bone and antagonist activity in breast and (unlike tamoxifen) neutral effects on the endometrium. The MORE randomized trial (Ettinger 1999) showed increased bone mineral density and reduced vertebral fracture risk in postmenopausal osteoporosis, with a lower incidence of breast cancer but an increased risk of venous thromboembolism. It is FDA-approved for postmenopausal osteoporosis prevention/treatment and for reducing invasive breast-cancer risk in higher-risk postmenopausal women. It does not relieve—and may worsen—vasomotor symptoms, and it carries a VTE and fatal-stroke warning. Compounded raloxifene is not an FDA-approved formulation.

References

• Ettinger et al., JAMA 1999 (MORE raloxifene fracture trial)
• The NAMS 2022 Hormone Therapy Position Statement, Menopause 2022 (SERM/bone context)