Introduction
Raloxifene, available under the brand name Evista, is a popular medication used to treat osteoporosis in menopausal women. Osteoporosis is a skeletal degeneration characterized by low bone mass, structural deterioration of bone tissue, and an increased susceptibility to bone fractures with subsequent risk of morbidity and mortality. Women are at a higher risk than men because of their genetic structure and hormonal changes during menopause that impact bone density.
Studies have shown that 20% of bone loss occurs during the stages of menopause, and an estimated 10 million people above 50 have osteoporosis, resulting in significant functional impairment and reduced quality of life. In such conditions, Raloxifene mimics the estrogen hormone and works in preventing and treating postmenopausal conditions of bone thinning.
In addition to decreasing the incidence of bone fractures by 30-50%, Raloxifene has been shown to have additive effects on bone turnover and bone mineral density when used adjunctively with synthetic hormones like alendronate and teriparatide.
Here are certain things to remember before buying Raloxifene to better understand its strengths, doses, and associated risks.
Five things to know before buying Raloxifene
It is a prescription medication.
Raloxifene UK belongs to the class of SERM (Selective Estrogen Receptor Modulators) and is on Tier 2 of prescription drug plans. Tier 2 includes drugs available in both branded and generic versions that cost a little more than Tier 1 (generic) drugs. Additionally, it is a prescription medication. You need to obtain a physician’s prescription to ascertain your medical condition and eligibility for use to buy Evista Raloxifene in the UK.
Based on your prescription, you buy Raloxifene UK from selected pharmacies or physician’s clinics with a dispensing counter and dealing with this osteoporosis medicine. You can even buy Evista Raloxifene in UK online without any hassle. The best way is to google ‘Raloxifene buy UK’ that will give you a list of online pharmaceuticals dealing with Raloxifene. Be careful as to choose an authentic site that will provide you with genuine medicine. Owing to the chronic nature of osteoporosis for which it is prescribed, you may be required to use this medication for long periods, with the use extending to three years in some cases.
Keeping in mind its long-term use, it is vital to be aware of the risks associated with the medicine.
Benefits and risks associated with its use
Raloxifene use is not just limited to osteoporosis conditions, but it is also used to reduce invasive breast cancer risk in postmenopausal women demonstrating a high risk for invasive breast cancer.
Women with inherited changes/mutation to certain genes like BRCA1 and BRCA2 (concerned with producing proteins to help repair damaged DNA), females with dense breasts, and those with a history of breast cancers or non-cancerous breast diseases like atypical hyperplasia or lobular carcinoma in situ as observed in breast biopsies are at an increased risk of breast cancer.
Studies have shown that a female’s breast cancer risk is related to the estrogen and progesterone made by her ovaries. Exposure to high hormone levels during the menopausal period increases the risk of breast cancer significantly. In such conditions, Raloxifene binds to the estrogen receptors and activates the estrogen pathways and blockage of the tissues expressing the estrogen receptors to modify cellular and tissue responses to estrogens.
Risks associated with Raloxifene use
Because of the nature of the action of Raloxifene, its use is often associated with several risks in the form of hot flashes and embolisms in the lungs or legs. Use of Raloxifene has been observed to lead to deep vein thrombosis or pulmonary embolism that can lead to a range of complications and sometimes even death.
In a study conducted on 101 postmenopausal women with or at an increased risk of coronary heart disease for five or more years, the incidence of venous thromboembolism was higher in the Raloxifene group than in the placebo group.
Image Credit – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559135/
The American Cancer Society has stated the risk of blood clots associated with Raloxifene use to be less than 1%. Which can increase if a woman has had an episode of a blood clot in the past. Additionally, it can result in side effects like
- Swelling of hands, legs, and feet
- Joint Pain
- Difficulty falling asleep
It is an FDA-approved medication.
In addition to being FDA approved for treating osteoporosis and breast cancer, Raloxifene has shown increased effectiveness than other medications. In a long-term study to evaluate the effectiveness of Raloxifene and Tamoxifen ( a selective estrogen receptor used to prevent breast cancer in women treatment of breast cancer in men and women), 184,460 women were included in a long-term clinical trial. The success rate of Raloxifene was observed to be greater than the Tamoxifen group.
Use of Raloxifene resulted in significantly less occurrence of uterine hyperplasia (a side effect observed in breast cancer patients).
Not everyone is suitable for the use of Raloxifene.
Because of the estrogen-modulating effects of the drug, using it can result in adverse reactions in people with certain medical conditions. The use of Raloxifene is contraindicated in
- In patients with an active or past history of thromboembolic events like deep thrombosis, retinal vein thrombosis, pulmonary embolism, or those presenting risk factors of venous thromboembolic events
- Studies have shown that Raloxifene is associated with the risk of fatal stroke and that women with increased age, diabetes, and smoking habit are at an increased risk.
- It should not be used in people with antithrombin deficiency as Raloxifene use increases the risk of venous thromboembolism, and antithrombin deficiency can be life-threatening.
- In People with antiphospholipid syndrome, a condition in which the immune system creates antibodies that attack tissues in the body, resulting in blood clot formation in the arteries and veins in the legs, lungs, kidneys, and spleen.
Conclusion
Raloxifene use can improve bone mineral density in postmenopausal women with an increase in osteoarthritis and improve the quality of their life significantly. It even works for breast cancer conditions and reduces its risk. But despite its numerous advantages, Raloxifene must be used with caution as it can lead to a significant reduction in plasma antithrombin activity. Using it also comes with the risk of impacting the homocysteine levels, and for patient safety, Raloxifene must be used strictly under the physician’s guidance.
