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Evista Review Article

 

Estrogenes are main female hormones, which level is decreasing after the menopause or ovary removal. They also regulate bone turnover, and its decrease leads to osteoporosis; a condition leading to a decrease in bone density and weakened bones. Evista (raloxifene) slows this weakening, by decreasing bone turnover and increasing bone density. This leads to a decreased risk of fractures. EVISTA is currently the only approved medicine proven to reduce the risk of spinal fractures due to osteoporosis and the risk of invasive breast cancer in postmenopausal women suffering with osteoporosis.

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Evista is a drug indicated for the prevention and treatment of osteoporosis. Known by the generic name Raloxifene, is slows the weakening of bones by reducing bone turnover and augmenting the density of bones.

Osteoporosis is the brittle-bone disease occurring in women after menopause. Basically estrogen, which is among the most important female hormones, is responsible for regulating the bone turnover. After menopause of ovary removal, estrogen level decreases and leads to osteoporosis that decreases the bone density and weakens them, this in turn increases the risk of fractures.

Unlike estrogen therapy that sometimes increases the risk of cancer, Evista do not have these effects on the uterus and breasts. Evista is the only medicine that has been approved with proven effectiveness in reducing the risk of spinal fractures and invasive breast cancers that is common in women suffering from osteoporosis post-menopause.

Osteoporosis is promoted due to various factors, including Caucasian or Asian descent, slender build,
early menopause, smoking, drinking, low calcium diet, inactive lifestyle and family history of osteoporosis.


Dosage

Evista should be taken once a day with or without food. It is also recommended that a person take calcium and vitamin D supplements if one does not follow a complete and balanced diet routine. One should not consume tobacco or alcohol while taking this drug and weight-bearing exercises for strengthening the bones are advised.

In case a dose of Evista is missed, it should be taken immediately after you remember but if it is the time of next dose then skip it and get back to regular routine.


Side effects

The best side effect of Evista is that it decreases the total cholesterol and LDL or bad cholesterol without affecting the triglyceride levels or HDL i.e. good cholesterol.

Some other common side effects of this drug may include abdominal pain, arthritis, breast pain, diarrhoea, dizziness, fever, flu symptoms, bronchitis, chest pain, depression, gas and gynaecological problems. One might even experience headache, hot flashes, increased cough, indigestion, infection, insomnia, leg cramps, muscle ache, joint pain, nasal inflammation, nausea, sweating, swelling, tendon soreness, rash, sinusitis, sore throat, stomach and intestinal problems, uterine discharge, urinary tract infection, vomiting and weight gain.

If you experience change in intensity or development of any of the above side effects, then consult your doctor immediately.


Cautions

Evista should not be prescribed to women who are pregnant or are likely to be pregnant during the treatment. Women with a history of blood clot formation, including deep vein thrombosis (blood clot in the legs), retinal vein thrombosis (blood clot in the retina of the eye) and pulmonary embolism (blood clot in the lungs) should avoid this drug as it enhances the risk of blood clots. It should also not be taken during extensive periods of immobilization like while recovering from surgery or long bed rest or before 72 hours of surgical procedure, as it promotes clots. If you are taking Evista, make sure to tell your doctor prior to surgery.

If you experience any allergic reaction after consuming Evista then stop its usage. This drug should not be taken before the beginning of menopause. People with problem of congestive heart failure, breast cancer, a liver condition, or cancer, presently or in past, should consult doctor before taking this medicine.

Intake of Evista might result in unusual uterine bleeding or breast problems in some women, and the same should be informed to the doctor. Evista should never be taken along with estrogen hormones and if a person have problem with high blood triglyceride levels.


Interactions

Evista might develop interactions when indicated with other drugs, especially:

Cholestyramine (Questran)
Clofibrate (Atromid-S)
Diazoxide (Proglycem)
Ibuprofen (Advil, Motrin, Nuprin)
Diazepam (Valium)
Naproxen (Aleve, Anaprox, Naprosyn)
Warfarin (Coumadin)
Indomethacin (Indocin)


PDF

Why is this drug prescribed?
Evista is prescribed to treat and prevent osteoporosis, the brittle-bone disease that strikes some women after menopause. A variety of factors promote osteoporosis. The more factors that apply to you, the greater your chances of developing the disease. These factors include:
Caucasian or Asian descent
Slender build
Early menopause
Smoking
Drinking
A diet low in calcium
An inactive lifestyle
Osteoporosis in the family

Most important fact about this drug
Like estrogen, Evista reduces bone loss and increases bone density. However, Evista does not have estrogen-like effects on the uterus and breasts, and therefore is unlikely to increase the risk of cancer, as estrogen therapy sometimes can do. Although Evista has been shown to increase bone density over the course of a two-year study, its longer-term ability to prevent bone fractures has not yet been proven.

How should you take this medication?
Take Evista once daily, at any time, with or without food. Take calcium and vitamin D supplements as well, if you do not get enough in your diet. Avoid alcohol and tobacco. Do weight-bearing exercises to strengthen your bones.
--If you miss a dose... Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take a double dose.
--Storage instructions.. Store at room temperature.

What side effects may occur?
Evista has one very positive side effect: It lowers total cholesterol and LDL ("bad") cholesterol. It does not affect HDL ("good") cholesterol or triglyceride levels. The unwanted side effects of Evista cannot be predicted. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Evista.

More common side effects may include:
Abdominal pain, arthritis, breast pain, bronchitis, chest pain, depression, diarrhea, dizziness, fever, flu symptoms, gas, gynecological problems, headache, hot flashes, increased cough, indigestion, infection, insomnia, joint pain, leg cramps, muscle ache, nasal inflammation, nausea, rash, sinusitis, sore throat, stomach and intestinal problems, sweating, swelling, tendon soreness, uterine discharge, urinary tract infection, vomiting, weight gain

Why should this drug not be prescribed?
Evista is not for use by women who are--or could become--pregnant. You should also avoid this drug if you have a history of blood clot formation, including deep vein thrombosis (blood clot in the legs), pulmonary embolism (blood clot in the lungs), and retinal vein thrombosis (blood clot in the retina of the eye), since Evista increases the risk of clots. Avoid the drug, too, if it gives you an allergic reaction.

Special warnings about this medication
Because of Evista's tendency to promote clots, you should not take it during long periods of immobilization such as recovery from surgery or prolonged bed rest, or for 72 hours beforehand. If you are scheduled for surgery, make sure the doctor is aware that you are taking Evista. For the same reason, if you are going on a trip where your movement will be restricted, make a point of periodically getting up and walking around. Evista is not needed prior to menopause and shouldn't be taken until menopause has passed. It has not been studied in premenopausal women and its use is not recommended. Use Evista with caution if you have congestive heart failure, a liver condition, or cancer. Be cautious, too, if you've had breast cancer in the past; the drug's effect in this situation is unknown.

If you develop unusual uterine bleeding or breast problems while taking Evista, tell your doctor immediately. Evista will not cure hot flashes. (In fact, it may cause them.) Nevertheless, never combine Evista with estrogen hormones. If you've had a problem with high blood triglyceride levels when taking estrogen, Evista may cause the same problem. However, it tends to lower cholesterol levels by 6 to 11 percent.

Possible food and drug interactions
If Evista is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Evista with the following:
Cholestyramine (Questran)
Clofibrate (Atromid-S)
Diazepam (Valium)
Diazoxide (Proglycem)
Ibuprofen (Advil, Motrin, Nuprin)
Indomethacin (Indocin)
Naproxen (Aleve, Anaprox, Naprosyn)
Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding Evista can harm a developing baby. Do not use if you are or may become pregnant. Also avoid breastfeeding while taking Evista.

Recommended dosage

POSTMENOPAUSAL WOMEN
The recommended dosage is one 60-milligram tablet once a day.

Overdosage
There have not been any reports of overdose with Evista. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.

key words: raloxifeno, raloxifen


Evista notes:

The generic name of Evista is raloxifeno and is prescribed for reducing the risk of spinal fractures that are caused due to osteoporosis. It is also commonly prescribed to reduce the risk for invasive breast cancer that is prone in postmenopausal women suffering from osteoporosis. The estrogen hormone that regulates the formation and destruction of bones in women usually decreases in levels after menopause in women or after the removal of the ovaries, as a result of which it leads to a loss of bone density and weakening of bones. This condition is known as osteoporosis. Evista is a powerful drug that is clinically proven in decreasing the bone turnover, which thereby helps in increasing the density of bone to some extend. Regular administration of raloxifeno by women with osteoporosis helps in making their bones stronger and thus controls the risks of fractures in women associated with osteoporosis.

Even though Evista can effectively help in strengthening the bones and control the loss of bone density in women after menopause as the Estrogen hormone does, still it cannot successfully offer estrogen-like effects on the breasts and uterus like the body hormone. Thus, estrogen therapies can unlikely paves way for cancer. In spite of the ability of this drug to increase the bone density in women, no strong evidence has been so far reported with the drug with the ability to prevent fractures of bone successfully after long-term usage. Use of alcohol and tobacco is strictly prohibited while using these drugs.

Some commonly found side effects of Evista include: bronchitis, abdominal, joint, chest and breast pain, arthritis, diarrhea, gynecological problems, nasal inflammation, urinary tract infection, intestinal problems, sinusitis, insomnia, depression, dizziness, flu symptoms, hot flashes, nausea, rash, infection, sweating, swelling, tendon soreness, uterine discharge, weight gain etc. It should not be used by pregnant women.


 

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