These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Evista General Information [posted
12/04/98]
Question: I'm 52 years old, post-period, slim and athletic, on 0.15mg Synthroid (to
replace the hormone now no longer sufficiently produced by my own thyroid). Recently I
tried PremPro, with disastrous results. Last year I also tried Miacalcin and Fosamax, both
of which caused undesirable side effects. I am very concerned about Osteoporosis, and
while I exercise and incorporate Calcium in generous quantities in my diet, I still
consider additional support in this area to be recommended. EVISTA, which is a
selective estrogen receptor modulator that apparently doesn't disturb as much of the
female body as HRT does, has been given me as an alternative. What do you know about
Raloxifene H Cl (a.k.a. evista), its efficacy, side effects, counter indications, and how,
based on my self description, it might affect me? Thank you for any pertinent information
you have.
Answer: Reloxifene is a fairly new drug that is promising in giving the cardiovascular and osteoporotic advantages of estrogen without the risk of breast cancer. It is fairly well tolerated in my patients taking it. Nausea, constipation and weight gain are the major complaints. It can cause phlebitis(which it shares with estrogen) and has an increased risk of cancer of the uterus(also a shared risk) as much as we can tell. It suffers from lack of long term outcome studies,but markers for cardiovascular risk (like HDL and LDL cholesterol) are initially favorable. I recommend it, with the caveat that there is a lack of long term studies. Tamoxifene used in breast cancer may be an alternative, studies are needed. You will probably benefit in terms of heart, bones.
General Information
on Evista [posted 12/02/98]
Question: Without periods for many years, I apparently have passed through
menopause without the nasty symptoms some American women report. At tje age pf 52, I have
a prescription for EVISTA to help with post-menopausal osteoporosis without the (on me, at
least) disastrous side-effects of PREMPRO which I just tried. I eat a generally healthy
diet, with lots of fruits and vegetables, dairy products, and lean meat. Naturally taken
to sports, I tend to remain physically well-balanced and trim, and I haven't, up until
now, had to depend on pharmaceuticals. The Synthroid was obviously needed a year ago when
my thyroid stopped functioning. Will EVISTA seem as dramatic a need, will it cause
prohibitively unpleasant side effects as the PREMPRO did? What do you know generally about
counterindications and/or successes of the new class of selective estrogen receptor
modulators? Thank you very much for anything enlightening you have to say!
Answer: Usual side effects are gi,
nausea, constipation etc. Some experience weight gain also.
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