Prelox

Indications

Raloxifene Hydrochloride is used in women after the menopause to treat and prevent osteoporosis (thinning of the bones), lowering the risk of spine fractures. In postmenopausal women with osteoporosis or at high risk of breast cancer, it is also used to reduce the risk of invasive breast cancer.

How It Works

Raloxifene is a selective oestrogen receptor modulator (SERM). It acts like oestrogen on bone, slowing bone loss and helping to keep bones strong, but blocks oestrogen's effects on breast and womb tissue. It does not relieve menopausal hot flushes.

Dosage and Administration

The usual dose is 60 mg once a day, at any time of day, with or without food, as prescribed by your doctor. Most women also need enough calcium and vitamin D from diet or supplements. It is a long-term treatment; do not stop without speaking to your doctor.

Interactions

• Cholestyramine and similar resins reduce raloxifene absorption; do not take them together.
• It may change the effect of Warfarin; your blood clotting (INR) should be checked when starting or stopping.
• Do not use with oestrogen hormone therapy taken by mouth, patch or injection.
• Take Levothyroxine at least a few hours apart.

Contraindications

• Current or past blood clots in the legs (deep vein thrombosis), lungs (pulmonary embolism) or eyes (retinal vein thrombosis).
• Women who are or may become pregnant, and breastfeeding women.
• Liver disease, severe kidney disease or unexplained vaginal bleeding.
• Active womb cancer; it is not for men or premenopausal women.

Side Effects

Common effects include hot flushes, leg cramps, flu-like symptoms, swelling of the hands, feet or ankles and joint pain. Raloxifene increases the risk of blood clots, and in women with heart disease or high risk of it, the risk of death from stroke.

Get urgent medical help if you have pain, swelling or redness in one leg, sudden chest pain or shortness of breath, coughing up blood, sudden change in vision, or signs of stroke such as sudden weakness, numbness of the face or limbs, or difficulty speaking.

Pregnancy and Lactation

Raloxifene must not be used during pregnancy or by women who could become pregnant, as it may harm the baby. It must not be used while breastfeeding.

Precautions and Warnings

• Stop raloxifene at least 3 days before a long period of immobility, such as surgery, bed rest or long journeys, and restart only when fully mobile; your doctor will advise.
• Tell your doctor about any history of stroke, heart disease, high blood pressure, smoking or atrial fibrillation.
• Report any vaginal bleeding or breast changes.
• It does not treat hot flushes and may make them worse.

Overdose

Overdose may cause leg cramps and dizziness. Contact a doctor or poison centre promptly.

Therapeutic Class

Selective oestrogen receptor modulator (SERM), bone resorption inhibitor.

Storage

Store below 30°C in a dry place, away from light. Keep out of the reach of children.