Raloxifene is a selective benzothiophene estrogen receptor modulator (SERM). Raloxifene binds to estrogen receptors (ER) as a mixed estrogen agonist/antagonist; it displays both an ER-alpha-selective partial agonist/antagonist effect and a pure ER-beta-selective antagonist effect. This agent functions as an estrogen agonist in some tissues (bones, lipid metabolism) and as an estrogen antagonist in others (endometrium and breasts), with the potential for producing some of estrogen’s beneficial effects without producing its adverse effects. (NCI04)
Raloxifene is a member of the class of 1-benzothiophenes that is 1-benzothiophene in which the hydrogens at positions 2, 3, and 6 have been replaced by p-hydroxyphenyl, p-[2-(piperidines-1-yl)ethoxy]benzoyl, and hydroxy groups, respectively. A second-generation selective estrogen receptor modulator (SERM) is used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist in mammary glands and uterine tissue. It has a role as a bone density conservation agent, an estrogen receptor modulator, and an estrogen antagonist. It is a member of phenols, an aromatic ketone, a member of 1-benzothiophenes, and N-oxy ethyl piperidine. It is a conjugate base of raloxifene(1+).
Raloxifene Hydrochloride is the hydrochloride salt form of raloxifene, a selective benzothiophene estrogen receptor modulator (SERM) with lipid-lowering effects and activity against osteoporosis. Raloxifene hydrochloride specifically binds to estrogen receptors in responsive tissue, including the liver, bone, breast, and endometrium. The resulting ligand-receptor complex is translocated to the nucleus where, depending on the tissue type, it promotes or suppresses the transcription of estrogen-regulated genes, thereby exerting its agonistic or antagonistic effects. This agent functions as an estrogen agonist in lipid metabolism, thereby decreasing total and LDL cholesterol levels. In tissue like bone, it decreases bone resorption and bone turnover and increases bone mineral density. Raloxifene hydrochloride acts as an estrogen antagonist in uterine and breast tissue. This agent also exerts an anti-proliferative effect on estrogen-sensitive breast cancer.
Raloxifene is a second-generation selective estrogen receptor modulator (SERM) that mediates anti-estrogenic effects on breast and uterine tissues, and estrogenic effects on bone, lipid metabolism, and blood coagulation. Exhibiting tissue-specific effects distinct from [estradiol], raloxifene is the first of the benzothiophene group of antiestrogens to be labeled a SERM. Available in many countries worldwide, raloxifene was initially approved by the FDA in December 1997 under the market name Evista® for the management and prevention of osteoporosis in postmenopausal women and reduction in risk for invasive breast cancer in postmenopausal women with osteoporosis or those who are at high risk for invasive breast cancer. However, it has a negligible effect on altering the development and progression of breast cancer itself. The most common causes of osteoporosis include postmenopausal deficiency of estrogen and age-related deterioration in bone homeostasis. Due to the risk of bone fractures that may lead to morbidities and reduced quality of life, the management of osteoporosis in postmenopausal women with the use of therapeutic agents in addition to concurrent therapies is critical. Due to the decline in estrogen levels in postmenopausal osteoporosis, hormone replacement therapy (HRT), such as estradiol, has been used to ameliorate the condition. However, due to the off-target actions of HRT, newer non-hormonal agents such as raloxifene and [tamoxifen] have been developed to reduce adverse events through selective pharmacological actions on tissue-specific therapeutic targets. The main effects of raloxifene are to preserve bone mineral density and decrease the risk of breast cancer in postmenopausal women. Compared to estrogen and tamoxifen, raloxifene was not associated with an increased risk of uterine cancer and it does not cause endometrial proliferation. Although rare, there was an increased risk of venous thromboembolism during clinical trials of postmenopausal women receiving raloxifene. In addition, a clinical study consisting of postmenopausal women with documented coronary heart disease or at increased risk for coronary events showed an increased risk for fatal stroke with raloxifene therapy compared to a placebo. It is strongly advised that the risk-benefit ratio is considered before starting raloxifene therapy in women at risk of thromboembolic disease or strokes, such as a prior history of stroke, transient ischemic attack, atrial fibrillation, hypertension, or cigarette smoking.
Mechanism of Action
Raloxifene is a selective estrogen receptor modulator that acts as both an estrogen agonist and antagonist via differential effects on the tissue-specific estrogen receptors. Based on the findings of competitive binding assays, raloxifene displays a binding affinity that is similar to that of [estradiol], the predominant circulating estrogen. Estrogens play variable roles in different tissues in females, including the bone, breasts, uterus, and liver, by binding to the steroid nuclear hormone receptors, Estrogen Receptor alpha (ERα) or Estrogen Receptor beta (ERβ). These receptors are normally bound to the Heat Shock Protein 90 (Hsp90) when unbound to the ligand. Ligand binding induces a conformational change in the receptor that promotes dissociation of the receptor from Hsp90, dimerization, and translocation into the nucleus. This movement into the nucleus allows the receptor to bind to genomic locations based on sequence recognition of the DNA binding domain, also known as the Estrogen Response Elements (EREs). In bones, endogenous estrogens normally modulate multiple DNA response elements, including the gene-encoding transforming growth factor-β3 (TGF-β3), which is a cytokine embedded in the bone matrix. TGF-β3 plays an important role in bone remodeling by working with other cytokines to induce the production of osteoblasts, such as IL-6, and attenuate the activity of osteoclasts. Estrogens typically maintain bone integrity by inhibiting the cytokines that recruit osteoclasts and oppose the bone-resorbing, Ca2+-mobilizing action of parathyroid hormone. In contrast, estrogens promote osteoblast proliferation, augment the production of TGF-β3 and bone morphogenic proteins, and inhibit apoptosis. Mimicking the action of endogenous estrogen in bone tissues, raloxifene binds to the estrogen receptor to influence gene transcription through interactions with the estrogen response element (ERE) and a distinct DNA target, the raloxifene response element (RRE). It occupies the same ER ligand binding site as estrogen. Upon binding, raloxifene induces a conformational change of the receptor, allowing mediation of direct binding to transcriptional elements by accessory proteins. Increased expression of bone matrix proteins, such as alkaline phosphatase, osteonectin, osteocalcin, and collagen may be seen. The agonistic or antagonistic action of raloxifene depends on the extent of recruitment of coactivators and corepressors to estrogen receptor (ER) target gene promotors. In breast tissues, raloxifene acts as an estrogen receptor antagonist to attenuate the estrogen-dependent proliferative effects of epithelial cell expansion. In addition to the antiproliferative effects, raloxifene prevents the production of cytokines and the recruitment of macrophages and lymphocytes into the tumor mass.
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Bone remodeling is controlled by the actions of bone-degrading osteoclasts and bone-forming osteoblasts (OBs). Aging and loss of estrogen after menopause affect bone mass and quality. Estrogen therapy, including selective estrogen receptor modulators (SERMs), can prevent bone loss and increase bone mineral density in postmenopausal women. Although investigations of the effects of estrogen on osteoclast activity are well advanced, the mechanism of action of estrogen on OBs is still unclear. The proline-rich tyrosine kinase 2 (Pyk2) is important for bone formation and female mice lacking Pyk2 (Pyk2-KO) exhibit elevated bone mass, increased bone formation rate, and reduced osteoclast activity. Therefore, in the current study, we examined the role of estrogen signaling on the mechanism of action of Pyk2 in OBs. As expected, Pyk2-KO OBs showed significantly higher proliferation, matrix formation, and mineralization than WT OBs. In addition, we found that Pyk2-KO OBs cultured in the presence of either 17beta-estradiol (E2) or raloxifene, a SERM used for the treatment of post-menopausal osteoporosis, showed a further robust increase in alkaline phosphatase (ALP) activity and mineralization. We examined the possible mechanism of action and found that Pyk2 deletion promotes the proteasome-mediated degradation of estrogen receptor a (ERa), but not estrogen receptor beta (ERbeta). As a consequence, E2 signaling via ERbeta was enhanced in Pyk2-KO OBs. In addition, we found that Pyk2 deletion and E2 stimulation had an additive effect on ERK phosphorylation, which is known to stimulate cell differentiation and survival. Our findings suggest that in the absence of Pyk2, estrogen exerts an osteogenic effect on OBs through altered ERalpha and ERbeta signaling. Thus, targeting Pyk2, in combination with estrogen or raloxifene, maybe a novel strategy for the prevention and/or treatment of bone loss diseases.
Indications
- Indicated for the prevention and treatment of osteoporosis in postmenopausal women, as well as prevention and treatment of corticosteroid-induced bone loss. Indicated for the reduction in the risk of invasive breast cancer in postmenopausal women with osteoporosis or postmenopausal women with a high risk for invasive breast cancer.
- Optruma is indicated for the treatment and prevention of osteoporosis in postmenopausal women. A significant reduction in the incidence of vertebral, but not hip fractures has been demonstrated. When determining the choice of Optruma or other therapies, including estrogens, for an individual postmenopausal woman, consideration should be given to menopausal symptoms, effects on uterine and breast tissues, and cardiovascular risks and benefits (see section 5. 1).
- Evista is indicated for the treatment and prevention of osteoporosis in postmenopausal women. A significant reduction in the incidence of vertebral, but not hip fractures has been demonstrated. When determining the choice of Evista or other therapies, including estrogens, for an individual postmenopausal woman, consideration should be given to menopausal symptoms, effects on uterine and breast tissues, and cardiovascular risks and benefits.
- Raloxifene is indicated for the treatment and prevention of osteoporosis in postmenopausal women. A significant reduction in the incidence of vertebral, but not hip fractures has been demonstrated. When determining the choice of raloxifene or other therapies, including estrogens, for an individual postmenopausal woman, consideration should be given to menopausal symptoms, effects on uterine and breast tissues, and cardiovascular risks and benefits. It has a role as a bone density conservation agent, an estrogen antagonist, and an estrogen receptor modulator. It contains raloxifene(1+).
FDA-approved Indications
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Raloxifene is an FDA-approved second-generation selective estrogen receptor modulator (SERM), a drug with an estrogen-agonistic effect on bone, increasing bone mineral density and mass by decreasing bone resorption. It is indicated in the treatment and prevention of postmenopausal osteoporosis.
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Raloxifene is also indicated for the risk reduction of invasive breast cancer in postmenopausal women, demonstrating a high risk for invasive breast cancer or women with osteoporosis. The definition of high breast cancer risk is one or more first-degree relatives with breast cancer, or at least one breast biopsy showing lobular carcinoma in situ (LCIS), or atypical hyperplasia, or a 5-year predicted breast cancer risk of more than 1.66%.[rx]
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Studies are underway on raloxifene as an adjuvant treatment for postmenopausal women with schizophrenia. It shows particularly promising results in mild presentations of schizophrenia.[rx]
Use in Cancer
- Raloxifene hydrochloride is approved to prevent: Breast cancer. It is used to decrease the chance of invasive breast cancer in postmenopausal women who have a high risk of developing the disease or who have osteoporosis.
- Raloxifene hydrochloride is also approved to prevent and treat: Osteoporosis in postmenopausal women.
- Raloxifene hydrochloride is also being studied in the treatment of other types of cancer.
Contraindications
- Contraindications to raloxifene include past medical history of deep venous thrombosis, renal vein thrombosis, pulmonary embolism, malignancy, active smoking, or any thrombophilia (factor V Leiden deficiency, prothrombin gene mutation G20210A, antiphospholipid syndrome, deficiency of antithrombin, protein c and s deficiency).
- Death due to stroke: Postmenopausal women with coronary heart disease or at increased risk for coronary events are at increased risk of death due to stroke when treated with raloxifene.
- Perform risk-benefit analysis in women with a risk of strokes, such as women with a history of transient ischemic attack (TIA) or stroke, cigarette smoking habit, hypertension, and atrial fibrillation.
- the high amount of triglyceride in the blood
- increased risk of blood clotting
- a clot in the small veins that carry blood to or from the retina of the eye
- high blood pressure
- coronary artery disease
- a clot in the lung
- atrial fibrillation
- chronic heart failure
- a transient ischemic attack, a type of stroke that lasts only a few minutes
- a stroke
- thrombophlebitis is an inflamed vein due to a blood clot
- blood clot in a deep vein of the extremities
- blood clot formation in vein
- liver problems
- pregnancy
- tobacco smoking
- lupus anticoagulant disorder
- chronic kidney disease stage 3A (moderate)
- chronic kidney disease stage 3B (moderate)
- chronic kidney disease stage 4 (severe)
- kidney disease with likely reduction in kidney function
- history of pulmonary embolism
- history of deep vein thrombosis
- history of venous thromboembolism
- history of a blood clot in the retinal vein
Dosage
Strengths: 60 mg
Osteoporosis
- 60 mg orally per day
- For treatment or prevention of osteoporosis, advise patients to add supplemental calcium and/or vitamin D if daily intake is inadequate.
- When this drug is used to reduce the risk of invasive breast cancer, the optimum duration of treatment is not known.
- Treatment and prevention of osteoporosis in postmenopausal women.
- Reduction in risk of invasive breast cancer in postmenopausal women with osteoporosis and/or at high risk of invasive breast cancer.
Prevention of Osteoporosis
- 60 mg orally per day
- For treatment or prevention of osteoporosis, advise patients to add supplemental calcium and/or vitamin D if daily intake is inadequate.
- When this drug is used to reduce the risk of invasive breast cancer, the optimum duration of treatment is not known.
- Treatment and prevention of osteoporosis in postmenopausal women.
- Reduction in risk of invasive breast cancer in postmenopausal women with osteoporosis and/or at high risk of invasive breast cancer.
Prevention of Breast Cancer
- 60 mg orally per day
- For treatment or prevention of osteoporosis, advise patients to add supplemental calcium and/or vitamin D if daily intake is inadequate.
- When this drug is used to reduce the risk of invasive breast cancer, the optimum duration of treatment is not known.
Side Effects
The Most Common
- hot flashes (more common in the first 6 months of raloxifene therapy)
- leg cramps
- swelling of the hands, feet, ankles, or lower legs
- flu-like syndrome
- joint pain
- sweating
- difficulty falling asleep or staying asleep
- Hot flashes, including sudden sweating and feelings of warmth (especially common during the first 6 months of treatment)
- increased white vaginal discharge
- joint or muscle pain
- mental depression
- problems of stomach or intestines, including passing of gas, upset stomach, or vomiting
- swollen joints
- trouble in sleeping
- weight gain (unexplained)
More common
- Bloody or cloudy urine
- chest pain
- difficult, burning, or painful urination
- fever
- frequent urge to urinate
- infection, including body aches or pain, congestion in throat, cough, dryness or soreness of throat, runny nose, and loss of voice
- leg cramping
- skin rash
- swelling of hands, ankles, or feet
- vaginal itching
Rare
- Abdominal pain (severe)
- aching body pains
- congestion in lungs
- decreased vision or other changes in vision
- diarrhea
- difficulty in breathing
- hoarseness
- loss of appetite
- nausea
- trouble in swallowing
- weakness
Drug interaction
DRUG | INTERACTION |
---|---|
Abemaciclib | The metabolism of Abemaciclib can be decreased when combined with Raloxifene. |
Acalabrutinib | The metabolism of Acalabrutinib can be decreased when combined with Raloxifene. |
Acenocoumarol | The serum concentration of Acenocoumarol can be increased when it is combined with Raloxifene. |
Acetylcysteine | The excretion of Raloxifene can be decreased when combined with Acetylcysteine. |
Adenine | The metabolism of Raloxifene can be decreased when combined with Adenine. |
Afatinib | Afatinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Albendazole | The metabolism of Albendazole can be decreased when combined with Raloxifene. |
Alectinib | The metabolism of Alectinib can be decreased when combined with Raloxifene. |
Alfuzosin | The metabolism of Alfuzosin can be decreased when combined with Raloxifene. |
Almotriptan | The metabolism of Almotriptan can be decreased when combined with Raloxifene. |
Alpelisib | The metabolism of Alpelisib can be decreased when combined with Raloxifene. |
Alprazolam | The metabolism of Alprazolam can be decreased when combined with Raloxifene. |
Aminohippuric acid | The excretion of Raloxifene can be decreased when combined with Aminohippuric acid. |
Aminophenazone | The metabolism of Aminophenazone can be decreased when combined with Raloxifene. |
Aminophylline | The metabolism of Aminophylline can be decreased when combined with Raloxifene. |
Amiodarone | The metabolism of Amiodarone can be decreased when combined with Raloxifene. |
Amitriptyline | The metabolism of Amitriptyline can be decreased when combined with Raloxifene. |
Amodiaquine | The metabolism of Amodiaquine can be decreased when combined with Raloxifene. |
Amprenavir | The excretion of Raloxifene can be decreased when combined with Amprenavir. |
Anastrozole | The metabolism of Anastrozole can be decreased when combined with Raloxifene. |
Antipyrine | The metabolism of Antipyrine can be decreased when combined with Raloxifene. |
Apalutamide | The metabolism of Apalutamide can be decreased when combined with Raloxifene. |
Apixaban | The metabolism of Apixaban can be decreased when combined with Raloxifene. |
Apomorphine | The metabolism of Apomorphine can be decreased when combined with Raloxifene. |
Aripiprazole | The metabolism of Aripiprazole can be decreased when combined with Raloxifene. |
Aripiprazole | The metabolism of Aripiprazole lauroxil can be decreased when combined with Raloxifene. |
Artemether | The metabolism of Artemether can be decreased when combined with Raloxifene. |
Asciminib | The metabolism of Raloxifene can be decreased when combined with Asciminib. |
Astemizole | The metabolism of Astemizole can be decreased when combined with Raloxifene. |
Asunaprevir | The metabolism of Asunaprevir can be decreased when combined with Raloxifene. |
Ataluren | The excretion of Raloxifene can be decreased when combined with Ataluren. |
Atazanavir | The metabolism of Raloxifene can be decreased when combined with Atazanavir. |
Atorvastatin | The metabolism of Atorvastatin can be decreased when combined with Raloxifene. |
Avanafil | Avanafil may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Avatrombopag | Avatrombopag may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Axitinib | The metabolism of Axitinib can be decreased when combined with Raloxifene. |
Azelastine | The metabolism of Azelastine can be decreased when combined with Raloxifene. |
Azithromycin | The metabolism of Azithromycin can be decreased when combined with Raloxifene. |
Beclomethasone | Beclomethasone dipropionate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Belumosudil | Belumosudil may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Bempedoic acid | The excretion of Raloxifene can be decreased when combined with Bempedoic acid. |
Benzocaine | The metabolism of Benzocaine can be decreased when combined with Raloxifene. |
Benzphetamine | The metabolism of Benzphetamine can be decreased when combined with Raloxifene. |
Benzyl alcohol | The metabolism of Benzyl alcohol can be decreased when combined with Raloxifene. |
Bezafibrate | The excretion of Raloxifene can be decreased when combined with Bezafibrate. |
Bicalutamide | The metabolism of Bicalutamide can be decreased when combined with Raloxifene. |
Bortezomib | The metabolism of Bortezomib can be decreased when combined with Raloxifene. |
Bosutinib | The metabolism of Bosutinib can be decreased when combined with Raloxifene. |
Brentuximab | The metabolism of Brentuximab vedotin can be decreased when combined with Raloxifene. |
Brigatinib | The metabolism of Brigatinib can be decreased when combined with Raloxifene. |
Brivaracetam | The metabolism of Brivaracetam can be decreased when combined with Raloxifene. |
Brompheniramine | The metabolism of Brompheniramine can be decreased when combined with Raloxifene. |
Buprenorphine | Buprenorphine may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Bupropion | The serum concentration of Bupropion can be increased when it is combined with Raloxifene. |
Busulfan | The metabolism of Busulfan can be decreased when combined with Raloxifene. |
Cabazitaxel | The metabolism of Cabazitaxel can be decreased when combined with Raloxifene. |
Cabergoline | The metabolism of Cabergoline can be decreased when combined with Raloxifene. |
Caffeine | Caffeine may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Cannabidiol | Cannabidiol may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Capmatinib | The serum concentration of Raloxifene can be increased when it is combined with Capmatinib. |
Carbamazepine | The metabolism of Carbamazepine can be decreased when combined with Raloxifene. |
Caspofungin | The excretion of Raloxifene can be decreased when combined with Caspofungin. |
Celecoxib | The metabolism of Celecoxib can be decreased when combined with Raloxifene. |
Cenobamate | The metabolism of Cenobamate can be decreased when combined with Raloxifene. |
Cephalexin | The metabolism of Cephalexin can be decreased when combined with Raloxifene. |
Ceritinib | The metabolism of Ceritinib can be decreased when combined with Raloxifene. |
Cerivastatin | The metabolism of Cerivastatin can be decreased when combined with Raloxifene. |
Chloroquine | The metabolism of Chloroquine can be decreased when combined with Raloxifene. |
Chlorpromazine | The metabolism of Chlorpromazine can be decreased when combined with Raloxifene. |
Cholecystokinin | The excretion of Raloxifene can be decreased when combined with Cholecystokinin. |
Cholesterol | Cholesterol may increase the excretion rate of Raloxifene which could result in a lower serum level and potentially a reduction in efficacy. |
Cholestyramine | Cholestyramine can cause a decrease in the absorption of Raloxifene resulting in a reduced serum concentration and potentially a decrease in efficacy. |
Cholic Acid | The excretion of Raloxifene can be increased when combined with Cholic Acid. |
Cilostazol | The metabolism of Cilostazol can be decreased when combined with Raloxifene. |
Cinnarizine | The metabolism of Cinnarizine can be decreased when combined with Raloxifene. |
Cisapride | The metabolism of Cisapride can be decreased when combined with Raloxifene. |
Clarithromycin | The excretion of Raloxifene can be decreased when combined with Clarithromycin. |
Clobazam | The metabolism of Clobazam can be decreased when combined with Raloxifene. |
Clofazimine | Clofazimine may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Clomipramine | The metabolism of Clomipramine can be decreased when combined with Raloxifene. |
Clonidine | The metabolism of Clonidine can be decreased when combined with Raloxifene. |
Clopidogrel | The metabolism of Clopidogrel can be decreased when combined with Raloxifene. |
Clotiazepam | The metabolism of Clotiazepam can be decreased when combined with Raloxifene. |
Cobicistat | Cobicistat may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Cobimetinib | The metabolism of Cobimetinib can be decreased when combined with Raloxifene. |
Colchicine | The metabolism of Colchicine can be decreased when combined with Raloxifene. |
Colesevelam | Colesevelam can cause a decrease in the absorption of Raloxifene resulting in a reduced serum concentration and potentially a decrease in efficacy. |
Colestipol | Colestipol can cause a decrease in the absorption of Raloxifene resulting in a reduced serum concentration and potentially a decrease in efficacy. |
Conivaptan | The metabolism of Conivaptan can be decreased when combined with Raloxifene. |
C estrogens | The excretion of Raloxifene can be decreased when combined with Conjugated estrogens. |
Copanlisib | The metabolism of Copanlisib can be decreased when combined with Raloxifene. |
Crizotinib | The metabolism of Crizotinib can be decreased when combined with Raloxifene. |
Cyclophosphamide | The metabolism of Cyclophosphamide can be decreased when combined with Raloxifene. |
Cyclosporine | The metabolism of Cyclosporine can be decreased when combined with Raloxifene. |
Dabrafenib | The metabolism of Dabrafenib can be decreased when combined with Raloxifene. |
Daclatasvir | Daclatasvir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Dacomitinib | The metabolism of Dacomitinib can be decreased when combined with Raloxifene. |
Dapsone | The metabolism of Dapsone can be decreased when combined with Raloxifene. |
Darolutamide | The serum concentration of Raloxifene can be increased when it is combined with Darolutamide. |
Darunavir | The excretion of Raloxifene can be decreased when combined with Darunavir. |
Dasabuvir | Dasabuvir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Dasatinib | The metabolism of Dasatinib can be decreased when combined with Raloxifene. |
Deferasirox | The metabolism of Raloxifene can be decreased when combined with Deferasirox. |
Desogestrel | The metabolism of Raloxifene can be increased when combined with Desogestrel. |
Dexamethasone | Dexamethasone may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Dexamethasone | Dexamethasone acetate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Dexibuprofen | The metabolism of Dexibuprofen can be decreased when combined with Raloxifene. |
Diclofenac | The metabolism of Diclofenac can be decreased when combined with Raloxifene. |
Diethylstilbestrol | Diethylstilbestrol may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Digitoxin | The metabolism of Digitoxin can be decreased when combined with Raloxifene. |
Digoxin | The excretion of Raloxifene can be decreased when combined with Digoxin. |
Dihydroergocornine | The metabolism of Dihydroergocornine can be decreased when combined with Raloxifene. |
Dihydroergocristine | The metabolism of Dihydroergocristine can be decreased when combined with Raloxifene. |
Dihydroergotamine | The metabolism of Dihydroergotamine can be decreased when combined with Raloxifene. |
Diltiazem | The metabolism of Diltiazem can be decreased when combined with Raloxifene. |
Dipyridamole | The excretion of Raloxifene can be decreased when combined with Dipyridamole. |
Docetaxel | The metabolism of Docetaxel can be decreased when combined with Raloxifene. |
Dofetilide | The metabolism of Dofetilide can be decreased when combined with Raloxifene. |
Domperidone | The metabolism of Domperidone can be decreased when combined with Raloxifene. |
Dosulepin | The metabolism of Dosulepin can be decreased when combined with Raloxifene. |
Doxazosin | The metabolism of Doxazosin can be decreased when combined with Raloxifene. |
Doxorubicin | The metabolism of Doxorubicin can be decreased when combined with Raloxifene. |
Dronabinol | The serum concentration of Dronabinol can be increased when it is combined with Raloxifene. |
Dronedarone | The metabolism of Dronedarone can be decreased when combined with Raloxifene. |
Drospirenone | The metabolism of Drospirenone can be decreased when combined with Raloxifene. |
Duvelisib | The metabolism of Duvelisib can be decreased when combined with Raloxifene. |
Ebastine | The metabolism of Ebastine can be decreased when combined with Raloxifene. |
Efavirenz | The metabolism of Efavirenz can be decreased when combined with Raloxifene. |
Elagolix | The metabolism of Elagolix can be decreased when combined with Raloxifene. |
Elbasvir | Elbasvir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Elexacaftor | The metabolism of Elexacaftor can be decreased when combined with Raloxifene. |
Eliglustat | The metabolism of Eliglustat can be decreased when combined with Raloxifene. |
Eltrombopag | Eltrombopag may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Eluxadoline | The excretion of Raloxifene can be decreased when combined with Eluxadoline. |
Enasidenib | The metabolism of Enasidenib can be decreased when combined with Raloxifene. |
Entrectinib | The metabolism of Entrectinib can be decreased when combined with Raloxifene. |
Enzalutamide | The serum concentration of Enzalutamide can be increased when it is combined with Raloxifene. |
Epinastine | The metabolism of Epinastine can be decreased when combined with Raloxifene. |
Erdafitinib | The metabolism of Erdafitinib can be decreased when combined with Raloxifene. |
Ergotamine | The metabolism of Ergotamine can be decreased when combined with Raloxifene. |
Erlotinib | The metabolism of Erlotinib can be decreased when combined with Raloxifene. |
Ertugliflozin | The metabolism of Raloxifene can be decreased when combined with Ertugliflozin. |
Erythromycin | The excretion of Raloxifene can be decreased when combined with Erythromycin. |
Esketamine | The metabolism of Esketamine can be decreased when combined with Raloxifene. |
Estetrol | The metabolism of Estetrol can be decreased when combined with Raloxifene. |
Estradiol | Estradiol may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Estradiol acetate | Estradiol acetate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Estradiol benzoate | Estradiol benzoate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Estradiol cypionate | Estradiol cypionate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Estradiol | Estradiol dienanthate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Estradiol valerate | Estradiol valerate may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Eszopiclone | The metabolism of Eszopiclone can be decreased when combined with Raloxifene. |
Ethinylestradiol | The metabolism of Raloxifene can be increased when combined with Ethinylestradiol. |
Etoposide | The metabolism of Etoposide can be decreased when combined with Raloxifene. |
Everolimus | The metabolism of Everolimus can be decreased when combined with Raloxifene. |
Febuxostat | The excretion of Raloxifene can be decreased when combined with Febuxostat. |
Fedratinib | Fedratinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Fenfluramine | The metabolism of Fenfluramine can be decreased when combined with Raloxifene. |
Fenofibrate | The metabolism of Fenofibrate can be decreased when combined with Raloxifene. |
Fentanyl | The metabolism of Fentanyl can be decreased when combined with Raloxifene. |
Fexinidazole | The metabolism of Fexinidazole can be decreased when combined with Raloxifene. |
Filgotinib | The serum concentration of Raloxifene can be increased when it is combined with Filgotinib. |
Finerenone | The serum concentration of Finerenone can be increased when it is combined with Raloxifene. |
Flunitrazepam | The metabolism of Flunitrazepam can be decreased when combined with Raloxifene. |
Fluoroestradiol | Raloxifene may decrease effectiveness of Fluoroestradiol F-18 as a diagnostic agent. |
Fluorouracil | The metabolism of Fluorouracil can be decreased when combined with Raloxifene. |
Fluoxetine | The metabolism of Fluoxetine can be decreased when combined with Raloxifene. |
Flurbiprofen | The metabolism of Raloxifene can be decreased when combined with Flurbiprofen. |
Fluticasone | The excretion of Raloxifene can be decreased when combined with Fluticasone. |
Fluticasone | The excretion of Raloxifene can be decreased when combined with Fluticasone furoate. |
Fluticasone | The excretion of Raloxifene can be decreased when combined with Fluticasone propionate. |
Fluvastatin | The metabolism of Fluvastatin can be decreased when combined with Raloxifene. |
Fosaprepitant | The metabolism of Fosaprepitant can be decreased when combined with Raloxifene. |
Fosphenytoin | The metabolism of Fosphenytoin can be decreased when combined with Raloxifene. |
Fostamatinib | Fostamatinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Fostemsavir | Fostemsavir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Fusidic acid | Fusidic acid may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Gefitinib | Gefitinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Gemfibrozil | The metabolism of Raloxifene can be decreased when combined with Gemfibrozil. |
Gilteritinib | Gilteritinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Glasdegib | Glasdegib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Glecaprevir | Glecaprevir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Grazoprevir | Grazoprevir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Halofantrine | The metabolism of Halofantrine can be decreased when combined with Raloxifene. |
Haloperidol | The serum concentration of Haloperidol can be increased when it is combined with Raloxifene. |
Halothane | The metabolism of Halothane can be decreased when combined with Raloxifene. |
Hydrocodone | The metabolism of Hydrocodone can be decreased when combined with Raloxifene. |
Hydroxychloro | The metabolism of Hydroxychloroquine can be decreased when combined with Raloxifene. |
Ibrutinib | The metabolism of Ibrutinib can be decreased when combined with Raloxifene. |
Ibuprofen | The metabolism of Ibuprofen can be decreased when combined with Raloxifene. |
Idelalisib | The metabolism of Idelalisib can be decreased when combined with Raloxifene. |
Ifosfamide | The metabolism of Ifosfamide can be decreased when combined with Raloxifene. |
Iloperidone | The metabolism of Iloperidone can be decreased when combined with Raloxifene. |
Imatinib | Imatinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Imipramine | The metabolism of Imipramine can be decreased when combined with Raloxifene. |
Indinavir | The metabolism of Raloxifene can be decreased when combined with Indinavir. |
Indomethacin | The metabolism of Raloxifene can be decreased when combined with Indomethacin. |
Infigratinib | The metabolism of Infigratinib can be decreased when combined with Raloxifene. |
Irbesartan | The metabolism of Irbesartan can be decreased when combined with Raloxifene. |
Irinotecan | The metabolism of Irinotecan can be decreased when combined with Raloxifene. |
Isavuconazole | Isavuconazole may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Isoflurane | The metabolism of Isoflurane can be decreased when combined with Raloxifene. |
Istradefylline | The metabolism of Istradefylline can be decreased when combined with Raloxifene. |
Itraconazole | Itraconazole may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Ivermectin | The excretion of Raloxifene can be decreased when combined with Ivermectin. |
Ivosidenib | The metabolism of Ivosidenib can be decreased when combined with Raloxifene. |
Ixabepilone | The metabolism of Ixabepilone can be decreased when combined with Raloxifene. |
Ixazomib | The metabolism of Ixazomib can be decreased when combined with Raloxifene. |
Ketamine | The metabolism of Ketamine can be decreased when combined with Raloxifene. |
Ketoconazole | The metabolism of Raloxifene can be decreased when combined with Ketoconazole. |
Ketorolac | The metabolism of Ketorolac can be decreased when combined with Raloxifene. |
Lacosamide | The metabolism of Lacosamide can be decreased when combined with Raloxifene. |
Lamotrigine | The metabolism of Raloxifene can be increased when combined with Lamotrigine. |
Lansoprazole | Lansoprazole may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Lapatinib | The metabolism of Lapatinib can be decreased when combined with Raloxifene. |
Lasmiditan | The serum concentration of Raloxifene can be increased when it is combined with Lasmiditan. |
Ledipasvir | Ledipasvir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Lefamulin | The metabolism of Lefamulin can be decreased when combined with Raloxifene. |
Lenvatinib | The excretion of Raloxifene can be decreased when combined with Lenvatinib. |
Letermovir | Letermovir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Levacetylmethadol | The metabolism of Levacetylmethadol can be decreased when combined with Raloxifene. |
Levamlodipine | The serum concentration of Levamlodipine can be increased when it is combined with Raloxifene. |
Levocarnitine | The excretion of Raloxifene can be decreased when combined with Levocarnitine. |
Levomilnacipran | The metabolism of Levomilnacipran can be decreased when combined with Raloxifene. |
Levothyroxine | Raloxifene can cause a decrease in the absorption of Levothyroxine resulting in a reduced serum concentration and potentially a decrease in efficacy. |
Linagliptin | The metabolism of Linagliptin can be decreased when combined with Raloxifene. |
Lomitapide | The metabolism of Lomitapide can be decreased when combined with Raloxifene. |
Loperamide | The metabolism of Loperamide can be decreased when combined with Raloxifene. |
Lopinavir | The excretion of Raloxifene can be decreased when combined with Lopinavir. |
Lorcaserin | The metabolism of Lorcaserin can be decreased when combined with Raloxifene. |
Lovastatin | The metabolism of Lovastatin can be decreased when combined with Raloxifene. |
Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Raloxifene. |
Maribavir | Maribavir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Meperidine | The metabolism of Meperidine can be decreased when combined with Raloxifene. |
Mephenytoin | The metabolism of Mephenytoin can be decreased when combined with Raloxifene. |
Mestranol | The metabolism of Mestranol can be decreased when combined with Raloxifene. |
Methadone | The metabolism of Methadone can be decreased when combined with Raloxifene. |
Methotrexate | The metabolism of Methotrexate can be decreased when combined with Raloxifene. |
Methoxyflurane | The metabolism of Methoxyflurane can be decreased when combined with Raloxifene. |
Methylphenobar | The metabolism of Methylphenobarbital can be decreased when combined with Raloxifene. |
Methylprednisone | The metabolism of Methylprednisone can be decreased when combined with Raloxifene. |
Methyltestosterone | The metabolism of Methyltestosterone can be decreased when combined with Raloxifene. |
Methysergide | The metabolism of Methysergide can be decreased when combined with Raloxifene. |
Mexiletine | The metabolism of Mexiletine can be decreased when combined with Raloxifene. |
Mianserin | The metabolism of Mianserin can be decreased when combined with Raloxifene. |
Midazolam | The serum concentration of Midazolam can be increased when it is combined with Raloxifene. |
Midostaurin | The metabolism of Midostaurin can be decreased when combined with Raloxifene. |
Mifepristone | The excretion of Raloxifene can be decreased when combined with Mifepristone. |
Mitapivat | The metabolism of Raloxifene can be increased when combined with Mitapivat. |
Montelukast | The metabolism of Montelukast can be decreased when combined with Raloxifene. |
Morphine | The metabolism of Morphine can be decreased when combined with Raloxifene. |
Mycophenolate | The metabolism of Mycophenolate mofetil can be decreased when combined with Raloxifene. |
Naproxen | The metabolism of Naproxen can be decreased when combined with Raloxifene. |
Nefazodone | The excretion of Raloxifene can be decreased when combined with Nefazodone. |
Nelfinavir | The metabolism of Raloxifene can be increased when combined with Nelfinavir. |
Neratinib | The metabolism of Neratinib can be decreased when combined with Raloxifene. |
Netupitant | The metabolism of Netupitant can be decreased when combined with Raloxifene. |
Nevirapine | The metabolism of Nevirapine can be decreased when combined with Raloxifene. |
Nicardipine | The metabolism of Nicardipine can be decreased when combined with Raloxifene. |
Nicotine | The metabolism of Nicotine can be decreased when combined with Raloxifene. |
Nilotinib | The metabolism of Nilotinib can be decreased when combined with Raloxifene. |
Nintedanib | The metabolism of Nintedanib can be decreased when combined with Raloxifene. |
Norethisterone | The metabolism of Norethisterone can be decreased when combined with Raloxifene. |
Norgestimate | The metabolism of Norgestimate can be decreased when combined with Raloxifene. |
Nortriptyline | The metabolism of Nortriptyline can be decreased when combined with Raloxifene. |
Novobiocin | Novobiocin may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Nystatin | The excretion of Raloxifene can be decreased when combined with Nystatin. |
Olaparib | The metabolism of Olaparib can be decreased when combined with Raloxifene. |
Olodaterol | The metabolism of Olodaterol can be decreased when combined with Raloxifene. |
Ombitasvir | The metabolism of Raloxifene can be decreased when combined with Ombitasvir. |
Omeprazole | Omeprazole may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Osilodrostat | The metabolism of Osilodrostat can be decreased when combined with Raloxifene. |
Osimertinib | The metabolism of Osimertinib can be decreased when combined with Raloxifene. |
Ospemifene | The risk or severity of adverse effects can be increased when Raloxifene is combined with Ospemifene. |
Oteseconazole | The serum concentration of Raloxifene can be increased when it is combined with Oteseconazole. |
Ouabain | The excretion of Raloxifene can be decreased when combined with Ouabain. |
Ozanimod | The metabolism of Ozanimod can be decreased when combined with Raloxifene. |
Paclitaxel | The metabolism of Paclitaxel can be decreased when combined with Raloxifene. |
Pacritinib | The serum concentration of Raloxifene can be increased when it is combined with Pacritinib. |
Palbociclib | The metabolism of Palbociclib can be decreased when combined with Raloxifene. |
Panobinostat | The metabolism of Panobinostat can be decreased when combined with Raloxifene. |
Pantoprazole | Pantoprazole may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Paramethadione | The metabolism of Paramethadione can be decreased when combined with Raloxifene. |
Paritaprevir | Paritaprevir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Pazopanib | The metabolism of Pazopanib can be decreased when combined with Raloxifene. |
Perampanel | The metabolism of Perampanel can be decreased when combined with Raloxifene. |
Perhexiline | The metabolism of Perhexiline can be decreased when combined with Raloxifene. |
Pexidartinib | The metabolism of Pexidartinib can be decreased when combined with Raloxifene. |
Phenobarbital | The metabolism of Raloxifene can be increased when combined with Phenobarbital. |
Phenprocoumon | The metabolism of Phenprocoumon can be decreased when combined with Raloxifene. |
Phenytoin | The metabolism of Phenytoin can be decreased when combined with Raloxifene. |
Pibrentasvir | Pibrentasvir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Pimavanserin | The metabolism of Pimavanserin can be decreased when combined with Raloxifene. |
Pimozide | The metabolism of Pimozide can be decreased when combined with Raloxifene. |
Pioglitazone | The metabolism of Pioglitazone can be decreased when combined with Raloxifene. |
Piroxicam | The metabolism of Piroxicam can be decreased when combined with Raloxifene. |
Pitavastatin | The metabolism of Pitavastatin can be decreased when combined with Raloxifene. |
Pomalidomide | The metabolism of Pomalidomide can be decreased when combined with Raloxifene. |
Ponatinib | The metabolism of Ponatinib can be decreased when combined with Raloxifene. |
Pralsetinib | Pralsetinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Prasugrel | The metabolism of Prasugrel can be decreased when combined with Raloxifene. |
Pravastatin | Pravastatin may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Pretomanid | The metabolism of Pretomanid can be decreased when combined with Raloxifene. |
Primidone | The metabolism of Raloxifene can be increased when combined with Primidone. |
Probenecid | The metabolism of Raloxifene can be decreased when combined with Probenecid. |
Progesterone | Progesterone may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Promethazine | The metabolism of Promethazine can be decreased when combined with Raloxifene. |
Propofol | The metabolism of Propofol can be decreased when combined with Raloxifene. |
Prucalopride | The metabolism of Prucalopride can be decreased when combined with Raloxifene. |
Quinidine | The metabolism of Quinidine can be decreased when combined with Raloxifene. |
Quinine | The metabolism of Quinine can be decreased when combined with Raloxifene. |
Rabeprazole | Rabeprazole may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Regorafenib | The metabolism of Regorafenib can be decreased when combined with Raloxifene. |
Remdesivir | The excretion of Raloxifene can be decreased when combined with Remdesivir. |
Repaglinide | The metabolism of Repaglinide can be decreased when combined with Raloxifene. |
Reserpine | The excretion of Raloxifene can be decreased when combined with Reserpine. |
Retapamulin | The metabolism of Retapamulin can be decreased when combined with Raloxifene. |
Ribociclib | The metabolism of Ribociclib can be decreased when combined with Raloxifene. |
Rifampicin | The metabolism of Raloxifene can be increased when combined with Rifampicin. |
Rifamycin | The excretion of Raloxifene can be decreased when combined with Rifamycin. |
Rilpivirine | Rilpivirine may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Riociguat | The metabolism of Riociguat can be decreased when combined with Raloxifene. |
Ripretinib | Ripretinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Ritonavir | The metabolism of Raloxifene can be increased when combined with Ritonavir. |
Roflumilast | The serum concentration of Roflumilast can be increased when it is combined with Raloxifene. |
Rolapitant | Rolapitant may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Romidepsin | The metabolism of Romidepsin can be decreased when combined with Raloxifene. |
Rosiglitazone | The metabolism of Rosiglitazone can be decreased when combined with Raloxifene. |
Rosuvastatin | The metabolism of Rosuvastatin can be decreased when combined with Raloxifene. |
Roxadustat | The serum concentration of Raloxifene can be increased when it is combined with Roxadustat. |
Roxithromycin | The excretion of Raloxifene can be decreased when combined with Roxithromycin. |
Rucaparib | Rucaparib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Ruxolitinib | The metabolism of Ruxolitinib can be decreased when combined with Raloxifene. |
Sacubitril | The excretion of Raloxifene can be decreased when combined with Sacubitril. |
Safinamide | Safinamide may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Saquinavir | Saquinavir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Selegiline | The metabolism of Selegiline can be decreased when combined with Raloxifene. |
Selexipag | The metabolism of Selexipag can be decreased when combined with Raloxifene. |
Selinexor | The excretion of Raloxifene can be decreased when combined with Selinexor. |
Selumetinib | The metabolism of Selumetinib can be decreased when combined with Raloxifene. |
Sevelamer | Sevelamer can cause a decrease in the absorption of Raloxifene resulting in a reduced serum concentration and potentially a decrease in efficacy. |
Sevoflurane | The metabolism of Sevoflurane can be decreased when combined with Raloxifene. |
Sildenafil | The excretion of Raloxifene can be decreased when combined with Sildenafil. |
Simeprevir | Simeprevir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Simvastatin | The metabolism of Simvastatin can be decreased when combined with Raloxifene. |
Siponimod | The metabolism of Siponimod can be decreased when combined with Raloxifene. |
Sirolimus | The metabolism of Sirolimus can be decreased when combined with Raloxifene. |
Sitagliptin | The metabolism of Sitagliptin can be decreased when combined with Raloxifene. |
Sodium | The metabolism of Raloxifene can be decreased when combined with Sodium aurothiomalate. |
Sonidegib | The metabolism of Sonidegib can be decreased when combined with Raloxifene. |
Sorafenib | The metabolism of Sorafenib can be decreased when combined with Raloxifene. |
Sotagliflozin | Sotagliflozin may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Sotorasib | The serum concentration of Raloxifene can be increased when it is combined with Sotorasib. |
Stiripentol | The excretion of Raloxifene can be decreased when combined with Stiripentol. |
Sulfadiazine | The metabolism of Sulfadiazine can be decreased when combined with Raloxifene. |
Sulfasalazine | Sulfasalazine may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Sunitinib | The metabolism of Sunitinib can be decreased when combined with Raloxifene. |
Suvorexant | The metabolism of Suvorexant can be decreased when combined with Raloxifene. |
Tacrolimus | The serum concentration of Tacrolimus can be increased when it is combined with Raloxifene. |
Tafamidis | The serum concentration of Raloxifene can be increased when it is combined with Tafamidis. |
Tamoxifen | The metabolism of Tamoxifen can be decreased when combined with Raloxifene. |
Tasimelteon | The metabolism of Tasimelteon can be decreased when combined with Raloxifene. |
Taurocholic acid | Taurocholic acid may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Tazarotene | The metabolism of Tazarotene can be decreased when combined with Raloxifene. |
Tazemetostat | The metabolism of Tazemetostat can be decreased when combined with Raloxifene. |
Tegafur | The metabolism of Tegafur can be decreased when combined with Raloxifene. |
Telaprevir | The excretion of Raloxifene can be decreased when combined with Telaprevir. |
Telithromycin | The excretion of Raloxifene can be decreased when combined with Telithromycin. |
Telmisartan | Telmisartan may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Temsirolimus | The metabolism of Temsirolimus can be decreased when combined with Raloxifene. |
Teniposide | The metabolism of Teniposide can be decreased when combined with Raloxifene. |
Tenofovir | The metabolism of Tenofovir alafenamide can be decreased when combined with Raloxifene. |
Tepotinib | Tepotinib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Terbinafine | The metabolism of Terbinafine can be decreased when combined with Raloxifene. |
Terfenadine | The metabolism of Terfenadine can be decreased when combined with Raloxifene. |
Teriflunomide | Teriflunomide may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Testosterone | The metabolism of Testosterone cypionate can be decreased when combined with Raloxifene. |
Testosterone | The metabolism of Testosterone enanthate can be decreased when combined with Raloxifene. |
Testosterone | The metabolism of Raloxifene can be increased when combined with Testosterone propionate. |
Theophylline | The metabolism of Theophylline can be decreased when combined with Raloxifene. |
Thiotepa | The metabolism of Thiotepa can be decreased when combined with Raloxifene. |
Tipranavir | The metabolism of Raloxifene can be increased when combined with Tipranavir. |
Tivozanib | Tivozanib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Tofacitinib | The metabolism of Tofacitinib can be decreased when combined with Raloxifene. |
Tolbutamide | The metabolism of Tolbutamide can be decreased when combined with Raloxifene. |
Tolvaptan | The metabolism of Tolvaptan can be decreased when combined with Raloxifene. |
Torasemide | The metabolism of Torasemide can be decreased when combined with Raloxifene. |
Trabectedin | The metabolism of Trabectedin can be decreased when combined with Raloxifene. |
Tramadol | The metabolism of Tramadol can be decreased when combined with Raloxifene. |
Trastuzumab | The metabolism of Trastuzumab emtansine can be decreased when combined with Raloxifene. |
Treprostinil | The metabolism of Treprostinil can be decreased when combined with Raloxifene. |
Tretinoin | The metabolism of Tretinoin can be decreased when combined with Raloxifene. |
Trimethadione | The metabolism of Trimethadione can be decreased when combined with Raloxifene. |
Troglitazone | The metabolism of Troglitazone can be decreased when combined with Raloxifene. |
Tucatinib | The metabolism of Tucatinib can be decreased when combined with Raloxifene. |
Valproic acid | The metabolism of Valproic acid can be decreased when combined with Raloxifene. |
Valsartan | The excretion of Raloxifene can be decreased when combined with Valsartan. |
Vandetanib | The metabolism of Vandetanib can be decreased when combined with Raloxifene. |
Vardenafil | The metabolism of Vardenafil can be decreased when combined with Raloxifene. |
Velpatasvir | The metabolism of Velpatasvir can be decreased when combined with Raloxifene. |
Vemurafenib | The metabolism of Vemurafenib can be decreased when combined with Raloxifene. |
Venetoclax | The metabolism of Venetoclax can be decreased when combined with Raloxifene. |
Venlafaxine | Venlafaxine may increase the excretion rate of Raloxifene which could result in a lower serum level and potentially a reduction in efficacy. |
Verapamil | The metabolism of Verapamil can be decreased when combined with Raloxifene. |
Vinblastine | The metabolism of Vinblastine can be decreased when combined with Raloxifene. |
Vincristine | The metabolism of Vincristine can be decreased when combined with Raloxifene. |
Vindesine | The metabolism of Vindesine can be decreased when combined with Raloxifene. |
Vinflunine | The metabolism of Vinflunine can be decreased when combined with Raloxifene. |
Vinorelbine | The metabolism of Vinorelbine can be decreased when combined with Raloxifene. |
Vismodegib | Vismodegib may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Vorapaxar | The metabolism of Vorapaxar can be decreased when combined with Raloxifene. |
Vortioxetine | The metabolism of Vortioxetine can be decreased when combined with Raloxifene. |
Voxelotor | The serum concentration of Voxelotor can be increased when it is combined with Raloxifene. |
Voxilaprevir | Voxilaprevir may decrease the excretion rate of Raloxifene which could result in a higher serum level. |
Warfarin | The serum concentration of Warfarin can be increased when it is combined with Raloxifene. |
Zanubrutinib | The metabolism of Zanubrutinib can be decreased when combined with Raloxifene. |
Zidovudine | The metabolism of Raloxifene can be increased when combined with Zidovudine. |
Ziprasidone | The metabolism of Ziprasidone can be decreased when combined with Raloxifene. |
Zopiclone | The metabolism of Zopiclone can be decreased when combined with Raloxifene. |
Zuclopenthixol | The metabolism of Zuclopenthixol can be decreased when combined with Raloxifene. |
Pregnancy and Lactation
AU TGA pregnancy category: X
US FDA pregnancy category: Not assigned.
Pregnancy
Raloxifene Hydrochloride Tablets are contraindicated for use in pregnant women and are not indicated for use in females of reproductive potential. Based on the mechanism of action, Raloxifene Hydrochloride Tablets may block the important functions that estrogen has during all stages of pregnancy. Limited data on Raloxifene Hydrochloride Tablets used in pregnant women are insufficient to inform any drug-associated risks for birth defects or miscarriage.
Lactation
Raloxifene Hydrochloride Tablets are not indicated for use in females of reproductive potential. There is no information on the presence of raloxifene in human milk, the effects on the breastfed child, or the effects on milk production. However, based on the mechanism of action, Raloxifene Hydrochloride Tablets may block the important functions that estrogen has in mammary tissue during lactation
How should this medicine be used?
Raloxifene comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take raloxifene at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take raloxifene exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Continue to take raloxifene even if you feel well. Do not stop taking raloxifene without talking to your doctor.
What special precautions should I follow?
Before taking raloxifene,
- tell your doctor and pharmacist if you are allergic to raloxifene, any other medications, or any of the ingredients in raloxifene tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners) such as warfarin (Coumadin, Jantoven), cholestyramine (Prevalite), colestipol (Colestid), diazepam (Valium), diazoxide (Proglycem), medications that contain estrogen such as hormone replacement therapy (ERT or HRT), and lidocaine (Akten, Lidoderm, Xylocaine). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have any type of cancer and if you have or have ever had breast lumps or breast cancer; heart failure; kidney disease; or liver disease. If you have ever taken estrogen, tell your doctor if your triglycerides increased during your treatment.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Do not become pregnant while taking raloxifene. If you become pregnant while taking raloxifene, call your doctor immediately. Raloxifene may harm the fetus.
- you should know that raloxifene has not been found to cause spotting or menstrual-like bleeding nor to increase the risk of cancer of the lining of the uterus. Tell your doctor if you develop vaginal bleeding or spotting. Your doctor will need to examine you or order tests to find the cause of the bleeding.
- you should know that although raloxifene decreases the chance that you will develop invasive breast cancer, there is still a risk that you will develop this condition. You will still need regularly scheduled breast exams and mammograms before you start taking raloxifene and during your treatment with raloxifene. Call your doctor if you notice tenderness, enlargement, lumps, or any other changes in your breasts.
- if you are taking raloxifene to treat osteoporosis, talk to your doctor about other things you can do to prevent osteoporosis from developing or worsening. Your doctor will probably tell you to avoid smoking and drinking large amounts of alcohol and to follow a regular program of weight-bearing exercise.
What special dietary instructions should I follow?
- You should eat and drink plenty of foods and drinks that are rich in calcium and vitamin D while you are taking raloxifene. Your doctor will tell you which foods and drinks are good sources of these nutrients and how many servings you need each day. If you find it difficult to eat enough of these foods or if you have a condition that makes it difficult for your body to absorb the nutrients that you eat, tell your doctor. In that case, your doctor can prescribe or recommend a supplement.
References