Evista may reduce your risk of vertebral fractures from osteoporosis but not other types of fractures. It’s not a first-line treatment for osteoporosis, but a doctor can determine whether the benefits for you outweigh the risks.

Raloxifene is approved by the Food and Drug Administration (FDA) to prevent and treat osteoporosis, a condition that weakens your bones. Healthcare professionals only recommended it for people assigned female at birth who have undergone menopause.

Raloxifene is also known by its brand name, Evista. This article explores the risks and benefits of taking Evista for osteoporosis.

Raloxifene (Evista) is part of a class of drugs known as selective estrogen-receptor modulators (SERMs).

It works by imitating the beneficial effects of the hormone estrogen on your bones, helping to prevent bone loss and improve density.

In other parts of your body, such as your breasts, raloxifene actually blocks the effects of estrogen. It can help to lower your risk of breast cancer.

Research suggests that Evista can effectively prevent vertebral fractures, which are common among people with osteoporosis. They affect the spine and can occur without a fall or other accident.

In particular, a landmark 1999 study concluded that Evista lowers the risk of a vertebral fractures in people with osteoporosis by approximately 30%.

Similarly, the authors of a 2023 systematic review reported that taking Evista for 3 years can reduce vertebral fractures. However, Evista doesn’t prevent other types of fractures.

For this reason, the American College of Physicians (ACP) does not recommend raloxifene as a first-line treatment for people with osteoporosis.

The authors of a 2020 systematic review that compared the effectiveness of several osteoporosis treatments also suggested that while Evista may reduce the incidence of vertebral fractures, the risks may outweigh the benefits.

Like all drugs, Evista carries a risk of side effects. Most of the time, side effects are mild. Some potential side effects include:

Studies have also linked Evista to an increased risk of blood clots and stroke. According to the Royal Osteoporosis Society, approximately 1 in 100 to 1 in 1000 people who take raloxifene experience deep vein thrombosis (DVT), a type of blood clot that can lead to other potentially fatal complications.

It’s important to discuss the risks and benefits of taking raloxifene with your doctor.


  • reduces your risk of a vertebral fracture as a result of osteoporosis
  • reduces your risk of postmenopausal invasive breast cancer
  • cheaper than other osteoporosis medications


  • may cause mild side effects
  • does not reduce your risk of a non-vertebral or hip fracture
  • increases your risk of experiencing a blood clot or stroke
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Healthcare professionals do not recommend Evista for people at risk of experiencing blood clots, pulmonary embolism, or stroke.

They also do not recommend it for those who are pregnant or may become pregnant and those who are currently nursing.

Evista is available in tablet form. The recommended dose is 60 milligrams (mg) or one tablet per day.

It’s always best to follow your doctor or pharmacist’s instructions when taking Evista. You can take it by mouth at any time of the day. You do not need to take it alongside food.

Alendronic acid (Fosamax) is a common osteoporosis treatment. It’s available as a daily or weekly tablet or solution.

ACP guidelines recommend Fosamax over Evista since there is more high quality evidence to suggest that Fosamax prevents vertebral, non-vertebral, and hip fractures.

But the authors of a 2020 study comparing both medications found that Evista was as effective at preventing fractures as Fosamax.

Denosumab (Prolia) is another first-line treatment for osteoporosis. Studies have shown that it can reduce the risk of vertebral, non-vertebral, and hip fractures.

Prolia is not available in a generic form, and it’s more expensive than other medications for osteoporosis. A healthcare professional administers it as an injection once every 6 months.

How long will I need to take Evista for osteoporosis?

Osteoporosis drugs are meant to be taken for long periods of time, typically several years. During this time, your doctor may continue to monitor your bone and overall health.

How much does Evista for osteoporosis cost?

According to the ACP, the cost of a daily dose is $2.40 for generic raloxifene and $70 for Evista. These costs might vary according to where you live and your insurance coverage.

Is Evista a hormone?

Evista isn’t a hormone, but it works by modifying the action of the hormone estrogen in your body. Unlike estrogen-based hormone replacement therapy, though, Evista is selective. That means it amplifies the effects of estrogen in the bone tissue and blocks the effects of estrogen in other areas of the body.

Raloxifene (Evista) is a medication for osteoporosis. While studies have proven it to be effective at preventing vertebral fractures, it may not prevent other types of fractures. It also carries a risk of serious side effects, including blood clots and strokes.

But unlike other osteoporosis drugs, raloxifene can reduce your risk of breast cancer. It might be helpful to people with osteoporosis and at an increased risk of breast cancer.

To learn more, talk with a healthcare professional.