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Decreases in estrogen levels after oophorectomy or menopause lead to increases in bone resorption and accelerated bone lossBone is initially lost rapidly because the compensatory increase in bone formation is inadequate to offset resorptive lossesIn addition to loss of estrogenthis imbalance between resorption and formation may be due to age-related impairment of osteoblasts or their precursorsIn some womenthese changes will eventually lead to decreased bone massosteoporosisand increased risk for fracturesparticularly of the spinehipand wristVertebral fractures are the most common type of osteoporotic fracture in postmenopausal xnxx minor. women.
Physicians should instruct their patients to read the Medication Guide before starting therapy with EVISTA and to reread it each time the prescription is renewed.
CholestyramineCholestyraminean anion exchange resincauses a 60reduction in the absorption companies that sell cialas, companies that sell cialas, companies that sell cialas, companies that sell cialas, companies that sell cialas, companies that sell cialas. and enterohepatic cycling of raloxifene after a single doseAlthough not specifically studiedit is anticipated that other anion exchange resins would have a similar effectsee DRUG INTERACTIONS
In clinical trialsEVISTA-treated women had an increased risk of venous thromboembolismdeep vein thrombosis and pulmonary embolismOther venous thromboembolic events also could occurA less serious eventsuperficial thrombophlebitisalso has been reported more frequently with EVISTA than with placeboThe greatest risk for deep vein thrombosis and pulmonary embolism occurs during the first 4 months of treatmentand the magnitude of risk appears to be similar to the reported risk associated with use of hormone therapyBecause immobilization increases the risk for venous thromboembolic events independent of therapyEVISTA should be discontinued at least 72 hours prior to and during prolonged immobilizatione.gpost-surgical recoveryprolonged bed restand EVISTA therapy should be resumed only after the patient is fully ambulatoryIn additionwomen taking EVISTA should be advised to move about periodically during prolonged travelThe risk-benefit balance should be considered in women at risk of thromboembolic disease for other reasonssuch as congestive heart failuresuperficial thrombophlebitisand active malignancysee CONTRAINDICATIONS and ADVERSE REACTIONS
In contrasthoweverthe rate of fatal stroke is stated to have been higher in the raloxifene group than in the placebo group2.2 per 1000 women using raloxifene per year v1.5 per 1000 women using placebo per yearp0.0499no confidence intervals were stated1 This means that about 1 in 455 women in the trial taking raloxifene would have had a stroke in a yearas compared with only 1 in 667 women in the trial taking placeboIn terms of the number needed to harm1428 postmenopausal women at risk of a cardiovascular event would have to be treated with the drug before 1 woman would have a treatment-related fatal strokeThe reasons for this effectif it is realare unclear.
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evista is classified as a selective estrogen receptor modulator serm .