Ralox

Introduction
Ralox is a medicine used in the treatment and prevention of osteoporosis in postmenopausal women. It helps in preventing bone loss that can develop in women after menopause. It makes the bone stronger and lowers the risk of fractures. Ralox can be taken with or without food. Take it regularly and do not stop taking the medicine even if you get better until that doctor tells you it is alright to stop. Along with taking the medicine, exercise regularly to strengthen muscles around the affected joint and manage your weight. You should also avoid smoking and excessive consumption of alcohol while on treatment with this medicine. The most common side effects of this medicine include hot flashes, leg cramps, peripheral edema, flu syndrome, joint pain, and sweating. If any of these side effects does not resolve with time or get worsen, you should let your doctor know. Your doctor may help with ways to reduce or prevent these symptoms by reducing the dose or prescribing an alternative medicine. To make sure the medicine is safe for you, before taking this medicine, let your doctor know all the other medicines you are taking. Also tell your doctor if you have any problems with your heart, kidneys, or liver. If you are pregnant or breastfeeding, consult your doctor first before taking this medicine.

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Uses of Ralox
Osteoporosis
Side effects of Ralox
Common
Leg cramps
Peripheral edema
Flu-like symptoms
Joint pain
Sweating
How to use Ralox
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Ralox may be taken with or without food, but it is better to take it at a fixed time.
How Ralox works
Ralox works like estrogen, a natural female hormone to stop the bone loss that can develop in women after menopause.
Quick Tips
Inform your doctor if you have if you have any type of cancer, heart failure, kidney disease, high triglycerides or liver disease.
Inform your doctor if you are on estrogen therapy.
Do not take calcium supplements unless advised by doctor. Taking calcium supplements more than recommended will not provide extra protection for your bones but may cause adverse side effects including kidney stones.
Stop using raloxifene immediately if you develop: lumps in the breast, signs of stroke (sudden numbness or weakness), severe headache, slurred speech, vision problems; chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or pain, swelling, warmth, or redness in one or both legs.
Avoid sitting still for long periods of time while you are taking raloxifene.
Inform your doctor immediately if you observe bleeding / spotting from vagina during the treatment.
Tell your doctor if you are or planning to become pregnant or are breastfeeding.
Brief Description
Indication
Post-menopausal osteoporosis, Malignant gastrointestinal stromal tumours, Prevention & risk reduction of invasive breast cancer

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Administration
May be taken with or without food.
Adult Dose
Oral Prophylaxis of postmenopausal osteoporosis; Osteoporosis in postmenopausal women Adult: 60 mg once daily. Breast Cancer Prevention; risk reduction of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer 60 mg PO qDay for 5 years Hepatic impairment: Contraindicated.

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Renal Dose
Renal impairment: Severe: Contraindicated.
Contraindication
Active or history of venous thromboembolic events including DVT, pulmonary embolism, retinal vein thrombosis. Unexplained uterine bleeding. Patients w/ signs/symptoms of endometrial cancer. Hepatic (including cholestasis) and severe renal impairment. Pregnancy, women who may become pregnant, and lactation.
Mode of Action
Raloxifene is a selective oestrogen receptor modulator that has both selective agonist or antagonist activities on oestrogen receptors. It acts as an agonist on bone by preventing bone loss and partially on cholesterol metabolism by decreasing total and LDL cholesterol levels but antagonises oestrogen effects leading to development of breast and uterine cancer.
Precaution
Women w/ risk factors for venous thromboembolism including CHF or active malignancy, risk factors for stroke (e.g. TIA, AF), history of oestrogen-induced hypertriglyceridaemia. Moderate renal impairment. Monitoring Parameters Monitor serum triglyceride concentration. Lactation: Excretion in milk unknown; contraindicated

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Side Effect
>10% Hot flashes (8-29%),Flu syndrome (14-15%),Cramps/muscle spasm (6-12%),Arthralgia (11-16%),Infection (11%) 1-10% Insomnia (6%),Vomiting (5%),Sinusitis (10%),Venous thromboembolism (1-2% ),Bronchitis (10%),Pharyngitis (8%),Breast pain (4%),Gastroenteritis (<3%),Diaphoresis (3%) Frequency Not Defined Deep vein thrombosis,Cerebrovascular accident,Thrombosis of retinal vein (rare),Pulmonary embolism,Decreased fibrinogen _ Interaction Cholestyramine reduces the absorption of raloxifene. Raloxifene with warfarin may reduce the prothrombin response and time. Caution when used in hghly protein-bound drugs such as diazepam, lidocaine and diazoxide.