And what are the common side effects?
Common side effects of Premarin and Progestin in post-menopausal women include breast pain/enlargement; vaginitis due to yeast or other causes, and leg cramps. Less common side effects include breast and uterine cancer; and heart attack.
Aprela is a pipeline drug that appears to have all the benefits of Prempro and Premarin, but without increased risk of breast and uterine cancer, or heart attacks. It’s completed phase III clinical trials, and manufacturer Wyeth expects to file an NDA (new drug application) for Aprela sometime after the first half of 2009.
Selective estrogen receptor modulators (SERMs)
This type of drug has a split personality: in some parts of the body it acts like estrogen, while in others, it doesn’t. Evista (raloxifene) is the SERM most commonly prescribed for osteoporosis.
So what’s with the seemingly opposite effect SERMS have in different parts of your body? Why is that important? As mentioned above, estrogen is great for building bones. Unfortunately, for women with breast cancer (or those at identified high risk of getting it), estrogen is a no-no; it encourages breast cancer growth. Evista acts like estrogen on the bones, yet at the same time isn’t recognized as estrogen by breast tissue. Thus it helps bones, but doesn’t encourage breast cancer; a win-win for women.
Evista
Is it recommended for me?
Evista is recommended for the prevention and treatment of osteoporosis in post-menopausal women. It’s not recommended if you have or have had blood clots in the legs, lungs, or eyes. Also, if you’ve had a heart attack (or are at risk for one), Evista may increase your risk of dying from a stroke.
How will it help me?
Evista stops the thinning of bones; increases bone mineral density (BMD); and helps balance bone turnover rate (the rate at which your bones break down, and build up). It’s recommended as protection against first spinal fractures; and for subsequent spinal fractures as well, although its effect isn’t as great there. Evista hasn’t been shown to be effective protection against hip, wrist, or other types of fractures.
When and how would I take it?
Evista is a 60mg pill. You can take it any time of the day, with or without food. Unlike a bisphosphonate, there’s really no protocol involved in how you take Evista, other than to be sure you take it every day. Since you can take Evista with both calcium and vitamin D, without negative effect, it’s easy to take it along with your daily vitamins and supplements.
And what are the common side effects?
The most common side effects of Evista are hot flashes, leg cramps, swelling, flu-like symptoms, joint pain, and sweating. Less common, though serious, side effects include blood clots, and dying from stroke. Obviously, you’d discuss the risk of these serious side effects with your doctor.
A couple of other SERMS are in the drug pipeline, currently wending their way towards FDA approval. Viviant, which works similarly to Evista, should be up for FDA review sometime in the second half of 2009. Fablyn received FDA advisory committee approval last September, and will be up for review in early 2009.
