Selective estrogen receptor modulators
SERMS (SELECTIVE ESTROGEN RECEPTOR MODULATORS)
This group have estrogenic activity on osteoporosis protection and cholesterol lowering effect with anti-oestrogenic effect on breast (studies have shown reduced breast cancer risk with Raloxifene), and no stimulatory effect on endometrium. They do not control vasomotor symptoms but are indicated for postmenopausal women at risk of or with existing osteoporosis and who are unwilling or unable to take HRT.Presently only one SERM is available:
| RALOXIFENE* (EVISTA) | 60 mgs once daily | €21.73 for 28 |
It is possible to change from HRT to Raloxifene if the patient is known to be postmenopausal, by having had at least 1 year amenorrhoea, or by being aged 54 or more. Since Raloxifene does not control vasomotor symptoms, worth having 1 month treatment free following cessation of HRT, to assess if vasomotor symptoms are still present. If so, consideration should be given as to whether to restart HRT or commence Raloxifene and tolerate vasomotor symptoms.