raloxifene hydrochloride

CLINICAL USE

Treatment and prevention of osteoporosis in post-menopausal women

DOSE IN NORMAL RENAL FUNCTION

60 mg daily

PHARMACOKINETICS

Molecular weight :510

%Protein binding :98–99

%Excreted unchanged in urine : <0.2

Volume of distribution (L/kg) :2348

half-life – normal/ESRD (hrs) :27.7/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: antagonism of anticoagulant effect of coumarinsColestyramine: reduced absorption of raloxifene – avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

There are case reports of it being beneficial in females on haemodialysis and also a benefit to the lipid profile. (Hernandez E, Valera R, Alonzo E, et al. Effects of raloxifene on bone metabolism and serum lipids in post-menopausal women on chronic haemodialysis. Kidney Int. 2003; 63(6): 2269–74.)This study showed that raloxifene could reduce vertebral fractures although they were more likely to suffer from side effects. (Ishani A, Blackwell T, Jamal SA, et al. The effect of raloxifene treatment in post-menopausal women with CKD. J Am Soc Nephrol. 2008; 19:1430–8.)Manufacturer advises use is contraindicated in severe renal impairment due to lack of data rather than known toxicity< 6% of dose is excreted in the urine

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