CLINICAL USE


Treatment and prevention of osteoporosis in post-menopausal women

DOSE IN NORMAL RENAL FUNCTION

60 mg daily

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :510
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :98–99
  • %Excreted unchanged in urine &nbsp &nbsp : <0.2

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :2348

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

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    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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