Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Raloxifene
Drug ID BADD_D01903
Description Raloxifene is a second generation selective estrogen receptor modulator (SERM) that mediates anti-estrogenic effects on breast and uterine tissues, and estrogenic effects on bone, lipid metabolism, and blood coagulation.[A4979,T28] Exhibiting tissue-specific effects distinct from [estradiol], raloxifene is the first of the benzothiophene group of antiestrogens to be labelled a SERM.[A4977] Available in many countries worldwide, raloxifene was initially approved by the FDA in December, 1997 under the market name Evista® for the management and prevention of osteoporosis in postmenopausal women and reduction in risk for invasive breast cancer in postmenopausal women with osteoporosis or those who are at high risk for invasive breast cancer. However, it has a negligible effect on altering the development and progression of breast cancer itself.[label] The most common causes of osteoporosis include postmenopausal deficiency of estrogen and age-related deterioration in bone homeostasis. Due to the risk of bone fractures that may lead to morbidities and reduced quality of life, the management of osteoporosis in postmenopausal women with the use of therapeutic agents in addition to concurrent therapies is critical. Due to the decline in estrogen levels in postmenopausal osteoporosis, hormone replacement therapy (HRT), such as estradiol, has been used to ameliorate the condition. However, due to the off-target actions by HRT, newer non-hormonal agents such as raloxifene and [tamoxifen] have been developed to reduce adverse events through selective pharmacological actions on tissue-specific therapeutic targets.[T28] The main effects of raloxifene are to preserve the bone mineral density and decrease the risk of breast cancer in postmenopausal women. Compared to estrogen and tamoxifen, raloxifene was not associated with an increased risk of uterine cancer and it does not cause endometrial proliferation.[A716] Although rare, there was an increased risk of venous thromboembolism during clinical trials of postmenopausal women receiving raloxifene. In addition, a clinical study consisting of postmenopausal women with documented coronary heart disease or at increased risk for coronary events showed an increased risk for fatal stroke with raloxifene therapy compared to placebo.[label] It is strongly advised that the risk-benefit ratio is considered before starting raloxifene therapy in women at risk of thromboembolic disease or strokes, such as the prior history of stroke, transient ischemic attack, atrial fibrillation, hypertension, or cigarette smoking.[label]
Indications and Usage Indicated for the prevention and treatment of osteoporosis in postmenopausal women, as well as prevention and treatment of corticosteroid-induced bone loss.[label] Indicated for the reduction in the risk of invasive breast cancer in postmenopausal women with osteoporosis or postmenopausal women with a high risk for invasive breast cancer.[label]
Marketing Status approved; investigational
ATC Code G03XC01
DrugBank ID DB00481
KEGG ID D08465
MeSH ID D020849
PubChem ID 5035
TTD Drug ID D01XBA
NDC Product Code 69097-825; 71610-524; 71335-1663; 70518-3046; 60687-266
UNII YX9162EO3I
Synonyms Raloxifene Hydrochloride | Keoxifene Hydrochloride | Raloxifene HCl | LY-139481 | LY139481 | LY 139481 | Raloxifene | Keoxifene | Evista | LY-156758 | LY156758 | LY 156758
Chemical Information
Molecular Formula C28H27NO4S
CAS Registry Number 84449-90-1
SMILES C1CCN(CC1)CCOC2=CC=C(C=C2)C(=O)C3=C(SC4=C3C=CC(=C4)O)C5=CC=C(C=C5)O
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Vaginal discharge21.08.02.002--
Vaginal haemorrhage24.07.03.005; 21.08.01.001--
Vaginal infection21.14.02.002; 11.01.10.002--
Varicose vein24.10.04.001--Not Available
Venous thrombosis24.01.01.008--Not Available
Vertigo17.02.12.002; 04.04.01.003--
Visual impairment06.02.10.013--Not Available
Vitreous detachment12.01.04.005; 06.09.01.002--Not Available
Vomiting07.01.07.003--
Weight increased13.15.01.006--
Deep vein thrombosis24.01.02.0030.000905%Not Available
Acute coronary syndrome24.04.04.011; 02.02.02.0150.000226%Not Available
Lymphatic disorder01.09.01.003--Not Available
Musculoskeletal stiffness15.03.05.0270.000882%Not Available
Musculoskeletal discomfort15.03.04.001--Not Available
Vasodilation procedure25.03.01.001--Not Available
Angiopathy24.03.02.007--Not Available
Hot flush24.03.01.005; 21.02.02.001; 08.01.03.0270.002036%
Breast disorder21.05.04.004--Not Available
Cardiac disorder02.11.01.003--Not Available
Connective tissue disorder10.04.04.026; 15.06.01.006--Not Available
Embolism24.01.01.009--
Decreased appetite14.03.01.005; 08.01.09.0280.000769%
Blood disorder01.05.01.004--Not Available
Renal impairment20.01.03.0100.000226%Not Available
Cystitis noninfective20.03.02.001--
Osteonecrosis of jaw15.02.04.010; 24.04.05.0050.001357%
Breast cancer recurrent21.05.01.017; 16.10.01.0090.000226%Not Available
Superficial vein thrombosis24.01.02.016--Not Available
Vulvovaginal inflammation21.14.02.014--Not Available
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