AncillaryAncillarySERM

Raloxifene

Also known as Evista · Raloxifene hydrochloride

Written by enwyReviewed 4 Aug 20262 sources0 comments

Raloxifene is a second-generation SERM approved for osteoporosis and breast cancer risk reduction. In the PED context it is valued specifically for gynaecomastia: clinical data suggest it reduces established pubertal gynaecomastia more effectively than tamoxifen, making it a preferred SERM when glandular tissue has already formed.

01 Overview

Raloxifene antagonises the oestrogen receptor in breast tissue while acting as an agonist in bone, which is why it both protects against osteoporosis and blocks oestrogen-driven breast growth. A comparative study in adolescents with pubertal gynaecomastia found raloxifene produced greater reduction in breast tissue than tamoxifen, which is the basis for its reputation as the stronger SERM for gyno.

Unlike tamoxifen and clomifene it is used less for HPTA restart and more as a targeted anti-gynaecomastia agent. It carries the SERM-class risk of venous thromboembolism and can cause hot flushes and leg cramps.

02 Mechanism

Selective oestrogen receptor modulator: antagonist at breast tissue, agonist in bone; blocks oestrogen-driven glandular breast growth.

03 Dosing

Tier	Dose	Route	Notes
Gynaecomastia	60 mg/day	Oral	Commonly 60 mg/day; some use up to 120 mg/day short-term for established gyno.
Osteoporosis (label)	60 mg/day	Oral	FDA-approved dose in post-menopausal women.

04 Effects

Effect	Magnitude	Evidence
Gynaecomastia regressionReduced established breast tissue more than tamoxifen in a comparative adolescent study.	greater than tamoxifen	Clinical
Bone-protectiveAgonist activity in bone increases bone mineral density, unlike aromatase inhibitors.	increased BMD	Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Venous thromboembolism riskClass SERM risk of deep vein thrombosis and pulmonary embolism.	Severe	Uncommon	Clinical
Hot flushesVasomotor flushing, the most frequent reported effect.	Mild	Common	Clinical
Leg crampsMuscle/leg cramps reported in label trials.	Mild	Common	Clinical

06 Legal status

United States

Prescription drug (Rx)

Approved as Evista. · as of Jan 2026

United Kingdom

POM

as of Jan 2026

07 References

Raloxifene versus tamoxifen for pubertal gynaecomastiaJ Pediatr

Evista (raloxifene) FDA labelUS FDA

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.