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Hepatic ImpairmentThe disposition of raloxifene was compared in 9 patients with mildChild-Pugh Class Ahepatic impairmenttotal bilirubin ranging from 0.6 to 2 mg/dLto 8 subjects with normal hepatic function following a single dose of 60 mg raloxifene HClApparent clearance of raloxifene was reduced 56and the half-life of raloxifene was not altered in patients with mild hepatic impairmentPlasma raloxifene concentrations were approximately 150higher than those in healthy volunteers and correlated with total bilirubin concentrationsThe pharmacokinetics of raloxifene has not been studied in patients with moderate or severe hepatic impairmentRaloxifene should be used with caution in patients with hepatic impairmentsee WARNINGS AND PRECAUTIONS and Use in Specific Populations

Raloxifene decreases the risk of spine fractures in postmenopausal women with osteoporosisBut it does not appear to decrease the risk of hip fractureThe only agents that are definitely proven to decrease hip fracture risk are bisphosphonates

In a three-year study involving some 600 postmenopausal womenraloxifene was found to increase bone density and lower LDL cholesterolwhile having no stimulative effect on the uterine liningwhich means that it is unlikely to cause uterine cancer

These results are consistent with data from human studies of radiocalcium kinetics and markers of bone metabolismand are consistent with the action of EVISTA as a skeletal antiresorptive agent.

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