Raloxifene (Evista)
Second-generation SERM with pronounced tissue selectivity. Strong estrogen receptor antagonist in breast and uterine tissue. Estrogen agonist in bone, reducing osteoclast-mediated resorption and maintaining bone mineral density. Minimal uterine stimulation compared to tamoxifen. Demonstrated superior efficacy in gynecomastia reversal versus tamoxifen in clinical trials.
Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.
- estradiol
- lipid-panel
- hdl
- ldl
- triglycerides
- alt
- ast
- history-of-dvt-pe
- active-venous-thromboembolism
- pregnancy
- premenopausal-women
- PMID:15159289Raloxifene for the prevention of breast cancer in postmenopausal women — N Engl J Med, 2004
- PMID:14764776Raloxifene for gynecomastia — J Clin Endocrinol Metab, 2004
- PMID:22106945Raloxifene versus tamoxifen for gynecomastia in adolescents — J Pediatr Endocrinol Metab, 2011
- PMID:25428787Selective estrogen receptor modulators in the treatment of breast cancer — Front Oncol, 2014
Raloxifene is the SERM most people should be using for gynecomastia and are not. Head-to-head data against tamoxifen shows better breast tissue selectivity with less uterine stimulation. The 2% oral bioavailability sounds alarming until you understand that the active glucuronide metabolites do the work. The 28-hour half-life means daily dosing is sufficient. For existing gynecomastia — not prevention, reversal — 60mg daily for 3-6 months is the clinical protocol. Most people default to tamoxifen because they learned about it first, not because the evidence supports it.
This is not medical advice
Discuss with a licensed clinician before starting, stopping, or changing any compound. This page documents what the research literature describes — it is not a prescription.
See Raloxifene (Evista) in a protocol matched to you