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Head-to-head evidence comparison — which supplement is right for you?
Raloxifene (Evista) wins 1 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
Approved (postmenopausal women) / off-label (male) — clinician-directed. For osteoporosis treatment/prevention and breast-cancer risk reduction the standard, validated dose is 60 mg once daily (the MORE, CORE, RUTH and STAR trials all used 60 mg/day; MORE also tested 120 mg/day with no clear added fracture benefit and more side effects). For off-label male gynecomastia the small published pediatric series used roughly 60 mg/day; there is no FDA-approved male dose and the male evidence is thin and retrospective.
any
Raloxifene hydrochloride 60 mg tablets (approved for postmenopausal osteoporosis and breast-cancer risk reduction)
Approved (oncology) / off-label (male) — clinician-directed. For ER-positive breast cancer the standard adjuvant dose is 20 mg once daily for 5-10 years. For off-label male gynecomastia, the randomized trials used roughly 10-20 mg daily (10 mg/day prophylactically alongside an antiandrogen, 20 mg/day to treat established gynecomastia). For idiopathic male infertility, the trials typically used 20 mg/day. Bodybuilding 'post-cycle therapy' commonly uses 10-40 mg/day tapered — a use with no controlled-trial evidence. There is no FDA-approved male dose.
any
Tamoxifen citrate tablets (approved for breast cancer; off-label in men)
Months to years
Years
Throughout use
Throughout use
Years
Weeks to months
Weeks to a few months
Throughout use
Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators.
JAMA (1999) · Rct · n=7705
MORE: multicenter, randomized, double-blind, placebo-controlled trial of raloxifene 60 or 120 mg/day in 7,705 postmenopausal women with osteoporosis, followed up to 36 months
The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation.
JAMA (1999) · Rct · n=7705
Pre-specified breast-cancer analysis of the MORE RCT (7,705 postmenopausal women with osteoporosis), followed a median 40 months
Continuing outcomes relevant to Evista: breast cancer incidence in postmenopausal osteoporotic women in a randomized trial of raloxifene.
J Natl Cancer Inst (2004) · Rct · n=5213
CORE: extension of the randomized MORE trial giving 4 additional years of raloxifene 60 mg/day (n=3,510) vs continued placebo (n=1,703)
Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials.
Lancet (2011) · Meta analysis
EBCTCG patient-level meta-analysis of randomized adjuvant-tamoxifen trials; ER-positive disease cohort n=10,645
Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.
J Natl Cancer Inst (1998) · Rct · n=13388
NSABP P-1: randomized, placebo-controlled prevention trial of 20 mg/day tamoxifen for 5 years in 13,388 women at increased breast-cancer risk
A randomized trial comparing tamoxifen therapy vs. tamoxifen prophylaxis in bicalutamide-induced gynecomastia.
Clin Genitourin Cancer (2012) · Rct · n=176
Randomized multicenter trial in 176 men on bicalutamide monotherapy for prostate cancer: reactive tamoxifen 20 mg/day (arm A) vs prophylactic tamoxifen 10 mg/day started with bicalutamide (arm B)
Raloxifene (Evista) has a higher evidence score (5.3/10 vs 5.2/10) and wins in 1 of 3 categories.
No known interactions between Raloxifene (Evista) and Tamoxifen (Nolvadex) have been documented in our database. However, always consult a healthcare provider before combining supplements.