Evista is the original brand name for raloxifene hydrochloride 60 mg, an FDA-approved oral medication classified as a selective estrogen receptor modulator (SERM). It is used in postmenopausal women for two indications: prevention and treatment of osteoporosis, and reduction of invasive breast cancer risk in women at increased risk.

What is the generic name for Evista?

The generic name is raloxifene hydrochloride (also written raloxifene HCl). Generic 60 mg tablets have been available in the United States since 2014 and are therapeutically equivalent to brand-name Evista. Most US pharmacies dispense generic raloxifene by default.

Evista is taken as one 60 mg tablet by mouth once daily, with or without food, at any consistent time of day. Adherence is more important than timing — the bone density and breast cancer risk reduction benefits depend on continuous, long-term use.

How long until Evista works?

Bone density improvements are typically measured on DXA scans after 12 months of consistent use, with continued gains over subsequent years. The breast cancer risk reduction effect builds over years of treatment, with the major trials showing measurable benefit over 4 to 8 years of follow-up.

What are the most common side effects of Evista?

The most frequently reported side effects are hot flashes, leg cramps, peripheral edema, joint and muscle pain, flu-like symptoms, and sinus irritation. The most serious risk is venous thromboembolism (blood clots in the legs, lungs, or retinal veins), particularly in the first 4 months. See our full side-effects page for details.

Who should not take Evista?

Evista is contraindicated in women who are pregnant or could become pregnant, premenopausal women, women breastfeeding, and anyone with a personal history of venous thromboembolism. It should be used with caution in women with significant cardiovascular risk factors, prior stroke, severe liver impairment, or planned prolonged immobilization.

Does Evista treat menopause symptoms?

No. Evista is not approved or effective for menopausal symptoms such as hot flashes, night sweats, vaginal dryness, or mood changes. In fact, hot flashes are a common side effect of Evista itself. Women whose primary concern is menopausal symptom relief are typically not appropriate candidates for Evista.

How much does Evista or generic raloxifene cost?

Generic raloxifene 60 mg typically costs $15–$50 for a 30-day supply at US retail pharmacies, with discount programs often lowering that further. Most insurance plans cover the generic with a modest copay. Brand-name Evista is significantly more expensive and rarely necessary clinically.

Evista (Raloxifene): Brand Name Medication for Postmenopausal Women

What Is Evista?

Evista is the brand name for the prescription medication raloxifene hydrochloride. It is a once-daily oral tablet manufactured by Eli Lilly, first approved by the US Food and Drug Administration in 1997. Evista belongs to a class of medications called selective estrogen receptor modulators (SERMs) — molecules that interact with estrogen receptors throughout the body, mimicking estrogen in some tissues and blocking it in others.

Evista is approved by the FDA for two specific uses, both restricted to postmenopausal women:

Prevention and treatment of osteoporosis;
Reduction of the risk of invasive breast cancer in women at increased risk.

It is not approved for premenopausal women, not approved for treating existing breast cancer, and not effective for menopausal symptoms such as hot flashes.

Evista Generic Name and Active Ingredient

The generic name for Evista is raloxifene hydrochloride, often written as raloxifene HCl. Each Evista tablet contains 60 mg of the active ingredient. On pharmacy bottles and insurance forms you may see any of the following — all refer to the same medication:

Evista (brand name)
Raloxifene
Raloxifene hydrochloride
Raloxifene HCl

The hydrochloride is simply the pharmaceutical salt form that gives the tablet its stability and absorption profile. There is no clinical difference between brand and generic, or between the various ways the name is written.

Why Evista Has a Generic Now

Evista’s patent expired in March 2014, opening the way for FDA-approved generic manufacturers to produce raloxifene HCl 60 mg tablets. Multiple generic versions are now available in the US. Brand-name Evista is still produced but is now substantially more expensive than equivalent generics, and most prescriptions are filled generically by default.

Generic raloxifene must demonstrate bioequivalence to Evista — meaning the same amount of active ingredient reaches the bloodstream at the same rate — before FDA approval. In clinical use, generic and brand have been indistinguishable.

Evista Uses: FDA-Approved Indications

Postmenopausal osteoporosis (prevention and treatment)

Evista preserves bone mineral density and reduces the risk of new vertebral (spinal) fractures in postmenopausal women. This indication is supported by the pivotal MORE trial, which followed over 7,000 women for 3 years and showed a significant reduction in vertebral fracture risk. The benefit on non-vertebral fractures, including hip, was smaller.

Reduction of invasive breast cancer risk

Evista is approved for postmenopausal women at increased risk of breast cancer — usually defined by a Gail or similar risk score. The risk-reduction benefit specifically applies to invasive, estrogen-receptor-positive breast cancer. The major supporting trials are MORE, CORE, RUTH, and the head-to-head STAR comparison with tamoxifen.

Evista is not approved to treat existing breast cancer and is not used in premenopausal risk reduction (tamoxifen is the SERM choice for premenopausal women).

How Evista Differs from Other Postmenopausal Medications

Many postmenopausal women are presented with several treatment categories. Here is how Evista fits in:

vs Hormone Replacement Therapy (HRT): HRT (estrogen ± progestogen) treats menopausal symptoms and protects bone. Evista does not treat symptoms and protects bone somewhat less than HRT, but reduces breast cancer risk. Risk profile is also different.
vs Bisphosphonates (alendronate, risedronate, zoledronic acid): bisphosphonates are typically first-line for osteoporosis with significant fracture risk, especially hip-fracture risk. They do not affect breast cancer risk.
vs Denosumab (Prolia): a different mechanism (RANKL inhibitor), highly effective for bone but requires every-6-month injection. Does not affect breast cancer risk.
vs Tamoxifen: both are SERMs; tamoxifen is used in pre- and postmenopausal women and to treat existing breast cancer, but has more side effects in postmenopausal use. See raloxifene vs tamoxifen.
vs Aromatase inhibitors (anastrozole, exemestane): for breast cancer risk reduction in postmenopausal women they may be more effective than SERMs, but have a different side-effect profile and are not bone-protective.

Evista Side Effects

The Evista side-effect profile is identical to that of generic raloxifene (same active ingredient and dose). The most common are:

Hot flashes
Leg cramps and muscle pain
Peripheral edema (mild swelling)
Joint pain
Flu-like symptoms
Sinus and throat irritation

The most clinically important serious risks are venous thromboembolism (DVT, PE, retinal vein thrombosis), particularly in the first 4 months of use, and — in postmenopausal women with established coronary disease — a small increase in fatal stroke risk. The boxed warning on the Evista label reflects these signals.

For a thorough discussion, see our dedicated raloxifene side effects page.

Evista Cost and Insurance

Brand-name Evista is significantly more expensive than generic raloxifene. Without insurance, a 30-day supply of brand-name Evista can run several hundred dollars, whereas generic raloxifene typically costs $15 to $50 for the same supply, with discount programs often lowering that further. Most US insurance plans cover the generic with a small copay, and many require trying the generic before the brand.

Mail-order and 90-day fills usually reduce cost further and help with adherence.

Want a closer look at your options?

Whether you are already on Evista or considering it, a hormone-trained provider can review your full picture — bone density, breast cancer risk, clot history, menopausal symptoms — and help you understand whether Evista, an alternative, or a combination is the best fit.

Discuss Your Options with a Specialist

US-licensed providers · Confidential consultation · No obligation

Discussing Evista with Your Healthcare Provider

Whether starting Evista, continuing it, or reconsidering it, useful questions to bring to your appointment include:

“What is my current bone density and 10-year fracture risk (FRAX)?”
“What is my breast cancer risk based on a validated model?”
“Given those numbers, does Evista offer me a real benefit, or would another option fit better?”
“What side effects should prompt me to call you?”
“When will we recheck bone density, and what would change my treatment plan?”

If your primary care visit doesn’t leave time for that conversation, you are not alone. Many postmenopausal women find that a telehealth consultation with a clinician who specifically focuses on women’s hormonal health offers the longer, more individualized conversation that decisions in this category genuinely require.