Dr. Keith Roach
Dear Dr. Roach: I’m an 85-year-old woman in relatively good health. I was on raloxifene for about 45 years. My doctor at the time said that since I had a hysterectomy, I should have that surgery for the rest of my life to prevent breast cancer and osteoporosis. My bone density is normal.
A few months ago, my doctor refused to renew my prescription because he was not knowledgeable about drugs. We would like to hear your opinion on this decision.
— Hardware
Dear Hardware Person: Raloxifene was approved for use in the United States in 1997 to prevent osteoporosis and in 2007 to reduce the risk of breast cancer. Most experts who prescribe raloxifene believe that the drug must be taken for a long period of time.
One reason many people are concerned about taking osteoporosis drugs is because drugs that slow bone resorption are associated with an increased risk of atypical femoral fractures when taken for long periods of time. Bisphosphonates, such as alendronate and risendronate, belong to this class. RANKL activators like denosumab have also been associated with severe atypical femoral fractures. These drugs are generally reevaluated and usually discontinued after 3 to 5 years.
