Meta Information
ID:raloxifene
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/condition/history-of-vte
Target name:
History of Venous Thromboembolism (VTE)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene significantly increases the risk of blood clots, including deep vein thrombosis (DVT) and pulmonary embolism (PE).
Actionable advice:
Avoid completely if you have a personal history of blood clots.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene can cause fetal harm and is classified as Pregnancy Category X.
Actionable advice:
Avoid completely during pregnancy.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if raloxifene is excreted in human milk, but it could potentially harm the nursing infant.
Actionable advice:
Avoid completely while breastfeeding.
Target id:
/condition/history-of-stroke
Target name:
History of Stroke
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In women with coronary heart disease or at high risk for it, raloxifene was associated with an increased risk of death due to stroke.
Actionable advice:
Avoid completely if you have a history of stroke or transient ischemic attack (TIA).
Target id:
/procedure/prolonged-immobilization
Target name:
Prolonged Immobilization (e.g., Major Surgery, Bed Rest)
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
72
Hours after target:
null
Description:
Periods of prolonged immobilization significantly increase the risk of blood clots, which is compounded by raloxifene.
Actionable advice:
Discontinue at least 72 hours prior to and during any period of prolonged immobilization.
Target id:
/intervention/travel
Target name:
Long-Haul Travel
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
72
Hours after target:
null
Description:
Long periods of sitting during travel increase the risk of blood clots, a risk that is amplified by raloxifene.
Actionable advice:
Consider discontinuing 72 hours before extended travel and ensure mobility during the trip.
Target id:
/class/bile-acid-sequestrants
Target name:
Bile Acid Sequestrants (e.g., Cholestyramine)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Bile acid sequestrants can bind to raloxifene in the gut, significantly reducing its absorption and effectiveness.
Actionable advice:
Separate administration of raloxifene and bile acid sequestrants by at least 4 hours.
Target id:
/class/estrogens
Target name:
Systemic Estrogens (Hormone Replacement Therapy)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Concurrent use is not recommended as it may increase the risk of adverse effects like blood clots and endometrial changes, without established benefits.
Actionable advice:
Do not take raloxifene concurrently with systemic estrogen-containing medications.
Target id:
/condition/hepatic-impairment
Target name:
Severe Liver Disease
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene is metabolized by the liver; severe impairment can lead to significantly increased drug levels and risk of side effects.
Actionable advice:
Avoid use in cases of severe hepatic impairment or cholestasis.
Target id:
/intervention/levothyroxine_systemic_disease
Target name:
Levothyroxine
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Raloxifene may reduce the absorption of levothyroxine from the gut, potentially leading to undertreatment of thyroid conditions.
Actionable advice:
Separate administration of raloxifene and levothyroxine by at least 2 hours.
Target id:
/intervention/warfarin
Target name:
Warfarin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene can cause a small decrease in prothrombin time (PT), which may alter the anticoagulant effect of warfarin.
Actionable advice:
Monitor PT/INR closely if you must take these medications together.
Target id:
/condition/renal-impairment
Target name:
Severe Kidney Disease
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In severe renal impairment (CrCl <30 mL/min), raloxifene concentrations may increase, warranting caution.
Actionable advice:
Use with caution and under medical supervision in severe renal impairment.
Target id:
/intervention/vitamin_d3_systemic_healthspan
Target name:
Vitamin D
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
The bone-strengthening effects of raloxifene depend on having sufficient levels of vitamin D for calcium absorption and bone metabolism.
Actionable advice:
Ensure adequate daily intake of Vitamin D, as recommended by your physician.
Target id:
/intervention/calcium-citrate
Target name:
Calcium Supplements
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene helps direct calcium to the bones, but it cannot work effectively without an adequate supply of calcium.
Actionable advice:
Ensure adequate daily intake of calcium from diet or supplements.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene's absorption is not significantly affected by food, offering flexibility in administration.
Actionable advice:
You can take raloxifene at any time of day, with or without food.
Target id:
/biomarker/lipid-panel
Target name:
Lipid Panel
Severity:
minor
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene can beneficially decrease total and LDL cholesterol while slightly increasing HDL cholesterol, which affects the interpretation of lipid panel results.
Actionable advice:
Inform the interpreting physician that you are taking raloxifene when reviewing lipid results.
Target id:
/biomarker/thyroid-panel
Target name:
Thyroid Panel
Severity:
minor
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene can increase the concentration of thyroxine-binding globulin (TBG), leading to higher measured total T3 and T4 levels, though free hormone levels are typically unaffected.
Actionable advice:
Focus on TSH and free T4/T3 levels for accurate thyroid assessment.
Target id:
/biomarker/comprehensive-sex-hormone-panel
Target name:
Comprehensive Sex Hormone Panel
Severity:
minor
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
Raloxifene increases Sex Hormone-Binding Globulin (SHBG) levels, which can alter the total concentrations of sex hormones like testosterone and estradiol.
Actionable advice:
Consider measuring free or bioavailable hormone levels for a more accurate assessment.
Target id:
/class/highly-protein-bound-drugs
Target name:
Other Highly Protein-Bound Drugs (e.g., Diazepam, Lidocaine)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
There is a theoretical risk that raloxifene, which is highly protein-bound, could displace other protein-bound drugs, increasing their free concentration.
Actionable advice:
Be aware of this theoretical interaction, though it is not considered clinically significant for most drugs.