Raloxifene
Level 1c: This medication has little evidence of its use in transition but has no major specific side effects.
Raloxifene may cause breast development to be limited even after discontinuing the medication, it also may not suppress breast development.
Raloxifene is the only SERM (Selective Estrogen Receptor Modulator) we list (this is due to other SERMs having higher-risk side effects). This medication is often DIYed by trans feminine or non-binary people who want feminization without breast development, it should be noted there is little evidence for this use case and all information on this medication must be treated with caution.
Dosing and Monitoring
Dosing raloxifene is difficult and rather inconsistent. Many people have had success combining raloxifene with bicalutamide. This combination is rather safe as long as you monitor liver enzymes (for more information see "Safety and Effects"). Raloxifene by itself is difficult to dose and monitor due to blood estradiol levels not being indicative, generally, people have been known to take somewhere between 40mg and 120mg of raloxifene.
Safety and Effects
This information is about the safety of the drug raloxifene itself, this drug is often combined with several other drugs and understanding the safety of each combination is next to impossible; for safety always remember that all medications taken should be considered, please use a drug interaction checker for example webMDs; Always do your research before starting new medications. Raloxifene by itself is rather safe in terms of all-cause mortality, there is no difference in all-cause mortality between Raloxifene and placebo Marintino Silvana, 2005. Despite relative safety in all-cause mortality, there are many safety issues to consider.
General Disclaimer about Safety and Raloxifene
Raloxifene's use in trans people has not been studied, all information provided on safety is based on safety in other groups (cis-women or men with prostate cancer typically) and thus all recommendations involving raloxifene come with a high uncertainty.
Raloxifene and Breast Development
Raloxifene has not been studied in AMAB people attempting to prevent breast development. Anecdotally few have had success in preventing breast development, however, anecdotes have also suggested that breast development still can happen. While it likely will slow breast development compared to estradiol, there is no way to know if it can completely prevent it.
Raloxifene and Bone Density
Raloxifene does not completely prevent side effects of hormone deprivation however it shows a significantly decreased risk of osteoporosis as compared to complete hormone deprivation (Hagmeyer Kathleen, 1999). There is still no knowledge of the risk of osteoporosis for trans-feminine or non-binary people using raloxifene combined with an anti-androgen, essentially this risk is unknown.
Bone Density when Combined with Bicalutamide
There is evidence that the risk of osteoporosis when combining raloxifene and bicalutamide is low in AMAB people (Siber Paul, 2004). It should be noted that bicalutamide increases estradiol levels (Aly 2020).
Raloxifene and the Liver
By itself, raloxifene has not been known to cause issues with the liver.
The Liver when Combined with Bicalutamide
If possible, doing a liver panel after long-term use of bicalutamide is a good idea, especially when mixed with raloxifene. (Aly 2020).
| Seller | Product | Price | Single $/60mg | Bulk $/60mg | Stock | Notes |
|---|---|---|---|---|---|---|
| Medicina Mexico | Alvisver 60mg x 14 | $9.00 | $0.64 | $0.64 | Unknown | |
| Favskinhouse | Celvista 60mg x 28 | $66.00 | $2.36 | $2.36 | Unknown | |
| Inhouse Pharmacy | Evista 60mg x 28 | $121.00 | $4.32 | $4.32 | Unknown | |
| Medicina Mexico | Evista 60mg x 28 | $114.00 | $4.07 | $4.07 | Unknown | |
| RxAisle | Evista 60mg x 28 | $39.90 | $1.43 | $1.20 | Unknown | |
| Dragon Ordnance | Raloxifene 60mg x 30 | $60.00 | $2.00 | $2.00 | Yes | |
| Dragon Ordnance | Raloxifene 60mg x 50 | $45.00 | $0.90 | $0.90 | Yes | |
| DashPCT | Raloxiheal 60mg x 10 | $5.80 | $0.58 | $0.58 | Yes | |
| DashPCT | Raloxiheal 60mg x 10 | $17.00 | $1.70 | $1.70 | No | |
| Aipctshop | Raloxiheal 60mg x 10 | $8.43 | $0.84 | $0.84 | Unknown | |
| DashPCT | Raloxo 60mg x 10 | $17.00 | $1.70 | $1.70 | Yes | |
| DashPCT | Raloxo 60mg x 10 | $5.80 | $0.58 | $0.58 | Yes |