EVISTA® (raloxifene HCl): Osteoporosis Risk Assessment Guide

Risk Assessment Guide

Since women with osteoporosis often do not have symptoms until they break a bone, now is the time to talk to your healthcare professional about tests to help determine if you have osteoporosis. To help determine if you might be at risk, take the assessment below:

Answer the following questions to help determine if you might be at risk for osteoporosis*:

Your score is: 0

How to Grade Your Results:

1-2 points = Low risk
3-4 points = Medium risk
5-6 points = High risk
7 or higher = Very high risk

If these results suggest you may be at risk for osteoporosis, talk to your healthcare professional about specialized testing.

*This discussion of risk factors is to be used as an educational guide only. It is not designed to provide you with medical advice or to assess your actual risk of developing osteoporosis. You may have other risk factors or circumstances not discussed here that increase or decrease your risk for this disease.

Important Safety Information

EVISTA is not for everyone. Serious side effects can occur while taking EVISTA.

EVISTA may cause an increased risk of blood clots. You should not take EVISTA if you have had or are at risk for getting blood clots in the legs, lungs, or eyes. Stop taking EVISTA and call your doctor if you have swelling or feeling of warmth in your legs, chest pain, shortness of breath, coughing up blood or sudden changes in vision, as these may be signs of a blood clot. Being unable to move around for long periods may increase this risk. If you will need to be still for a long time, talk to your healthcare professional about ways to reduce the risk of blood clots.

In a study of women past menopause who were at high risk for heart attack, EVISTA increased the risk of dying from a stroke. However, EVISTA did not increase the risk of heart attack, stroke, or dying from other causes. Before taking EVISTA, tell your healthcare professional if you have had a stroke, mini-stroke, irregular heartbeat, high blood pressure, heart attack, history of smoking, or believe you have other risk factors for stroke or a heart attack.

You should not take EVISTA if you are nursing, pregnant, or may become pregnant, as it may harm your baby. If you have kidney or liver problems, you should talk to your healthcare professional about these conditions before taking EVISTA. Do not take EVISTA with estrogen in the form of pills, patches, or injections.

The most common side effects are hot flashes, leg cramps, swelling, flu-like symptoms, joint pain, and sweating. In clinical trials, side effects were usually mild enough that most women did not stop taking EVISTA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

For more safety information, and important information for patients taking EVISTA, see the Medication Guide.

	Do you have a small, thin frame and/or are you Caucasian or Asian? (2 points)
	Have you or a member of your family broken a bone as an adult? (3 points)
	Are you a postmenopausal woman? (2 points)
	Have you had an early or surgically induced menopause? (3 points)
	Have you been taking high doses of thyroid medication or high or prolonged doses of cortisone-like drugs for asthma, arthritis, or other diseases? (1 point)
	Is your diet low in dairy products and other sources of calcium? (2 points)
	Are you physically inactive? (1 point)
	Do you smoke cigarettes or drink alcohol in excess? (1 point)