Compare Fosamax vs. Evista

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Fosamax
(alendronate)

Evista
(raloxifene)

Prevents bone loss. Fosamax (alendronate) is a first-choice treatment for osteoporosis, but taking it can be a hassle.Prevents bone loss and lowers your risk of breast cancer. Evista (Raloxifene) is effective at reducing bone loss and lowering the risk of breast cancer in postmenopausal women, but does carry the risk of blood clots.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.27Fosamax
Reviews for Fosamax
43%
of people (All ages) say Fosamax is worth it
30%
say it works well
19%
say it's a big hassle
169 reviews
Have you used Fosamax (alendronate)?
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Have you used Evista (raloxifene)?
Worth itNot sureNot worth it
Side effects
FosamaxEvista
  • Abdominal pain 2%
  • Bone, muscle or joint pain 1%
  • Diarrhea 1%
  • Gas 2%
  • Headache 1%
  • Constipation 1%
  • Ulcer in esophagus 2%
More Fosamax side effects »
  • Arthralgia 2%
  • Flu Syndrome 3%
  • Any side effect 2%
  • Hot Flashes 4%
  • Bronchitis 1%
More Evista side effects »
How it works
FosamaxEvista
Fosamax (alendronate) is a bisphosphonate, which inhibits bone breakdown.Evista (Raloxifene) is a selective estrogen receptor modulator (SERM). It acts like estrogen to make your bones stronger and less likely to break, and also protects breast and uterus tissues from other estrogen effects.
Type of medication
FosamaxEvista
Prescription onlyPrescription only
Available as
FosamaxEvista
  • Pill
  • Effervescent tablet
  • Liquid
  • Pill
Used for
FosamaxEvista
Risk factors for serious side effects
FosamaxEvista
  • Taking anti-inflammatory medicines like ibuprofen, and naproxen
  • History of ulcers or stomach or esophageal conditions
  • Difficulty swallowing
  • Problems sitting or standing for at least 30 minutes
  • Oral or dental surgery
Detailed Fosamax (alendronate) risks & warnings »
  • History of stroke
  • Heart and blood vessel problems
  • History of mini stroke (TIA)
  • Atrial fibrillation
  • Smoking
Detailed Evista (raloxifene) risks & warnings »
Pregnancy

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

Alcohol
FosamaxEvista
No alcohol related info.
  • Regular exercise, cutting back on smoking, and drinking less alcohol can also reduce your risk of bone loss.
Food
FosamaxEvista
No food related info.
  • Take 1 tablet daily with or without food about the same time each day. It’s important to read the information you get with your medicine about how to take Evista (Raloxifene).
Kidneys and liver
FosamaxEvista
No kidneys and liver related info.
  • Evista (Raloxifene) is processed by the kidney and liver. If you have kidney or liver problems, talk to your doctor because you may need a different dose.
Pain
FosamaxEvista
  • Fosamax (alendronate) can cause bone and muscle pain. However, this is very rare. Stop taking the medication and talk to your doctor if this happens to you.
  • Fosamax (alendronate) can cause fractures in the legs as a result of little or no force. This is rare. If you notice a new dull or aching pain in your hips or thighs, talk to your doctor right away.
No pain related info.
Upsides and benefits
FosamaxEvista
  • First choice to treat osteoporosis
  • Lowers your risk of fractures due to osteoporosis.
  • Available generic.
  • Available as daily, weekly, or twice weekly dosing.
  • Comes as a regular tablet, an oral solution, or effervescent tablet.
  • Evista (Raloxifene) doesn’t affect the breast or uterus the same way that estrogen does, so the risk of cancer is much lower.
  • Taking Evista (Raloxifene) with calcium and vitamin D improves spine and hip bone health and lowers the risk of fractures.
  • Lowers total cholesterol and low-density lipoprotein (LDL) cholesterol (the bad cholesterol).
Downsides and risks
FosamaxEvista
  • Can harm your esophagus if you don't remain upright for 30 minutes after taking it.
  • Not recommended for people who can't sit or stand upright for at least 30 minutes.
  • Can increase the risk of atypical fractures.
  • Can cause bad heartburn or stomach problems.
  • Can only take Evista (Raloxifene) once you’re in menopause. You can't take it if you're pregnant or breastfeeding.
  • Evista (Raloxifene) isn’t as effective as tamoxifen at lowering the risk of invasive breast cancer.
  • Shouldn’t take it with any other forms of estrogen (pills, patches, or injection).
  • It doesn’t increase bone strength as much as estrogen does and isn’t effective for treating hot flashes.
Tips from our pharmacists for people taking the medication
FosamaxEvista
  • Take first thing in the morning with a full glass of water.
  • Avoid eating or drinking for 30 minutes after taking Fosamax (alendronate).
  • Remain upright for 30 minutes after taking Fosamax (alendronate).
  • Talk to your doctor if you develop pain around jaw, throat, chest, abdomen, hips or thighs.
  • Let your doctor know if you have any major dental procedures coming up. You may need to temporarily stop taking Fosamax (alendronate).
  • Dissolve the effervescent tablet in 4 ounces of plain water. When solution stops fizzing, wait 5 minutes before stirring for 10 seconds and drinking.
  • Take 1 tablet daily with or without food about the same time each day. It’s important to read the information you get with your medicine about how to take Evista (Raloxifene).
  • Your doctor may tell you to take calcium and vitamin D with Evista (Raloxifene) to prevent osteoporosis (bone thinning and loss), especially if you don’t get enough in your diet.
  • Regular exercise, cutting back on smoking, and drinking less alcohol can also reduce your risk of bone loss.
Learn more
More about FosamaxSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Fosamax (alendronate)?
Worth itNot sureNot worth it
More about EvistaSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Evista (raloxifene)?
Worth itNot sureNot worth it