Compare Fosamax vs. Evista

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


Fosamax (alendronate)

Prescription only

Evista (Raloxifene)

Prescription only
Prevents bone loss.

Fosamax (alendronate) is a first-choice treatment for osteoporosis, but taking it can be a hassle.

3.2/ 5 average rating with 169 reviewsforFosamax
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.

  • 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).
  • 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.
Used for
Dosage forms
  • Pill
  • Effervescent tablet
  • Liquid
  • Pill
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169 reviews so far
saidit'sworth it
saiditworked well
saidit'sa big hassle

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Side effects
1possible side effects
  • Abdominal pain
See more detailed side effects
6possible side effects
  • Any side effect
  • Peripheral edema
  • Muscle spasms/leg cramps
  • Hot Flashes
  • Cholelithiasis
  • Venous thromboembolic events
See more detailed side effects
Risks and risk factors
  • Irritation and ulcers to the stomach and esophagus
    • 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
  • Pain in the bones and muscles
  • Problems in the jaw bone
    • Oral or dental surgery
    • Cancer
    • Poor oral hygiene
    • Prolonged use of Fosamax (alendronate)
  • Leg bone fractures
  • Low calcium in the blood
See more detailed risks and warnings
  • Increased risk of stroke
    • History of stroke
    • Heart and blood vessel problems
    • History of mini stroke (TIA)
    • Atrial fibrillation
    • Smoking
    • High blood pressure
  • Increased risk of blood clots
  • Elevated triglycerides (fats in blood)
    • History of high triglycerides
  • Worsening kidney or liver function
See more detailed risks and warnings