Issues for surgery
Risk of venous thromboembolism (VTE) if continued (see Further information).
Advice in the perioperative period
Elective surgery
Stop 3 days prior to surgery that will result in reduced mobility.
If continuing, ensure adequate thromboprophylaxis.
Emergency surgery
Stop as soon as possible prior to surgery that will result in reduced mobility.
Ensure adequate thromboprophylaxis.
Post-operative advice
If discontinued pre-operatively, only restart when the patient is fully mobile2.
Interactions with common anaesthetic agents
None.
Interactions with other common medicines used in the perioperative period
None.
Further information
Risk of VTE
The risk of VTE with raloxifene is thought to be comparable to hormone replacement therapy (HRT). This has been confirmed in observational studies in the UK population, which demonstrated a statistically significant increase in VTE.
References
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com [Accessed on 1st June 2019]
Summary of Product Characteristics – Evista® (raloxifene). Daiichi Sankyo UK Limited. Accessed via www.medicines.org.uk 01/06/2019 [date of revision of the text October 2017]
Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. www.medicinescomplete.com [Accessed on 1st June 2019]
Vinogradova, Y. Coupland, C & Hippisley-Cox, J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ. 2019; 364:k4810