Duavee (Conjugated Estrogens/Bazedoxifene) for Osteoporosis

Duavee (conjugated estrogens/bazedoxifene) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to help prevent osteoporosis after menopause in women who have a uterus.

How Duavee Works and How It’s Taken

Duavee is a hormone medicine that contains conjugated estrogens and bazedoxifene. These medicines act on estrogen receptors, which are found in different tissues in the body. Bazedoxifene has different effects depending on the tissue. In the uterus, it helps lower the risk of too much growth of the uterine lining that can happen with the estrogen part of Duavee.

Doctors prescribe Duavee to help prevent osteoporosis after menopause in women who have a uterus. If Duavee is being used only to prevent osteoporosis, it should generally be considered for women at significant risk of osteoporosis. Nonestrogen medicines should also be considered.

Take one Duavee tablet once each day. Take it at the same time each day. You may take it with or without food. Swallow the tablet whole.

Keep Duavee in its blister package until you are ready to take it. Remove only one tablet at a time. Do not put Duavee in a pill box or pill organizer.

If you take a calcium or vitamin D supplement, you may take it at the same time as Duavee. Women taking Duavee to help prevent osteoporosis should add calcium and/or vitamin D if they do not get enough from their diet.

Typical Dosing for Osteoporosis

The recommended dose of Duavee for prevention of postmenopausal osteoporosis is one tablet by mouth once daily. Each tablet contains:

0.45 milligrams of conjugated estrogens
20 milligrams of bazedoxifene

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Duavee Side Effects

In clinical studies of Duavee, the most common side effects occurred in about 5 percent to 9 percent of people. These include:

Muscle spasms
Nausea
Diarrhea
Dyspepsia (upset stomach)
Upper abdominal (stomach) pain
Oropharyngeal pain (throat pain)
Dizziness
Neck pain

Serious Side Effects and Warnings

Duavee can cause serious side effects that may require immediate medical attention. These include:

Blood clots — Deep vein thrombosis and pulmonary embolism can cause leg swelling or pain, chest pain, or shortness of breath.
Stroke — Reduced blood flow to the brain can cause sudden weakness, trouble speaking, or vision changes.
Endometrial cancer — Cancer of the lining of the uterus can be associated with unusual vaginal bleeding after menopause, which can be a warning sign.
Breast cancer — The effect of Duavee on breast cancer risk is unknown, and estrogen therapy can affect breast tissue.
Ovarian cancer — The effect of Duavee on ovarian cancer risk is unknown.
Probable dementia in people age 65 and older — This decline in brain function is based on a study of an estrogen-alone product.
Gallbladder disease — Gallbladder problems may require surgery.
Retinal vascular thrombosis — A blood clot in the eye can cause sudden partial or complete vision loss.
High blood pressure — Blood pressure may increase.
Hypertriglyceridemia and pancreatitis — Very high blood fats can lead to pancreas inflammation.
Liver problems, including cholestatic jaundice — Bile flow problems can cause yellowing of the skin or eyes.
Severe allergic reactions — These include anaphylaxis or angioedema, which can cause swelling of the face, lips, tongue, or throat, or trouble breathing
Hypocalcemia — Low calcium levels in the blood can cause muscle cramps, tingling, or spasms.
Hereditary angioedema flare-ups — Worsening swelling episodes can occur in people with this condition.
Fluid retention — Extra fluid in the body can worsen certain heart or kidney problems.
Worsening of certain conditions — Asthma, diabetes, epilepsy, migraine, porphyria, systemic lupus erythematosus, or liver hemangiomas may become worse.

Get medical help right away if you think you are having a serious reaction.

This drug has a boxed warning, the FDA’s strongest safety warning, for some of the serious risks mentioned above. A boxed warning does not mean the drug is unsafe for everyone or that everyone faces the same level of risk.

How To Save on Duavee

Pfizer Inc, the manufacturer of Duavee, offers the Menopause Hormone Therapies (MHT) by Pfizer Savings Card. Eligible people with commercial insurance may pay as little as $25 per month.

The MHT savings card also allows you to check eligibility and enroll online.

To learn more, visit the Menopause Hormone Therapies (MHT) by Pfizer Savings Card website.

What To Know Before Taking Duavee

Before taking Duavee, tell your healthcare provider if you:

Have unusual vaginal bleeding
Have asthma, seizures, diabetes, migraine, endometriosis, lupus, or problems with your heart, liver, thyroid, or kidneys
Have high calcium levels in your blood
Are going to have surgery or will need to stay in bed for a long time
Have any other medical conditions

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention other hormone medicines, including progestins, estrogens, or medicines similar to Duavee.

Do not take Duavee if you:

Have unexplained vaginal bleeding
Have, may have, or have had breast cancer
Have or may have another cancer that depends on estrogen
Have or have had a blood clot, including deep vein thrombosis or pulmonary embolism
Have or have had a stroke or heart attack
Have liver impairment or liver disease
Have protein C, protein S, or antithrombin deficiency, or another known blood-clotting disorder
Have had a serious allergic reaction to estrogens, bazedoxifene, or any ingredient in Duavee
Are pregnant

Duavee is also FDA-approved to treat moderate to severe hot flashes caused by menopause in women who have a uterus.

If you miss a dose of Duavee, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the usual time. Do not take two doses at the same time unless your healthcare provider tells you to.

Do not take Duavee if you are pregnant. If you think you may be pregnant, take a pregnancy test. If the test is positive, do not take Duavee and contact your healthcare provider.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Duavee?

Studies found that Duavee helped increase bone mineral density in the spine and hip compared with placebo.

After 24 months, spine bone density increased by 1.72 percent in women who were one to five years past menopause and by 1.64 percent in women who were more than five years past menopause. Women who received placebo lost bone density.

In another study, after 12 months, the difference in spine bone density between Duavee and placebo was 1.51 percent. The difference in hip bone density was 1.21 percent.

How long does Duavee take to work for osteoporosis?

The studies measured changes in bone mineral density after 12 months and 24 months. It does not say exactly how soon Duavee starts helping the bones.

Does Duavee interact with other medicines?

Yes. Some medicines may affect how Duavee works.

Certain medicines can change the amount of Duavee in the body. These include:

Itraconazole, which can increase the amount of bazedoxifene and conjugated estrogens in the body
Rifampin, phenobarbital, and carbamazepine, which may lower the amount of some estrogens or bazedoxifene in the body
Phenytoin, which may lower the amount of bazedoxifene in the body
St. John’s wort, which may lower the amount of some estrogens in the body

A lower amount of bazedoxifene may reduce protection against too much growth of the lining of the uterus.

Tell your healthcare provider about all prescription medicines, over-the-counter medicines, vitamins, and herbal supplements you take.