Prempro vs. Duavee for Osteoporosis and Menopause: Important Differences and Potential Risks.

Prempro

Duavee

(conjugated estrogens / bazedoxifene)

Summary for Prempro

Prescription only

Prempro is a combination estrogen/progestin medication that relieves menopausal symptoms like vaginal dryness and hot flashes. It's also used for preventing osteoporosis after menopause. This hormone replacement therapy is an option for people with a uterus. The medication is brand only since there is no generic available. Follow your prescriber's instructions for the correct dose. Prempro is taken by mouth once a day with the same dose each day. Premphase is also taken daily but contains two types of tablets: one with estrogen and one with conjugated estrogens plus medroxyprogesterone, taken on different days. Common side effects include breast pain, headaches, and menstrual cramps.

Indications for Prempro

Moderate-to-severe vasomotor symptoms (VMS) of menopause, like hot flashes and night sweats
Moderate-to-severe vaginal symptoms due to menopause, like vaginal dryness and irritation
Prevention of bone loss (osteoporosis) after menopause

Pros and Cons for Prempro

Pros

Only need to take once a day by mouth
Relieves multiple menopausal symptoms
Includes a progestin which helps protect your uterus
Lowers your risk of fractures by keeping your bones healthy

Cons

Raises your risk of certain cancers, blood clots, and strokes
Has more possible side effects than similar alternatives
Not safe if you have liver problems
Can't be used if you have a history of breast cancer

Common Side Effects for Prempro

Breast pain (up to 36%)
Headaches (up to 19%)
Stomach pain (up to 17%)
Menstrual cramps (up to 13%)
Gas (up to 8%)
Nausea (up to 8%)
Depression (up to 8%)
More vaginal discharge than usual (up to 8%)

Warnings for Prempro

Risk of blood clot
Breast cancer
Uterine (endometrial) cancer
Dementia
Gallbladder and liver problems
Changes in calcium levels in the blood
Vision problems
High triglycerides
Low thyroid hormone levels (hypothyroidism)
Fluid Retention
Severe allergic reaction
Worsening of other medical conditions

Summary for Duavee

Prescription only

Duavee (conjugated estrogens / bazedoxifene) treats vasomotor symptoms of menopause like hot flashes and night sweats. It can also help prevent osteoporosis in people who've gone through menopause. This combination medication has two active ingredients. The estrogen helps restore estrogen levels in the body while the selective estrogen receptor modulator (SERM) helps protect against bone loss. The dosage is 1 tablet taken by mouth once every day. Side effects can include muscle spasms, nausea, and diarrhea.

Indications for Duavee

Treatment of moderate-to-severe vasomotor symptoms of menopause (e.g., hot flashes, night sweats)
Prevention of osteoporosis in people who've gone through menopause

Pros and Cons for Duavee

Pros

Relieves bothersome menopause symptoms, such as hot flashes and night sweats
Contains an ingredient (bazedoxifene) that helps lower the risk for uterine cancer (no need to take an additional progestin medication)

Cons

Not a first-choice option for preventing osteoporosis in people who've gone through menopause
Not recommended for people who haven't gone through menopause, people 75 years or older, or people with kidney problems

Common Side Effects for Duavee

Muscle spasms or twitching (9%)
Nausea (8%)
Diarrhea (8%)
Indigestion (7%)
Upper stomach pain (7%)
Throat pain (7%)
Dizziness (5%)
Neck pain (5%)

Warnings for Duavee

Risk for blood clots and related complications (e.g., heart attack, stroke)
Risk for uterine cancer (also called endometrial cancer)
Unknown risk for breast cancer or ovarian cancer
Risk for dementia
Gallbladder or liver problems in certain people
Changes in vision
High triglyceride (fat) levels
Low thyroid hormone levels in people who take thyroid hormone replacement therapy
Buildup of fluids in the body (fluid retention)
Worsening of other medical conditions