Duavee
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.
What is Duavee (conjugated estrogens / bazedoxifene)?
What is Duavee (conjugated estrogens / bazedoxifene) used for?
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
How Duavee (conjugated estrogens / bazedoxifene) works
Duavee (conjugated estrogens / bazedoxifene) is a combination of two active ingredients.
Conjugated estrogens is a mixture of estrogens that works as an estrogen replacement. It helps replace the natural estrogen that your body loses during menopause. This helps treat menopause symptoms, like hot flashes and night sweats.
Bazedoxifene is a selective estrogen receptor modulator (SERM). Its effects on estrogen receptors depend on where it works in the body. In bone, bazedoxifene acts like estrogen to prevent bone loss and improve bone mineral density (BMD), a measure of how strong your bones are. In the uterus, bazedoxifene stops estrogen from causing the uterine lining from growing too thick. This helps lower the risk of uterine cancer.
By working together, conjugated estrogens and bazedoxifene help relieve menopause symptoms and prevent osteoporosis while lowering the risk of uterine cancer.
Drug Facts
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What are the side effects of Duavee (conjugated estrogens / bazedoxifene)?
Common Side Effects
- Muscle spasms or twitching (9%)
- Nausea (8%)
- Diarrhea (8%)
- Indigestion (7%)
- Upper stomach pain (7%)
- Throat pain (7%)
- Dizziness (5%)
- Neck pain (5%)
Serious Side Effects
- Blood clot in leg: leg pain or swelling, skin that's warm to the touch
- Blood clot in lungs: trouble breathing, chest pain
- Blood clot near the heart (heart attack): chest pain that travels to the arm, neck, or jaw; shortness of breath; cold sweat
- Blood clot in the brain (stroke): sudden weakness on one side of the body, bad headache, changes in speech or vision, drooping face, confusion
- Unusual vaginal bleeding
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Acid or sour stomach
backache
belching
change in vaginal discharge
chills
clear or bloody discharge from the nipple
confusion
darkened urine
difficulty with speaking
dimpling of the breast skin
dizziness or lightheadedness
double vision
fainting
fast heartbeat
full or bloated feeling or pressure in the stomach
headache
inability to move the arms, legs, or facial muscles
inability to speak
indigestion
inverted nipple
loss of appetite
lump in the breast or under the arm
pain or feeling of pressure in the pelvis
pain, redness, or swelling in the arm or leg
pains in the stomach, side, or abdomen, possibly radiating to the back
persistent crusting or scaling of the nipple
redness or swelling of the breast
slow speech
sore on the skin of the breast that does not heal
stomach discomfort, upset, or pain
sudden shortness of breath or troubled breathing
swelling of the abdominal or stomach area
vaginal bleeding
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Neck pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Duavee (conjugated estrogens / bazedoxifene)
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
Pharmacist tips for Duavee (conjugated estrogens / bazedoxifene)
Duavee (conjugated estrogens / bazedoxifene) comes in blister cards that are sealed with a foil covering to help protect the medication from moisture. Keep the tablets in the blister cards. Don't use a pill organizer to store the medication.
Use 1 blister card at a time. Also take out 1 tablet at a time from the blister card when you're ready to take Duavee (conjugated estrogens / bazedoxifene).
Write the date on the provided line on the Duavee (conjugated estrogens / bazedoxifene) blister card when you take out the first tablet in the card. Don't take any of the tablets in the blister card if more than 60 days have passed since this written date.
You can take Duavee (conjugated estrogens / bazedoxifene) with or without food. Taking it with food can help prevent stomach upset, which is a possible side effect of the medication.
Swallow the Duavee (conjugated estrogens / bazedoxifene) tablet whole. Speak with your prescriber if you have trouble swallowing. They can discuss with you about other options for treating menopausal symptoms or for preventing osteoporosis.
Tell your prescriber at least 4 to 6 weeks before any planned surgeries, bedrest, or other situations where you won't be moving much. They'll tell you when you should stop taking Duavee (conjugated estrogens / bazedoxifene) before and when to restart it afterwards. This helps lower your risk for blood clots.
If you're taking Duavee (conjugated estrogens / bazedoxifene) for osteoporosis, speak with your prescriber about taking calcium and vitamin D supplements to help keep your bones strong. They can also recommend other ways to strengthen your bones, such as adding some weight-bearing exercises to your routine.
Don't take any progestins, other estrogens, or other selective estrogen receptor modulators (SERMs) while you're taking Duavee (conjugated estrogens / bazedoxifene). It can raise your risk for certain side effects.
Frequently asked questions about Duavee (conjugated estrogens / bazedoxifene)
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What are the risks and warnings for Duavee (conjugated estrogens / bazedoxifene)?
Duavee (conjugated estrogens / bazedoxifene) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk for blood clots and related complications (e.g., heart attack, stroke)
Risk factors: Personal or family history of blood clots | High blood pressure | Diabetes (high blood sugar) | Smoking | High cholesterol | People who are considered obese | Lupus | Taking additional estrogen medications
The active ingredients in Duavee (conjugated estrogens / bazedoxifene) can raise the risk of developing blood clots. These clots can block blood flow to other parts of the body, like the leg, lungs, heart, or brain. Some clots can lead to dangerous complications, such as heart attack or stroke.
Before you start taking Duavee (conjugated estrogens / bazedoxifene), speak with your prescriber about whether the medication is safe for you. There are many things that can raise your risk for blood clots, such as having high blood pressure, smoking, and long periods of time when you're not moving as much. Don't take Duavee (conjugated estrogens / bazedoxifene) to prevent heart disease.
Be sure you know the signs and symptoms of a blood clot, heart attack, and stroke.
Blood clot in arm or leg: swelling, pain, or tenderness in the arm or leg; skin that's warm to the touch
Blood clot in the lung: chest pain, trouble breathing
Heart attack (blood clot near the heart): chest pain traveling to the arm, neck, or jaw; shortness of breath; cold sweat; lightheadedness
Stroke (blood clot in the brain): sudden weakness on one side of the body, drooping face, bad headache, changes in speech or vision, confusion
Stop taking Duavee (conjugated estrogens / bazedoxifene) and get medical help as soon as possible if you have any signs or symptoms of a blood clot.
Risk for uterine cancer (also called endometrial cancer)
Risk factors: Estrogen therapy without additional progestin | People with a healthy uterus | Taking estrogen therapy for more than 1 year | Taking additional estrogen medications
Duavee contains conjugated estrogens and bazedoxifene. Estrogens can thicken and change the lining of your uterus called the endometrium. It can sometimes lead to uncontrolled growth of the uterine lining and put people with a healthy uterus at risk for uterine cancer (or endometrial cancer). Bazedoxifene helps balance out estrogen's effect on the uterine lining, which helps lower the risk for cancer.
Even though Duavee (conjugated estrogens / bazedoxifene) contains an ingredient that helps protect against the potential effects of estrogen on the uterine lining, it's important to be aware of this risk. Know the warning signs of uterine cancer, such as vaginal bleeding that doesn't go away or keeps coming back or pelvic pain. Speak with your prescriber if you're concerned about the risk for uterine cancer. Let your prescriber know if you notice any unusual vaginal bleeding.
Unknown risk for breast cancer or ovarian cancer
It isn't clear whether Duavee (conjugated estrogens / bazedoxifene) raises the risk for breast cancer or ovarian cancer. To be safe, it's important to continue to get screened for these cancers while you're taking this medication.
Get breast scans (mammograms) at the recommended times and do self-exams to check for any lumps or unusual changes. Talk to your primary care provider or gynecologist if you notice any unusual vaginal bleeding; vaginal discharge; pelvic pain; or unusual changes in breast shape, size, or color. They can examine you to see what's going on.
Risk for dementia
Risk factors: Age 65 years or older
Studies suggest that people age 65 years and older who've gone through menopause and are taking estrogen-only therapy might be at greater risk for dementia. Make sure you're aware of possible early signs of dementia, like memory loss, confusion about time, getting lost, and misplacing things often. Speak with your primary care provider if you're worried about the risk for dementia. Don't take Duavee (conjugated estrogens / bazedoxifene) to prevent dementia.
Gallbladder or liver problems in certain people
Risk factors: History of liver problems or jaundice
The risk for gallbladder problems is higher for people who've gone through menopause and are taking estrogen medications like Duavee (conjugated estrogens / bazedoxifene). Tell your prescriber if you've previously had jaundice (yellow of the skin or whites of the eyes). And let your care team know if you start noticing jaundice or stomach pain that doesn't go away after you start taking Duavee (conjugated estrogens / bazedoxifene). These can be signs of gallbladder or liver problems. Don't take this medication if you have liver problems.
Changes in vision
Although very rare, some people who took estrogens have had changes in their vision due to a clot that formed in the blood vessels of the eye. Stop taking Duavee (conjugated estrogens / bazedoxifene) right away and let your primary care provider know if you have sudden partial or complete vision loss, bulging eyes, double vision, or migraines.
High triglyceride (fat) levels
Risk factors: History of having high triglyceride levels in the blood
Estrogen therapy might make the triglyceride (fat) levels in your blood to go up. Too much triglyceride in your blood can lead swelling in the pancreas (pancreatitis). The risk for pancreatitis might be higher for people who already have high triglyceride levels. Contact your primary care provider right away if you notice symptoms of pancreatitis, like stomach pain that spreads to your back, stomach tenderness, nausea, vomiting, or fever.
Low thyroid hormone levels in people who take thyroid hormone replacement therapy
Risk factors: Low thyroid hormone levels (hypothyroidism)
Estrogens can cause changes in thyroid hormone levels in your body. Normally, your body can adjust to these changes by itself. But it might be harder for your body to adjust if you already have low thyroid hormone levels (hypothyroidism).
To help adjust to changes in thyroid hormone levels during treatment, you might need to take a higher dose of your thyroid hormone replacement medication for your thyroid condition while you're taking Duavee (conjugated estrogens / bazedoxifene). Continue to get blood tests done when instructed by your primary care provider to check your thyroid hormone levels.
Buildup of fluids in the body (fluid retention)
Risk factors: Heart failure | Kidney problems
It's possible for medications containing estrogens like Duavee (conjugated estrogens / bazedoxifene) to make your body hold onto extra fluid. Signs of fluid retention can include swelling of your hands, feet, or ankles.
Tell your primary care provider if you have heart failure because you're at higher risk for fluid retention. In addition, fluid retention can worsen this medical condition. Duavee (conjugated estrogens / bazedoxifene) isn't recommended for people with kidney problems (they're also at risk for complications from fluid retention).
Call your primary care provider if you notice swelling or signs that your heart condition is worsening while you're taking Duavee (conjugated estrogens / bazedoxifene).
Worsening of other medical conditions
Let your prescriber know about your full medical history before you start taking Duavee (conjugated estrogens / bazedoxifene). It's possible for this medication to worsen symptoms of other medical conditions. Examples include asthma, diabetes, epilepsy, migraine, and lupus. It can also include hypoparathyroidism and hereditary angioedema (a condition that causes serious swelling).
Duavee (conjugated estrogens / bazedoxifene) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 0.45mg/20mg | 30 tablets | $25.00 | $0.83 |
Typical dosing for Duavee (conjugated estrogens / bazedoxifene)
Each tablet contains 0.45 mg of conjugated estrogens and 20 mg of bazedoxifene.
The typical dose is 1 tablet by mouth once daily.
Interactions between Duavee (conjugated estrogens / bazedoxifene) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Etoricoxib
- Ginseng
- Levothyroxine
- Licorice
- Tipranavir
How much does Duavee (conjugated estrogens / bazedoxifene) cost?
Duavee (conjugated estrogens / bazedoxifene) contraindications
Currently have or have had breast cancer
Currently have or have had an estrogen-dependent cancer or tumor
Currently have or have had a blood clot, like deep vein thrombosis (DVT) or pulmonary embolism (PE)
Currently have or have had a stroke or heart attack
Liver problems
Blood-clotting problems
Currently pregnant
What are alternatives to Duavee (conjugated estrogens / bazedoxifene)?
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
Hot flashes, night sweats, and flushes caused by menopause
Vaginal dryness caused by menopause
Low estrogen levels due to certain conditions
Certain advanced stages of breast cancer
Certain advanced stages of prostate cancer
Prevention of bone loss (osteoporosis) after menopause
Treatment of moderate-to-severe symptoms of menopause (e.g., hot flashes, night sweats) for people with a healthy uterus
Prevention of osteoporosis for people who've gone through menopause with a healthy uterus
What is the latest news about Duavee (conjugated estrogens / bazedoxifene)?
Duavee (conjugated estrogens / bazedoxifene) images
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References
Best studies we foundCamacho, P. M., et al. (2020). American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis–2020 update. Endocrine Practice.
Denby, N. (2023). Weight gain and menopause. Women’s Health Concern.
Goldberg, T., et al. (2015). Conjugated estrogens/bazedoxifene (Duavee): A novel agent for the treatment of moderate-to-severe vasomotor symptoms associated with menopause and the prevention of postmenopausal osteoporosis. Pharmacy and Therapeutics.
Hoffman, S. R., et al. (2023). Comparative safety of conjugated estrogens/bazedoxifene versus estrogen/progestin combination hormone therapy among women in the United States: A multidatabase cohort study. Menopause.
MedlinePlus. (2024). Bone density.
Miller, P. D., et al. (2009). Effects of bazedoxifene on BMD and bone turnover in postmenopausal women: 2-yr results of a randomized, double-blind, placebo-, and active-controlled study. Journal of Bone and Mineral Research.
Ospina, N. S., et al. (2022). Hypoparathyroidism. Endocrine Society.
U.S. Pharmaceuticals. (2025). Duavee- conjugated estrogens/bazedoxifene tablet, film coated [package insert]. DailyMed.
Yu, K., et al. (2022). Estrogen receptor function: Impact on the human endometrium. Frontiers in Endocrinology.
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