Duavee

• 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 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.

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 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.

• 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.

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.

• 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.

• 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.

• 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).

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).