Duavee Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Duavee Tablet contains conjugated estrogens and bazedoxifene, a sex hormone combination used by women after menopause who still have their uterus. It treats moderate to severe hot flashes caused by menopause and helps prevent osteoporosis. The bazedoxifene component works alongside estrogen to lower the risk of uterine lining overgrowth that can occur with estrogen alone. This medicine carries a boxed warning due to risks of uterine cancer, heart and blood vessel problems, and probable dementia.

What is Duavee Tablet

Duavee is a prescription tablet that combines conjugated estrogens with bazedoxifene. Conjugated estrogens are a mixture of estrogen hormones, and bazedoxifene is a medicine that blocks estrogen from affecting certain cells. It is for women after menopause who still have their uterus.

Duavee Tablet uses

• Treating moderate to severe hot flashes (vasomotor symptoms) caused by menopause
• Preventing osteoporosis (weak, thin bones) after menopause

Benefits of Duavee Tablet

• Can reduce the number and severity of hot flashes
• Can help protect bone density in the spine and hip after menopause
• The bazedoxifene part lowers the risk of overgrowth of the uterine lining that can happen with estrogen alone

How Duavee Tablet works

Duavee pairs estrogen with bazedoxifene. The estrogen acts on estrogen receptors throughout the body to ease menopause symptoms and help protect bone. Bazedoxifene also acts on these receptors but blocks estrogen's effect specifically in the uterus, which helps prevent overgrowth of the uterine lining that estrogen alone can cause.

Duavee Tablet dosage

Take one tablet once a day at the same time each day. It can be taken with or without food. Swallow the tablet whole; do not crush, chew, or break it. Take only one tablet out of the blister pack at a time, right before you take it. If you take calcium or vitamin D supplements, you can take them at the same time as Duavee. Your doctor may want you to stop taking Duavee for a short time before major surgery or long periods of bed rest. Duavee should be used for the shortest time needed to treat your condition. It is not recommended for women 75 years of age or older. It has not been studied in people with kidney problems, so it is not recommended for them.

Available forms and strengths

• Tablet (film-coated, oval, pink, 0.45 mg/20 mg)

Side effects of Duavee Tablet

Common

• Dizziness
• Nausea
• Stomach pain or discomfort
• Diarrhea
• Muscle spasms
• Throat pain
• Neck pain
• Indigestion (upset stomach)

Serious

• Blood clots (in the leg, lungs, or near the heart)
• Stroke
• Heart attack
• Cancer of the lining of the uterus (endometrial cancer)
• Breast cancer
• Ovarian cancer
• Dementia (decline in brain function), mainly seen in women 65 and older
• Gallbladder problems requiring surgery
• Sudden loss of vision or blood clot in the eye
• High blood pressure
• High triglycerides (fats in the blood), which can lead to pancreatitis
• Liver problems, including yellowing of the skin or eyes (jaundice)
• Thyroid problems
• Fluid retention and swelling
• Low calcium levels (muscle spasms, numbness or tingling)
• Severe allergic reaction: swelling of the face, lips, tongue, or throat, difficulty breathing
• Worsening of asthma, diabetes, epilepsy, migraines, porphyria, or lupus

Warnings and precautions

This medicine carries a boxed warning, the strongest warning the FDA gives, because of increased risks of uterine (endometrial) cancer, heart and blood vessel problems, and probable dementia.

• Do not take other estrogen or progestin medicines while using Duavee, as this can raise your cancer risk further.
• Using unopposed estrogen raises the risk of endometrial cancer in women who still have a uterus.
• Estrogen therapy should not be used to try to prevent heart disease or dementia, because it may actually raise the risk of these conditions.
• Studies of estrogen-alone treatment found a higher chance of stroke and deep vein blood clots in postmenopausal women.
• A study found a higher chance of probable dementia in postmenopausal women 65 and older who used estrogen-alone therapy.
• Do not take this medicine if you have unexplained vaginal bleeding, liver disease, a bleeding disorder, a history of heart attack, stroke, blood clot, or certain cancers, or if you are about to have major surgery.
• People with high blood pressure, diabetes, high cholesterol, excess weight, or who smoke are at even higher risk of blood clots, stroke, or heart attack while on this medicine.
• Women 75 years of age or older should not take this medicine, since it has not been studied in that age group.
• Duavee must not be used by women who are pregnant. It can harm an unborn baby, and it is only meant for women who can no longer get pregnant.
•  Women who are not past menopause should use effective birth control. Duavee should not be used while breastfeeding.
• Duavee has not been studied in women with kidney problems, so it is not recommended for them. 
• It should not be used by women with liver disease or impaired liver function, since estrogens may not be processed normally by a damaged liver and bazedoxifene levels can build up much higher than normal.
• Alcohol use is listed as something to discuss with your doctor before taking this medicine.

Storage

• Store at room temperature between 68°F to 77°F (20°C to 25°C)
• Keep each tablet in its blister pack until you are ready to take it, to protect it from moisture
• Do not put Duavee in a pill box or pill organizer
• Write down the date you open the foil pouch
• Use the medicine within 60 days after opening the pouch
• Keep out of the reach of children

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away if you have signs of a heart attack, such as chest pain or pressure, pain spreading to the jaw or shoulder, nausea, or sweating.
• Call your doctor right away if you have signs of a stroke, such as sudden numbness or weakness (especially on one side), sudden severe headache, slurred speech, or problems with vision or balance.
• Call your doctor right away if you have signs of a blood clot, such as sudden vision loss, stabbing chest pain, shortness of breath, coughing up blood, or pain or warmth in one or both legs.
• Call your doctor right away if you have sudden vision loss, swelling, rapid weight gain, yellowing of the skin or eyes, memory problems, confusion, unusual behavior, unusual vaginal bleeding, pelvic pain, or a lump in the breast.
• Call your doctor right away if you have signs of low calcium, such as muscle spasms or cramps, or numbness or tingling around the mouth, fingers, or toes.
• Report any unusual vaginal bleeding to your doctor right away, since it can be a warning sign of uterine cancer.

Alternatives

• Premarin
• Tibolone
• Ospemifene