Duavee 0.45-20 Tablets
WARNING: Do not take other estrogens, a progestin, or other drugs like bazedoxifene while taking this drug.Do not use this drug to prevent heart disease or dementia. A study of women taking an estrogen with a progestin showed a raised chance of heart attack, stroke, blood clot, breast cancer, and dementia. The chance of stroke, blood clot, and dementia was also raised when the estrogen was taken alone. Not all products and doses were studied. It is not known if the same effects may happen with this drug.The chance of endometrial cancer may be raised with the use of estrogen alone in patients with a uterus. Use of a progestin along with estrogen may lower the risk. Call your doctor right away if you have unexplained or long-lasting vaginal bleeding.Use this drug for the shortest time needed at the lowest useful dose. Your doctor will talk with you on a regular basis to see if you need to keep taking this drug. @ COMMON USES: It is used to treat symptoms of low estrogen levels after menopause.It is used to prevent soft, brittle bones (osteoporosis) after menopause.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Estrogen-SERM Combination; Hormone Replacement Therapy (HRT)
Pharmacologic Class
Estrogen; Selective Estrogen Receptor Modulator (SERM)
Pregnancy Category
Category X
FDA Approved
Oct 2013
DEA Schedule
Not Controlled
Overview
What is this medicine?
Duavee is a medication for women after menopause. It contains two active ingredients: estrogens and bazedoxifene. The estrogens help reduce hot flashes and prevent bone thinning (osteoporosis). Bazedoxifene is added to protect the uterus from the effects of estrogen, so you don't need to take a separate progesterone medication. It's taken once a day by mouth.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your medication and follow the instructions closely.
General Instructions for All Uses:
You can take this medication with or without food.
Swallow the tablet whole - do not chew, break, or crush it.
Only remove the medication from the blister pack when you are ready to take it. Take the medication immediately after opening the blister pack. Do not store the removed medication for future use.
Continuing Your Medication:
Continue taking your medication as directed by your doctor or healthcare provider, even if you start to feel well.
Additional Instructions for Osteoporosis:
If you are taking this medication for soft, brittle bones (osteoporosis), be sure to take calcium and vitamin D as directed by your doctor.
Storing and Disposing of Your Medication:
Store your medication in its original container at room temperature in a dry place. Avoid storing it in a bathroom.
After opening, discard any unused medication after 60 days.
Keep all medications in a safe place, out of the reach of children and pets.
What to Do If You Miss a Dose:
If you miss a dose, take it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and return to your regular schedule.
Do not take two doses at the same time or take extra doses.
If you are unsure what to do if you miss a dose, contact your doctor for guidance.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your medication and follow the instructions closely.
General Instructions for All Uses:
You can take this medication with or without food.
Swallow the tablet whole - do not chew, break, or crush it.
Only remove the medication from the blister pack when you are ready to take it. Take the medication immediately after opening the blister pack. Do not store the removed medication for future use.
Continuing Your Medication:
Continue taking your medication as directed by your doctor or healthcare provider, even if you start to feel well.
Additional Instructions for Osteoporosis:
If you are taking this medication for soft, brittle bones (osteoporosis), be sure to take calcium and vitamin D as directed by your doctor.
Storing and Disposing of Your Medication:
Store your medication in its original container at room temperature in a dry place. Avoid storing it in a bathroom.
After opening, discard any unused medication after 60 days.
Keep all medications in a safe place, out of the reach of children and pets.
What to Do If You Miss a Dose:
If you miss a dose, take it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and return to your regular schedule.
Do not take two doses at the same time or take extra doses.
If you are unsure what to do if you miss a dose, contact your doctor for guidance.
Lifestyle & Tips
- Do not smoke, as smoking increases the risk of blood clots, stroke, and heart attack, especially when taking estrogen-containing medications.
- Maintain a healthy diet rich in calcium and vitamin D to support bone health.
- Engage in regular weight-bearing exercise to help prevent osteoporosis.
- Discuss any planned surgeries or prolonged bed rest with your doctor, as these situations can increase the risk of blood clots.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
0.45 mg conjugated estrogens and 20 mg bazedoxifene orally once daily
Dose Range:
0.45 - 20 mg
Condition-Specific Dosing:
vasomotorSymptomsOfMenopause:
0.45 mg conjugated estrogens and 20 mg bazedoxifene orally once daily
preventionOfPostmenopausalOsteoporosis:
0.45 mg conjugated estrogens and 20 mg bazedoxifene orally once daily
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment recommended, but use with caution due to potential for increased estrogen exposure.
Moderate:
No specific dose adjustment recommended, but use with caution due to potential for increased estrogen exposure.
Severe:
Not studied; use with caution due to potential for increased estrogen exposure.
Dialysis:
Not studied; use with caution due to potential for increased estrogen exposure.
Hepatic Impairment:
Mild:
Use with caution; monitor for adverse effects.
Moderate:
Use with caution; monitor for adverse effects.
Severe:
Not recommended due to potential for increased estrogen and bazedoxifene exposure.
Pharmacology
Mechanism of Action
Duavee combines conjugated estrogens (CE) and bazedoxifene (BZA). Conjugated estrogens provide estrogenic effects, primarily by binding to estrogen receptors (ERs) in target tissues, alleviating menopausal symptoms and preventing bone loss. Bazedoxifene is a selective estrogen receptor modulator (SERM) that acts as an estrogen agonist in some tissues (e.g., bone) and an estrogen antagonist in others (e.g., uterus and breast). In Duavee, bazedoxifene mitigates the estrogen-induced endometrial proliferation and breast stimulation, thereby eliminating the need for a progestin.
Pharmacokinetics
Absorption:
Bioavailability:
Conjugated Estrogens: Well absorbed. Bazedoxifene: Approximately 6% (low absolute bioavailability).
Tmax:
Conjugated Estrogens: 8.5-10.5 hours (for estrone). Bazedoxifene: 2-3 hours.
FoodEffect:
Food increases bazedoxifene Cmax by 25% and AUC by 42%.
Distribution:
Vd:
Conjugated Estrogens: Not readily available for specific components, but generally widely distributed. Bazedoxifene: Approximately 14.7 L/kg.
ProteinBinding:
Conjugated Estrogens: Highly protein bound (primarily to sex hormone-binding globulin and albumin). Bazedoxifene: >98% bound to plasma proteins.
CnssPenetration:
Limited for bazedoxifene; estrogens can cross the blood-brain barrier.
Elimination:
HalfLife:
Conjugated Estrogens: Estrone (major circulating estrogen) ~10-17 hours. Bazedoxifene: Approximately 30 hours.
Clearance:
Not readily available for specific components.
ExcretionRoute:
Conjugated Estrogens: Primarily renal. Bazedoxifene: Primarily fecal (70-80%), with minor renal excretion (10-20%).
Unchanged:
Conjugated Estrogens: Minimal. Bazedoxifene: <1% unchanged in urine.
Pharmacodynamics
OnsetOfAction:
Vasomotor symptoms: Within weeks. Bone density: Within months.
PeakEffect:
Vasomotor symptoms: 4-12 weeks. Bone density: 12-24 months.
DurationOfAction:
Effects persist as long as treatment is continued.
Safety & Warnings
BLACK BOX WARNING
Estrogens and Estrogen-SERM Combination Therapy:
1. Endometrial Cancer: The bazedoxifene component of Duavee reduces the risk of endometrial hyperplasia that can occur with estrogen alone. However, there is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens.
2. Cardiovascular Disorders: Estrogen-alone therapy and estrogen plus progestin therapy have been reported to increase the risk of stroke and deep vein thrombosis (DVT) in postmenopausal women. Duavee has not been studied in women with a history of stroke or DVT.
3. Probable Dementia: Estrogen-alone therapy and estrogen plus progestin therapy have been reported to increase the risk of probable dementia in postmenopausal women 65 years of age or older. Duavee has not been studied in women with probable dementia.
1. Endometrial Cancer: The bazedoxifene component of Duavee reduces the risk of endometrial hyperplasia that can occur with estrogen alone. However, there is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens.
2. Cardiovascular Disorders: Estrogen-alone therapy and estrogen plus progestin therapy have been reported to increase the risk of stroke and deep vein thrombosis (DVT) in postmenopausal women. Duavee has not been studied in women with a history of stroke or DVT.
3. Probable Dementia: Estrogen-alone therapy and estrogen plus progestin therapy have been reported to increase the risk of probable dementia in postmenopausal women 65 years of age or older. Duavee has not been studied in women with probable dementia.
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach pain or upset, light-colored stools, vomiting, or yellow skin and eyes.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Signs of gallbladder problems: pain in the upper right abdomen, right shoulder, or between the shoulder blades, yellow skin and eyes, fever with chills, bloating, or severe stomach upset or vomiting.
Signs of pancreatitis (pancreas problems): severe stomach pain, severe back pain, or severe stomach upset or vomiting.
Weakness on one side of the body, difficulty speaking or thinking, balance changes, drooping on one side of the face, or blurred vision.
Abnormal vaginal bleeding.
Vaginal itching or discharge.
Changes in vision or loss of vision, bulging eyes, or changes in how contact lenses feel.
Depression or mood changes.
Memory problems or loss.
Feeling extremely tired or weak.
Breast lump, breast pain or tenderness, or nipple discharge.
Swelling or fluid retention in the body (tell your doctor if you experience swelling, weight gain, or breathing difficulties).
Signs of a blood clot: chest pain or pressure, coughing up blood, shortness of breath, swelling, warmth, numbness, color changes, or pain in a leg or arm, or difficulty speaking or swallowing.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Dizziness.
Muscle spasms.
Stomach upset.
Stomach pain or diarrhea.
Throat pain.
* Neck pain.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach pain or upset, light-colored stools, vomiting, or yellow skin and eyes.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Signs of gallbladder problems: pain in the upper right abdomen, right shoulder, or between the shoulder blades, yellow skin and eyes, fever with chills, bloating, or severe stomach upset or vomiting.
Signs of pancreatitis (pancreas problems): severe stomach pain, severe back pain, or severe stomach upset or vomiting.
Weakness on one side of the body, difficulty speaking or thinking, balance changes, drooping on one side of the face, or blurred vision.
Abnormal vaginal bleeding.
Vaginal itching or discharge.
Changes in vision or loss of vision, bulging eyes, or changes in how contact lenses feel.
Depression or mood changes.
Memory problems or loss.
Feeling extremely tired or weak.
Breast lump, breast pain or tenderness, or nipple discharge.
Swelling or fluid retention in the body (tell your doctor if you experience swelling, weight gain, or breathing difficulties).
Signs of a blood clot: chest pain or pressure, coughing up blood, shortness of breath, swelling, warmth, numbness, color changes, or pain in a leg or arm, or difficulty speaking or swallowing.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Dizziness.
Muscle spasms.
Stomach upset.
Stomach pain or diarrhea.
Throat pain.
* Neck pain.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Sudden chest pain or shortness of breath
- Sudden severe headache
- Sudden numbness or weakness on one side of the body
- Sudden vision changes
- Sudden trouble speaking or understanding speech
- Pain, swelling, or redness in one leg
- Yellowing of the skin or eyes (jaundice)
- Unusual vaginal bleeding or spotting
- A lump in your breast
- Severe abdominal pain
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
If you are pregnant or think you might be pregnant. This medication is not recommended during pregnancy.
If you are breastfeeding or plan to breastfeed.
A history of certain health conditions, including:
+ Bleeding disorders
+ Blood clots or an increased risk of blood clots
+ Breast cancer
+ Liver problems or liver tumors
+ Heart attack
+ Stroke
+ Tumors that grow in response to estrogen
Unexplained vaginal bleeding
Kidney disease
If you have not yet gone through menopause or are still able to become pregnant
If you are over 75 years old, as this medication is not approved for use in this age group
* If the patient is a child, as this medication is not intended for pediatric use
Additionally, it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. This will help identify any potential interactions between this medication and your other health conditions or medications. Do not start, stop, or change the dosage of any medication without consulting your doctor first.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
If you are pregnant or think you might be pregnant. This medication is not recommended during pregnancy.
If you are breastfeeding or plan to breastfeed.
A history of certain health conditions, including:
+ Bleeding disorders
+ Blood clots or an increased risk of blood clots
+ Breast cancer
+ Liver problems or liver tumors
+ Heart attack
+ Stroke
+ Tumors that grow in response to estrogen
Unexplained vaginal bleeding
Kidney disease
If you have not yet gone through menopause or are still able to become pregnant
If you are over 75 years old, as this medication is not approved for use in this age group
* If the patient is a child, as this medication is not intended for pediatric use
Additionally, it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. This will help identify any potential interactions between this medication and your other health conditions or medications. Do not start, stop, or change the dosage of any medication without consulting your doctor first.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Your doctor may advise you to stop taking this drug before certain surgical procedures, and will provide guidance on when to resume taking it after the surgery or procedure.
If you anticipate being immobile for extended periods, such as during long trips, bedrest after surgery, or illness, discuss this with your doctor, as prolonged immobility may increase your risk of developing blood clots.
If you regularly consume grapefruit juice or eat grapefruit, consult with your doctor, as this may interact with your medication.
Be aware that medications like this one can cause high blood pressure. Follow your doctor's instructions for regular blood pressure checks.
Elevated triglyceride levels have been associated with this medication. If you have a history of high triglyceride levels, inform your doctor.
Adhere to your doctor's recommendations for regular blood tests and bone density checks.
It is crucial to maintain regular breast exams and gynecology check-ups, and to perform breast self-exams as instructed by your doctor.
This medication may affect the results of certain laboratory tests. Inform all your healthcare providers and laboratory personnel that you are taking this drug.
Refrain from smoking, as it increases the risk of heart disease. Consult with your doctor for guidance on quitting.
Limit your alcohol consumption while taking this medication.
The risk of certain side effects, such as heart attack, stroke, breast cancer, ovarian cancer, and others, may vary depending on factors like the duration of estrogen use, whether it is taken with or without a progestin, and other individual factors. Discuss the benefits and risks of using this medication with your doctor.
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.
If you anticipate being immobile for extended periods, such as during long trips, bedrest after surgery, or illness, discuss this with your doctor, as prolonged immobility may increase your risk of developing blood clots.
If you regularly consume grapefruit juice or eat grapefruit, consult with your doctor, as this may interact with your medication.
Be aware that medications like this one can cause high blood pressure. Follow your doctor's instructions for regular blood pressure checks.
Elevated triglyceride levels have been associated with this medication. If you have a history of high triglyceride levels, inform your doctor.
Adhere to your doctor's recommendations for regular blood tests and bone density checks.
It is crucial to maintain regular breast exams and gynecology check-ups, and to perform breast self-exams as instructed by your doctor.
This medication may affect the results of certain laboratory tests. Inform all your healthcare providers and laboratory personnel that you are taking this drug.
Refrain from smoking, as it increases the risk of heart disease. Consult with your doctor for guidance on quitting.
Limit your alcohol consumption while taking this medication.
The risk of certain side effects, such as heart attack, stroke, breast cancer, ovarian cancer, and others, may vary depending on factors like the duration of estrogen use, whether it is taken with or without a progestin, and other individual factors. Discuss the benefits and risks of using this medication with your doctor.
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Breast tenderness
- Abdominal pain
- Drowsiness/fatigue
- Vaginal bleeding (in women)
What to Do:
Seek immediate medical attention. There is no specific antidote. Treatment is symptomatic and supportive. Call 1-800-222-1222 (Poison Control Center) or go to the nearest emergency room.
Drug Interactions
Major Interactions
- CYP3A4 inducers (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, St. John's Wort): May decrease estrogen concentrations, potentially reducing efficacy.
- CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir, grapefruit juice): May increase estrogen concentrations, potentially increasing adverse effects.
- UGT1A1 inhibitors (e.g., atazanavir, indinavir): May increase bazedoxifene concentrations, potentially increasing adverse effects.
Moderate Interactions
- Thyroid hormone replacement therapy: Estrogens can increase thyroid-binding globulin (TBG), leading to increased circulating TBG and decreased free thyroid hormone. Patients on thyroid hormone replacement may require increased doses.
- Corticosteroids: Estrogens may decrease the metabolic clearance of corticosteroids, leading to increased corticosteroid effects.
- Oral anticoagulants (e.g., warfarin): Estrogens may diminish the anticoagulant effect of warfarin. Close monitoring of INR is recommended.
- Drugs metabolized by CYP1A2 (e.g., tizanidine, clozapine): Estrogens may inhibit CYP1A2, increasing concentrations of these drugs.
Minor Interactions
- Fluvoxamine: May increase bazedoxifene exposure (minor interaction).
Monitoring
Baseline Monitoring
Complete medical history and physical examination
Rationale: To identify pre-existing conditions, risk factors (e.g., VTE, breast cancer), and contraindications.
Timing: Prior to initiation of therapy
Blood pressure
Rationale: Estrogens can affect blood pressure.
Timing: Prior to initiation of therapy
Lipid profile
Rationale: Estrogens can affect lipid metabolism.
Timing: Prior to initiation of therapy
Liver function tests (LFTs)
Rationale: To assess hepatic function, especially given hepatic metabolism of both components.
Timing: Prior to initiation of therapy
Breast examination and mammography
Rationale: To screen for breast cancer, as estrogen therapy can increase risk.
Timing: Prior to initiation of therapy, as appropriate for age and risk factors
Pelvic examination and Pap test
Rationale: To screen for gynecological conditions, including cervical cancer.
Timing: Prior to initiation of therapy, as appropriate for age and risk factors
Routine Monitoring
Blood pressure
Frequency: Annually or as clinically indicated
Target: Normal range for age
Action Threshold: Significant elevation (e.g., >140/90 mmHg) warrants investigation and management.
Breast examination and mammography
Frequency: Annually (breast exam); biennially or as per national guidelines (mammography)
Target: No new masses or suspicious findings
Action Threshold: Any new lump, discharge, or suspicious mammogram finding requires immediate investigation.
Pelvic examination
Frequency: Annually or as clinically indicated
Target: No abnormal findings
Action Threshold: Any abnormal bleeding, pain, or mass requires investigation.
Lipid profile
Frequency: Periodically, as clinically indicated
Target: Optimal levels for cardiovascular health
Action Threshold: Significant adverse changes may warrant re-evaluation of therapy.
Symptom Monitoring
- Signs and symptoms of venous thromboembolism (VTE) such as leg pain, swelling, warmth, redness, sudden shortness of breath, chest pain.
- Signs and symptoms of stroke such as sudden severe headache, sudden numbness or weakness (especially on one side of the body), sudden vision changes, sudden trouble speaking or understanding speech, sudden dizziness or loss of balance.
- Signs and symptoms of myocardial infarction (MI) such as chest pain, discomfort in other areas of the upper body, shortness of breath, cold sweat, nausea, lightheadedness.
- Signs and symptoms of breast cancer such as new lump or mass, skin changes, nipple discharge.
- Signs and symptoms of endometrial cancer such as abnormal vaginal bleeding.
- Signs and symptoms of gallbladder disease such as right upper quadrant pain, nausea, vomiting.
- Signs and symptoms of liver dysfunction such as jaundice, dark urine, persistent nausea/vomiting, abdominal pain.
Special Patient Groups
Pregnancy
Duavee is contraindicated in pregnancy. There is no indication for Duavee in pregnant women. Estrogen administration during pregnancy has been associated with an increased risk of congenital anomalies of the reproductive organs in female fetuses and other adverse effects.
Trimester-Specific Risks:
First Trimester:
Increased risk of congenital anomalies, particularly reproductive organ abnormalities.
Second Trimester:
Not applicable, contraindicated.
Third Trimester:
Not applicable, contraindicated.
Lactation
Duavee is contraindicated during lactation. Estrogens are excreted in human milk and may decrease the quantity and quality of breast milk. Bazedoxifene is also likely excreted in human milk. Due to potential adverse effects on the infant, Duavee should not be used by nursing mothers.
Infant Risk:
High (L5) - Potential for adverse effects on the infant (e.g., feminization, decreased milk production).
Pediatric Use
Duavee is not indicated for use in pediatric patients. Safety and effectiveness have not been established in this population.
Geriatric Use
In the Women's Health Initiative (WHI) study, women 65 years of age and older treated with estrogen plus progestin or estrogen alone had an increased risk of probable dementia. While Duavee has not been studied in this specific context, caution should be exercised when considering use in women 65 years of age or older, weighing benefits against potential risks, particularly for cardiovascular events and dementia.
Clinical Information
Clinical Pearls
- Duavee is a unique estrogen-SERM combination that provides estrogen for symptom relief and bone protection, while bazedoxifene protects the uterus, eliminating the need for a progestin.
- It is indicated for moderate to severe vasomotor symptoms associated with menopause and for the prevention of postmenopausal osteoporosis.
- Patients should be counseled on the Black Box Warnings regarding cardiovascular events (stroke, VTE) and probable dementia, similar to other estrogen-containing therapies.
- Regular monitoring, including breast exams, mammograms, and pelvic exams, is crucial.
- Discontinue Duavee if a thrombotic event occurs or is suspected.
- Not for use in women with a uterus who have unexplained abnormal uterine bleeding.
- Consider the lowest effective dose for the shortest duration consistent with treatment goals and risks for the individual woman.
Alternative Therapies
- Other Selective Estrogen Receptor Modulators (SERMs) for osteoporosis prevention (e.g., Raloxifene)
- Non-hormonal therapies for vasomotor symptoms (e.g., SSRIs/SNRIs like paroxetine, venlafaxine; gabapentin; clonidine)
- Other osteoporosis treatments (e.g., Bisphosphonates, Denosumab, Teriparatide)
- Lifestyle modifications (e.g., diet, exercise, smoking cessation) for both symptom management and bone health.
Cost & Coverage
Average Cost:
$180 - $250 per 30 tablets
Insurance Coverage:
Tier 2 or Tier 3 (Brand-name prescription drug)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.