Conjugated Estrogens / Bazedoxifene

Duavee 0.45mg/20mg Tablets

Duavee (Conjugated estrogen / Bazedoxifene) is prescribed for postmenopausal women to manage vasomotor symptoms like hot flashes and night sweats and to prevent osteoporosis. It works by regulating estrogen levels using a combination of conjugated estrogens and bazedoxifene, a selective estrogen receptor modulator that balances the effects of estrogen. It is important to take Duavee as directed, typically once daily, and consult with a doctor regularly to monitor its effects and any potential side effects. Considerations include possible interactions with other medications, conditions like diabetes and heart disease, and contraindications such as liver tumors or a history of breast cancer.

Product Overview

Duavee is specifically approved for use in postmenopausal women to alleviate moderate to severe vasomotor symptoms associated with menopause, such as hot flashes and night sweats, and to help prevent osteoporosis, a common issue after menopause due to decreased bone density. The medication utilizes a dual-component approach, combining conjugated estrogens with bazedoxifene. Conjugated estrogens are a form of hormone replacement therapy that boosts estrogen levels, reducing menopausal symptoms and osteoporosis risk. Bazedoxifene acts as a selective estrogen receptor modulator (SERM), which helps modulate estrogen’s effects to prevent endometrial hyperplasia, a potential side effect of estrogen therapy.

Patients are advised to take Duavee once daily, with or without food, and to follow their doctor’s instructions closely. Regular medical check-ups are crucial to monitor the drug’s efficacy and side effects. Duavee is intended for short-term use, with the duration tailored to the individual’s symptoms and response to treatment. Duavee may interact with various medications and conditions. It can affect the metabolism of drugs processed by enzymes like CYP3A4 and may exacerbate conditions such as diabetes, hypertension, and liver disease. Patients must disclose their complete medical history, including any ongoing treatments, to their healthcare provider to avoid adverse effects.

Adverse reactions can range from mild, such as indigestion and dizziness, to severe, including blood clots and potential increases in cancer risk. It is contraindicated in women with certain cancers, liver disease, and those who are or may become pregnant. Effective communication with a healthcare provider is essential to navigate these risks and ensure the safe use of Duavee.

Uses of Duavee

Duavee is approved by the Food and Drug Administration for specific uses in females with a uterus. These include:

• Treating moderate to severe vasomotor symptoms associated with menopause, which include hot flashes and night sweats.
• Preventing osteoporosis following menopause.

How to Use Duavee?

Dosage

It comes in the form of an oral tablet and has one strength:

• Duavee 0.45mg/20mg tablets (0.45 milligrams (mg) conjugated estrogens and 20 mg bazedoxifene)

Recommended Dosage for Different Patients

Dosage for Treating Vasomotor Symptoms Due to Menopause

• Duavee is prescribed by doctors to manage vasomotor symptoms associated with menopause, which include conditions like hot flashes and night sweats.
• Recommended Dosage: The typical dosage involves taking one tablet daily.
• For detailed guidance on your specific dosage, particularly if you have other health concerns or are taking other medications, it is important to consult with your doctor. This discussion will help ensure the treatment is tailored to your individual health needs.

Dosage for Preventing Osteoporosis After Menopause

• Duavee is approved for use in preventing osteoporosis following menopause.
• Recommended Dosage: The standard dosage for this purpose is one tablet taken once daily.
• If you have any questions or concerns about your specific dosage, especially if you are managing other health conditions or medications, it is crucial to discuss these with your doctor. This will help ensure that your treatment plan is optimally tailored to your health requirements.

Long-term Treatment with Duavee

Duavee is generally prescribed for short-term use to address specific conditions related to menopause:

• Vasomotor Symptoms: It is used to treat symptoms such as hot flashes and night sweats during menopause.
• Osteoporosis Prevention: Duavee is also prescribed to help prevent osteoporosis after menopause.
• The duration of treatment with Duavee is typically limited to the period during which you are experiencing symptoms. It is not usually used indefinitely but rather for as long as it is needed to manage the symptoms effectively.

If you have questions or concerns about the duration of your treatment or when it might be appropriate to stop using Duavee, it is important to discuss these with your doctor. 

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Take Duavee exactly as your doctor has prescribed. Ensure you follow all the instructions provided on your prescription label and read any medication guides or instruction sheets that come with the medicine. Always use the medicine in the manner directed.
• Duavee should be used for the shortest duration necessary at the lowest effective dose to treat your condition.
• You can take Duavee with or without food, but for consistency, try to take it at the same time every day.
• Do not crush, chew, or break the tablet; swallow it whole.
• It’s important for your doctor to regularly check your progress to decide if you should continue taking Duavee. Additionally, you should self-examine your breasts for lumps each month and undergo regular mammograms.
• If you are scheduled for major surgery or will be on long-term bed rest, you might need to stop taking Duavee temporarily. Make sure any doctor or surgeon treating you is aware that you are using this medicine.
• Your doctor may also recommend taking extra calcium or vitamin D while you are on Duavee. Be sure to take only the amount of calcium or vitamin D that your doctor prescribes.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Duavee Work?

During menopause, levels of estrogen and progesterone—key female reproductive hormones that regulate the menstrual cycle—decline. This reduction can lead to vasomotor symptoms such as hot flashes and increase the risk of developing osteoporosis. Duavee functions by adjusting the estrogen levels in your body through a dual-component approach:

1. Conjugated Estrogen: These are a form of hormone replacement therapy (HRT). “Conjugated” estrogens refer to a combination of different types of estrogen. They help by boosting estrogen levels to mitigate menopausal symptoms and reduce osteoporosis risk.
2. Bazedoxifene: This component helps prevent the thickening of the endometrium (the lining of the uterus), which can lead to endometrial cancer if unchecked. Bazedoxifene acts like estrogen in certain parts of the body while opposing estrogen’s effects in others. It is categorized as a selective estrogen receptor modulator (SERM), which selectively mimics or blocks estrogen’s action depending on the target tissue.

Important Safety Information

Side Effects

Common side effects of Duavee may include:

• Neck pain
• Diarrhea
• Muscle spasms (muscle twitches or cramps)
• Nausea
• Upper abdominal (belly) pain
• Water retention (swelling), which usually occurs in your legs, hands, or feet
• Indigestion (upset stomach)
• Dizziness
• Sore throat

Serious side effects of Duavee may include:

• Retinal vascular thrombosis (a blood clot in a blood vessel in your retina). Signs may include:
  • Migraine
  • Blurry vision
  • Double vision
  • Bulging eyes
  • Sudden vision loss (usually in one eye)
• Allergic reaction.
• Dementia (trouble with thinking, memory, and communication).
• Hypertension (high blood pressure). 
• Unusual vaginal bleeding.
• Cardiovascular disease (disease of the blood vessels and heart), such as 
  • Some blood clots called venous thromboembolism (VTE)
  • Stroke
• Gallbladder disease.
• Cancer, such as endometrial cancer.

Symptoms of a Mild Allergic Reaction Include:

• Itchiness
• Flushing (swelling, warmth, or redness of the skin)
• Skin rash

Symptoms of a Severe Allergic Reaction:

• Swelling of the tongue, throat, or mouth
• Swelling under the skin, often seen in the lips, eyelids, feet, or hands
• Difficulty breathing

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

This medication carries a boxed warning, the most serious type of warning issued by the Food and Drug Administration (FDA). It alerts healthcare professionals and patients to potential severe risks associated with the drug.

Specific Risks Included in the Warning:

• Endometrial Cancer Risk: There is an increased risk of endometrial cancer in individuals with a uterus when taking drugs that contain estrogen, such as Duavee. Report any abnormal vaginal bleeding to your doctor immediately.
• Cardiovascular Disease Risk: Clinical trials have shown an increased risk of cardiovascular problems, including stroke and deep vein thrombosis (DVT) when estrogen is used alone for hormone replacement therapy (HRT). Duavee is not prescribed for the prevention of cardiovascular issues.
• Dementia Risk: In clinical trials, the use of estrogen alone for HRT increased the risk of dementia in individuals aged 65 and older after menopause. Therefore, Duavee is not used for dementia prevention.

Due to these risks, it is typically recommended that Duavee be used for the shortest duration necessary. Discuss your specific risks and treatment options with your doctor or pharmacist.

If prescribed Duavee, ensure you do not take any other medications containing estrogen without your doctor’s approval. Inform your doctor about all other medications you are taking to avoid potential interactions.

Precautions

Before starting treatment with Duavee, it’s crucial to discuss your complete health history with your doctor. Duavee may not be suitable if you have certain medical conditions or factors that could be impacted by its use:

• Diabetes: Duavee can influence your blood glucose levels. If you have diabetes, inform your doctor prior to starting Duavee so they can monitor your blood sugar more closely. Adjustments to your diabetes medications may be necessary during treatment with Duavee.
• Asthma: Duavee may exacerbate asthma symptoms. Changes in estrogen levels due to Duavee could lead to airway swelling, potentially triggering an asthma attack. It’s important to discuss your asthma with your doctor before beginning Duavee, as they might consider a different treatment option.
• Epilepsy: If you have epilepsy, the changes in estrogen levels associated with Duavee could trigger seizures. Since Duavee contains conjugated estrogens, which can affect seizure control, your doctor needs to be aware of your condition. They may need to monitor your epilepsy more closely or suggest an alternative treatment.
• Heart Failure: Individuals with heart failure may experience difficulty in fluid regulation, leading to swelling in the lower legs or hands. Since water retention is a common side effect of Duavee, it could exacerbate swelling associated with heart failure. Inform your doctor about any heart conditions before starting Duavee. They may need to monitor your fluid levels more intensively during treatment.
• High Triglyceride Levels: If you have high triglyceride levels, use caution with Duavee, as it can further increase these levels, potentially leading to pancreatitis. Your doctor should check your triglyceride levels before starting you on Duavee. Depending on your levels, they may choose to monitor your triglycerides more closely or recommend a different treatment option.
• Liver Tumors: Duavee may worsen certain types of liver tumors. Make sure to disclose any history of liver cancer or liver tumors to your doctor prior to beginning treatment with Duavee.
• Migraine: Changes in estrogen levels, such as those that might occur with Duavee use, can trigger migraines. If you are prone to migraines, discuss this with your doctor. They may consider an alternative treatment to avoid provoking migraine attacks.
• Lupus: If you have lupus, be aware that Duavee might trigger a lupus flare due to changes in estrogen levels, as Duavee contains estrogen. Discuss your condition thoroughly with your doctor before starting Duavee, as they might suggest an alternative treatment.
• Hereditary Angioedema (HAE): Duavee may exacerbate swelling issues, particularly of the face or tongue, in individuals with HAE. It is crucial to weigh the risks and benefits of using Duavee if you have this condition. Discuss with your doctor to determine the best course of action.
• Other Hormone Therapy: If you are currently on other forms of hormone therapy, such as additional estrogens, progestins, or selective estrogen receptor modulators (SERMs), there may be an increased risk of side effects from Duavee. Ensure all your current medications are known to your doctor to adjust your treatment plan as necessary.
• History of Jaundice: If you have previously experienced jaundice, especially related to liver problems, you may be at increased risk of developing jaundice again with Duavee use. Your doctor may need to monitor your liver function more closely or consider a different medication.
• Surgery or Bed Rest: Both surgery and prolonged bed rest increase the risk of blood clots, which is also a known side effect of Duavee. Inform your doctor if you are planning surgery or expect to be on bed rest while taking Duavee, as it may be necessary to reevaluate your treatment plan to minimize the risk of blood clots.
• Hypothyroidism: Duavee may lower thyroid hormone levels. If you have hypothyroidism and are taking thyroid replacement therapy, Duavee could further decrease your thyroid levels, necessitating adjustments in your medication dosage. Frequent monitoring of your thyroid function might be required. Discuss any concerns with your doctor to ensure your thyroid condition remains well-managed while on Duavee.
• Hypoparathyroidism: If you have hypoparathyroidism, characterized by low levels of parathyroid hormone, you may also have hypocalcemia or low calcium levels in your body. Taking Duavee could further decrease your calcium levels, which may lead to complications such as osteoporosis. Inform your doctor if you have hypoparathyroidism before starting Duavee so they can monitor your calcium levels more closely during treatment.
• Porphyria: This genetic condition affects the skin and nervous system and can be exacerbated by estrogens. Since Duavee contains estrogen, it’s important to discuss with your doctor if you have porphyria, as they might recommend a different treatment that is safer for your condition.
• Kidney Problems: Kidney issues, such as kidney disease, often lead to water retention, causing swelling in the lower legs or hands. Duavee also has the potential to cause water retention, which could worsen swelling if you have existing kidney problems. Duavee is generally not recommended for individuals with kidney issues. Make sure to tell your doctor about any kidney problems you have; they may suggest an alternative treatment that better suits your health needs.
• Weight Changes: Weight gain and loss are not directly associated with Duavee as side effects, according to clinical studies of the drug. If you experience unexplained weight loss while taking Duavee, it’s important to consult your doctor immediately. This symptom could be indicative of serious health issues, including some types of cancer. Duavee may increase the risk of certain cancers, such as endometrial, ovarian, and breast cancer. It is common for women to experience weight gain during menopause. Typically, women in their 50s and 60s may gain an average of 1.5 pounds (0.7 kilograms) per year. There is also a tendency to accumulate more fat around the abdomen compared to other areas of the body.

Other Important Precautions 

• Alcohol: Consuming alcohol during menopause can exacerbate symptoms such as hot flashes, which Duavee aims to treat. Additionally, the National Institutes of Health caution that long-term excessive alcohol use can lead to osteoporosis—a condition of weakened bones that Duavee also addresses. Since menopause itself increases the risk of osteoporosis, individuals going through menopause with a history of heavy alcohol consumption may face an even higher risk. Drinking alcohol while taking Duavee may also heighten the likelihood of experiencing certain side effects associated with the medication. It’s important to discuss your alcohol consumption with your healthcare provider to ensure the safe and effective use of Duavee.
• Pregnancy: Duavee is not recommended during pregnancy as it is specifically approved for postmenopausal women who are no longer able to become pregnant. There are no clinical studies evaluating the safety of Duavee in pregnant women. While animal studies do not always predict human outcomes, they suggest potential risks. If you are pregnant or planning to become pregnant, discuss alternative treatments with your doctor that may be safer during pregnancy. However, studies in animals have shown potential risks when bazedoxifene, one of the active ingredients in Duavee, is used during pregnancy. These risks include:
  • Reduced number of live offspring
  • Lower birth weights
  • Increased risk of certain heart and skeletal defects in offspring
• Fertility: Duavee may impact fertility, but it is approved for use only in women who have gone through menopause and are not expected to conceive. Although the effects of Duavee on human fertility have not been studied, animal studies with bazedoxifene have indicated possible fertility issues. It’s important to note that animal results may not directly apply to humans. If you have concerns about fertility, please consult your doctor.
• Birth Control: Since Duavee is intended for postmenopausal women, it is not a concern for those who can still become pregnant. However, if you are taking Duavee and have questions about birth control, it is best to discuss them with your doctor.
• Breastfeeding: Duavee is not advised for use during breastfeeding. Although it is generally prescribed to postmenopausal women who are unlikely to breastfeed, it’s important to consider that estrogen, one of the active drugs in Duavee, can affect breast milk production and quality. Estrogen is known to be present in small amounts in breast milk, but its effects on a breastfeeding infant are not fully understood. The passage of Duavee’s other active ingredient, bazedoxifene, into breast milk has not been studied; if you are breastfeeding or plan to, discuss your treatment options with your doctor to ensure the safety of both you and your child.

Contraindications

Duavee should not be used by women who have any of the following conditions:

• Women with undiagnosed abnormal uterine bleeding should not take Duavee until a diagnosis is established.
• If you have had anaphylactic reactions or angioedema related to Duavee or any of its components, you should avoid this medication.
• Women with clotting disorders, such as deficiencies in antithrombin, protein C, or protein S, should not use Duavee because it increases the risk of clotting.
• Those with a past or current diagnosis of breast cancer or suspected breast cancer are advised against using Duavee.
• Women with a current or suspected diagnosis of cancers, especially estrogen-dependent Neoplasia that grows with estrogen, should avoid Duavee.
• Women with a history of or current diagnosis of VTE or arterial thromboembolism should not take Duavee.
• Women with liver disease should avoid this medication due to potential complications.
• Duavee is contraindicated in pregnancy as it is intended for use only in postmenopausal women.

Missed Dose

• If you miss a dose of Duavee, take it as soon as you remember.
• If it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to compensate for the one you missed.
• If you are unsure about whether to take a missed dose or skip it, consult your doctor or pharmacist for guidance.
• To ensure you do not forget to take your medication, consider using a reminder system. This could be setting an alarm, placing reminder notes in visible locations such as your bathroom mirror or bedside table, or using a medication reminder app on your smartphone. These strategies can help maintain consistent treatment and maximize the effectiveness of your medication regimen.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

It is crucial to follow your doctor’s prescribed dosage for Duavee. Taking more than recommended can lead to overdose, which may cause harmful effects. Symptoms of Overdose May Include:

• Nausea
• Vomiting
• Abdominal pain
• Extreme tiredness
• Breast tenderness
• Dizziness
• Withdrawal bleeding

If you suspect an overdose, call your doctor immediately. Contact America’s Poison Centers at 800-222-1222 or use their online tool for guidance. If you experience severe symptoms, call 911 or your local emergency number or go directly to the nearest emergency room. Prompt action is essential in managing an overdose effectively.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

• Store Duavee tablets at room temperature, ideally between 68°F to 77°F (20°C to 25°C).
• Keep the medication in its original packaging to protect it from light.
• Avoid storing the medication in damp or wet areas, such as bathrooms, to prevent degradation.
• If you have leftover Duavee tablets after completing your treatment, it is important to dispose of them safely. Proper disposal helps prevent accidental ingestion by children or pets and minimizes environmental impact.
• Consult your pharmacist or local waste management guidelines for safe disposal methods.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Duavee Interactions

Duavee may interact with various medications, supplements, and foods. These interactions can have different impacts. Some may affect the effectiveness of the medication, while others can intensify side effects or make them more severe. It’s essential to consider these potential interactions to ensure the safe and effective use of Duavee.

Interactions with Other Medications

Here are some insights into medications that can interact with Duavee. Note that this is not an exhaustive list of all possible drug interactions. Before starting Duavee, it’s crucial to discuss with your doctor and pharmacist. Inform them about all medications you are currently taking, including prescription drugs, over-the-counter medications, and any vitamins, herbs, or supplements. This comprehensive information sharing helps prevent potential interactions. If you have any concerns about drug interactions that might affect you, be sure to consult with your doctor or pharmacist for more detailed guidance.

Interactions with CYP3A4 Inhibitors: Duavee is metabolized in your body by an enzyme called CYP3A4, which helps clear the medication from your system. CYP3A4 inhibitors are a category of drugs that block this enzyme’s activity. When CYP3A4 is inhibited, the levels of Duavee in your blood can increase, potentially heightening the risk of side effects. Examples of CYP3A4 Inhibitors Include:

• Antifungals: Itraconazole (Sporanox) and ketoconazole.
• Antibiotics: Erythromycin and clarithromycin.
• Antiviral: Ritonavir.

It’s important to tell your doctor about all medications you are currently taking before starting Duavee. This allows your doctor to identify any CYP3A4 inhibitors and make necessary adjustments to your treatment plan to manage the risk of increased side effects.

Interactions with CYP3A4 Inducers: CYP3A4 is an enzyme in your body that helps break down Duavee, aiding in its clearance from the system. CYP3A4 inducers are drugs that increase the activity of this enzyme. When CYP3A4 is overly active, it can lower the levels of Duavee in your blood, potentially reducing the drug’s effectiveness. Examples of CYP3A4 Inducers Include:

• Seizure Medications: Carbamazepine (Carbatrol, Tegretol) and phenobarbital.
• Antibiotic: Rifampin (Rifadin).

You must inform your doctor about your medications before you begin treatment with Duavee. This information helps your doctor identify any CYP3A4 inducers and potentially adjust your medication regimen to ensure the effectiveness of Duavee is not compromised.

Interactions with UGT Inducers: Duavee contains bazedoxifene as one of its active ingredients, metabolized by an enzyme known as uridine diphosphate glucuronosyltransferase (UGT). UGT inducers are drugs that increase the activity of this enzyme. When UGT is overactive, it can decrease the levels of bazedoxifene in your blood. This reduction might increase your risk for endometrial cancer, a potential side effect of Duavee. Examples of UGT Inducers Include:

• Seizure Medications: Carbamazepine (Carbatrol, Tegretol), phenobarbital, and phenytoin (Dilantin).
• Antibiotic: Rifampin (Rifadin).

Before starting treatment with Duavee, you must inform your doctor about all your medications. This will allow your doctor to determine if any of the drugs are UGT inducers, and they may need to adjust your medications accordingly to manage the risk of decreased bazedoxifene levels effectively.

Caution Advised When Using Duavee with Thyroid Medications: Duavee may affect thyroid hormone levels in your body. If you are taking medications that regulate thyroid hormones, using Duavee concurrently could potentially diminish the effectiveness of these thyroid medications.

Interactions with Thyroid Replacement Therapy

Thyroid replacement medications are prescribed to increase thyroid hormone levels in individuals with hypothyroidism, an underactive thyroid gland. Common examples of these drugs include:

• Levothyroxine (Levoxyl, Synthroid)
• Liothyronine (Cytomel)
• Liotrix (Thyrolar)

When taking Duavee in conjunction with any thyroid replacement drugs, your doctor might need to adjust the dosage of your thyroid medication. This adjustment is necessary because Duavee can reduce the levels of thyroid hormones in your body.

Additionally, your doctor may conduct thyroid function tests more frequently than usual. This regular monitoring ensures that your thyroid hormone levels remain within a healthy range while you are on Duavee and thyroid replacement therapy. If you have any concerns or questions about how Duavee interacts with your thyroid replacement drugs, it is essential to discuss these with your doctor. They can provide specific guidance and adjust your treatment plan to maintain optimal health.

Interactions with Herbs and Supplements

While the manufacturer of Duavee has not explicitly reported interactions with herbs or supplements, it’s still crucial to consult with your doctor or pharmacist before using any such products alongside Duavee. This precaution helps to ensure that your treatment remains safe and effective.

• Black Cohosh: Often used to manage menopausal hot flashes, black cohosh could increase the risk of side effects when taken with Duavee. This is because black cohosh can produce side effects that mimic those of Duavee. If you’re considering using black cohosh for hot flashes, discuss its safety and potential interactions with your doctor.
• St. John’s Wort: This herb may reduce the effectiveness of Duavee. It’s important to communicate with your healthcare provider before adding St. John’s wort, or any other herb or supplement, to your regimen while you are on Duavee.

Always inform your healthcare providers about any herbs or supplements you are using or plan to use while taking Duavee. This allows them to guide you appropriately and adjust your treatment if necessary to avoid any adverse interactions. If you have specific questions about using herbs or supplements with Duavee, your doctor or pharmacist is your best resource for tailored advice.

Interactions with Food Interactions

Certain foods can interact with Duavee, potentially affecting how the medication works in your body. You must be aware of these interactions to manage your treatment effectively.

Specific Food Interaction – Grapefruit: Consuming grapefruit or drinking grapefruit juice while taking Duavee can increase the levels of Duavee in your bloodstream. This heightened concentration may lead to an increased risk of experiencing side effects from the medication.

If you are taking Duavee and have concerns about your diet or specific foods like grapefruit, discussing these with your doctor is crucial. Your doctor can provide guidance on what foods to avoid to ensure the medication remains effective and safe.

Interactions with Lab Tests

Duavee can influence the results of various laboratory tests. If you are taking Duavee, it’s important to be aware of these potential impacts to ensure accurate test results. lab tests that may be affected include:

• Blood Tests: Such as those measuring blood clotting factors.
• Cholesterol Tests: Used to evaluate lipid levels.
• Cortisol Level Tests: These assess cortisol, a hormone linked to stress response.
• Glucose Tolerance Tests: These determine how your body processes glucose.
• Reproductive Hormone Levels: Tests that measure hormones like testosterone and estrogen.
• Thyroid Function Tests: These evaluate how well your thyroid gland is working.

Before undergoing any lab tests while on Duavee, inform your doctor about your medication use. This is crucial as it helps in interpreting your lab results accurately. If you have concerns or questions about how Duavee might affect your lab tests, discuss them with your doctor for clarity and guidance.

[Note: This isn’t a complete list, and there could be other drugs that interact with Duavee. Make sure to tell your doctor about any prescription, over-the-counter, or herbal products you’re taking.]

Duavee Alternatives

• Evista (raloxifene)
• Celexa (citalopram)
• Boniva (ibandronate)
• Gralise (gabapentin)
• Neurontin (gabapentin)
• Effexor XR (venlafaxine)
• Fosamax (alendronate)
• Prempro (estrogen/medroxyprogesterone)
• Premphase (estrogen/medroxyprogesterone)
• Actonel (risedronate)
• Lyrica (pregabalin)
• Brisdelle (paroxetine)
• Catapres (clonidine)
• Premarin (conjugated estrogens)
• Premarin Vaginal Cream (Conjugated Estrogens)
• Reclast (zoledronic acid)
• Estrace (estradiol) taken by mouth
• Alora (estradiol patch) applied to skin
• Climara (estradiol patch) applied to skin
• Minivelle (estradiol patch) applied to the skin
• Vivelle-Dot (estradiol patch) applied to skin
• Depo-Estradiol (estradiol) injected into muscle
• Delestrogen (estradiol) injected into muscle
• Divigel (estradiol gel) applied to skin
• EstroGel (estradiol gel) applied to skin
• Evamist (estradiol spray) applied to the skin
• Femring (estradiol ring) placed in vagina
• Activella (estradiol/norethindrone) taken by mouth
• Amabelz (estradiol/norethindrone) taken by mouth
• Lopreeza (estradiol/norethindrone) taken by mouth
• Angeliq (estradiol/drospirenone) taken by mouth
• Climara Pro (estradiol / levonorgestrel) applied to skin
• Femhrt (ethinyl estradiol/norethindrone) taken by mouth
• Jevantique Lo (ethinyl estradiol/norethindrone) taken by mouth
• Jinteli (ethinyl estradiol/norethindrone) taken by mouth
• Prefest (estradiol/norgestimate) taken by mouth
• Menest (esterified estrogens) taken by mouth
• Covaryx (estrogen/methyltestosterone) taken by mouth
• Estropipate, taken by mouth

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Frequently Asked Questions

How long does it take for Duavee to start working?

Duavee begins to act after the first dose, but it might take about a month for you to notice improvements in menopausal symptoms like hot flashes. The full benefits of the medication could take up to three months to manifest. When used for preventing osteoporosis, the effectiveness of Duavee is often monitored through bone mineral density tests conducted by your doctor during treatment. If you have any questions about what to expect while taking Duavee, it’s important to discuss them with your doctor for clarity and guidance.

How do I stop taking Duavee?

To stop taking Duavee, it’s essential to consult with your doctor first. Throughout your treatment, your doctor will monitor your progress to determine how long you should continue using the medication, aiming to prescribe it for the shortest time necessary to effectively manage your condition while minimizing side effects. If you’re considering stopping Duavee, your doctor can explain the risks and benefits of discontinuing the treatment and provide guidance on how to safely stop using the drug. This approach ensures that you manage your health effectively and avoid potential complications from abruptly stopping the medication.

What time of day should you take Duavee?

You can take one Duavee tablet orally once a day at any time that suits you, regardless of meals. If you are also taking supplemental calcium and/or vitamin D, you may take them simultaneously with Duavee. If you happen to miss a dose, simply take it as soon as you remember.

Do I need progesterone with Duavee?

No, you do not need to take progesterone with Duavee (conjugated estrogens/bazedoxifene). Typically, postmenopausal women with a uterus who take estrogen alone may experience thickening of the uterus lining, known as the endometrium. However, Duavee includes bazedoxifene, which helps counteract this effect of estrogen on the endometrium, reducing the need for progesterone.

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