Last reviewed 2026-04-20 · How we verify

Duavee (Bazedoxifene Acetate)

Pairs conjugated estrogens with bazedoxifene to bind and activate estrogen receptors α and β with tissue-specific effects.

DUAVEE is a combination hormone therapy pairing conjugated estrogens with bazedoxifene, a selective estrogen receptor modulator, indicated for moderate to severe vasomotor symptoms and postmenopausal osteoporosis prevention in women with a uterus. The bazedoxifene component provides tissue-selective antagonism in the uterus, reducing endometrial hyperplasia risk compared to estrogen monotherapy. Key risks include cardiovascular events, malignant neoplasms, and venous thromboembolism, requiring careful patient selection and periodic re-evaluation. The drug should be used for the shortest duration consistent with individual treatment goals and risk profiles.

At a glance

Mechanism of action

DUAVEE combines conjugated estrogens with bazedoxifene, both of which bind to and activate estrogen receptors α and β. Conjugated estrogens function as agonists at both ER-α and ER-β, while bazedoxifene acts as a selective estrogen receptor modulator (SERM), functioning as an agonist in some estrogen-sensitive tissues and an antagonist in others, such as the uterus. The pairing produces a composite effect specific to each target tissue, with the bazedoxifene component reducing the risk of endometrial hyperplasia that can occur with conjugated estrogens alone.

Approved indications

• Treatment of moderate to severe vasomotor symptoms associated with menopause
• Prevention of postmenopausal osteoporosis

Boxed warnings

• WARNING: ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, AND PROBABLE DEMENTIA • Women taking DUAVEE should not take additional estrogens [see Warnings and Precautions (5.1) ] • There is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens. DUAVEE has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer. Adequate diagnostic measures, including directed or random endometrial sampling when indicated, should

Common side effects

• Muscle spasms
• Nausea
• Diarrhea
• Dyspepsia
• Abdominal pain upper
• Oropharyngeal pain
• Dizziness
• Neck pain

Serious adverse events

• Serious adverse reactions
• Venous thromboembolism

Drug interactions

• Itraconazole (strong CYP3A4 inhibitor)
• St. John's Wort (Hypericum perforatum), phenobarbital, carbamazepine, rifampin (CYP3A4 inducers)
• Rifampin, phenobarbital, carbamazepine, phenytoin (UGT inducers)
• Atorvastatin