Bazedoxifene

(in DUAVEE)

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Pronunciation: ba-ze-DOX-i-feen

Bazedoxifene ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Bazedoxifene ballicule

What it isSERM sold only with conjugated estrogens (Duavee); menopausal vasomotor symptoms and osteoporosis prevention with intact uterus.

Why this oneBazedoxifene antagonizes the endometrium, allowing menopausal estrogen therapy without a progestin: a “tissue-selective estrogen complex.”

What limits itSERM-class venous thromboembolism risk persists, and the combination is for women with a uterus who cannot or will not take progestins.

Pearls

Not for osteoporosis alone; vasomotor relief should be the reason to use it.

Bazedoxifene molecular structure (skeletal formula) — Molecular structure: Bazedoxifene

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Sedation liability1 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk4 / 4

Defining liabilityVenous thromboembolism

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Endometrial cancer, cardiovascular disorders (stroke, DVT), and probable dementia; do not use estrogen therapy to prevent cardiovascular disease or dementia; do not take with additional estrogens.

FDA dosing	Population	Start	Target	Max
Moderate–severe vasomotor symptoms of menopause	Postmenopausal women with a uterus	1 tablet QD	1 tablet (CE 0.45 mg/bazedoxifene 20 mg) QD	1 tablet QD
Prevention of postmenopausal osteoporosis	Postmenopausal women with a uterus	1 tablet QD	1 tablet QD	1 tablet QD

Renal Not recommended (not studied in renal impairment)

Hepatic Contraindicated (hepatic impairment or disease)

Instructions

One tablet once daily, with or without meals; swallow whole
Do not take with additional estrogens, progestins, or estrogen agonist/antagonists
Add supplemental calcium and/or vitamin D if dietary intake inadequate (osteoporosis prevention)
Use for the shortest duration consistent with treatment goals

Available strengths

tab 20/0.45 mg

Contraindications

Undiagnosed abnormal uterine bleeding
Known, suspected, or past history of breast cancer
Known or suspected estrogen-dependent neoplasia
Active or past venous thromboembolism (DVT/PE)
Active or past arterial thromboembolism (e.g., stroke, MI)
Known hepatic impairment or disease
Known protein C, protein S, or antithrombin deficiency or other thrombophilic disorders
Pregnancy

Cautions

Cardiovascular disorders (VTE, stroke)
Malignant neoplasms (endometrial, breast, ovarian)
Gallbladder disease
Retinal vascular thrombosis
Hypertriglyceridemia leading to pancreatitis
Hepatic impairment / cholestatic jaundice
Hypothyroidism (increased thyroid-binding globulin)
Fluid retention
Hypocalcemia
Hereditary angioedema exacerbation

Adverse reactions

Muscle spasms
Nausea
Diarrhea
Dyspepsia
Upper abdominal pain
Oropharyngeal pain
Dizziness
Neck pain

Pregnancy Contraindicated in pregnancy; may cause fetal harm.

Lactation Not indicated in females of reproductive potential; estrogens present in milk and can reduce milk production.

Cost

Bazedoxifene ((IN DUAVEE))

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	brand $/mo	CostPlus
20/0.45 mg	tab	30 qd	—	$194.38	offered

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Self-check

Which partner accompanies bazedoxifene in US DUAVEE?
Conjugated estrogens.
Why can that combination omit a progestin?
Bazedoxifene antagonizes the endometrium.