The short answer
Duavee combines conjugated estrogens with bazedoxifene, a SERM that protects the uterine lining in place of a progestin. It is FDA-approved for people with a uterus to treat moderate-to-severe menopause hot flashes and to prevent postmenopausal osteoporosis. It carries the estrogen class boxed warnings and should not be combined with additional estrogens or progestins.
Boxed warning on the current Duavee label
The current Duavee label (DailyMed, updated April 2026) carries a boxed warning for endometrial cancer, cardiovascular disorders, and probable dementia. It states that women taking Duavee should not take additional estrogens, that estrogen therapy should not be used to prevent cardiovascular disease or dementia, and that the WHI estrogen-alone study reported increased risks of stroke and deep vein thrombosis. The FDA's November 2025 class initiative to remove some hormone therapy boxed-warning language has not changed this product's boxed warning as of our October 2026 check. Duavee should not be combined with a progestin or another SERM.
It should be used for the shortest duration consistent with treatment goals and reassessed periodically. Any abnormal vaginal bleeding needs evaluation.
Current label check
The medication-specific claims on this page were checked against these current product labels on 2026-10-03.
| Product label | Label date | Boxed warning on that label |
|---|---|---|
| Duavee (conjugated estrogens/bazedoxifene) | 2026-04-28 | Endometrial cancer, cardiovascular disorders, probable dementia |
Established evidence
What is Duavee?
Duavee is a once-daily tablet containing conjugated estrogens and bazedoxifene. The pairing is called a tissue-selective estrogen complex (TSEC). The estrogen treats hot flashes and protects bone; bazedoxifene blocks estrogen's effect on the uterine lining.
Availability of this product has been interrupted in the past, so current pharmacy supply should be confirmed with a pharmacist rather than assumed.
Who it is designed for
It is labeled for people with a uterus. Some people who experience mood, bloating, or breast tenderness side effects with progestins discuss Duavee as an alternative way to protect the endometrium. It is not intended for people who have had a hysterectomy, who typically use estrogen alone.
Established evidence
What the SMART trials showed
The Selective estrogens, Menopause, And Response to Therapy (SMART) trials showed reductions in hot flash frequency and severity versus placebo, preserved bone mineral density, and low rates of endometrial hyperplasia over up to two years. Fracture reduction was not a primary trial endpoint for this combination.
Established evidence
Who should not use it
- Undiagnosed abnormal uterine bleeding
- Known, suspected, or past breast cancer or estrogen-dependent cancer
- Active or past blood clots, stroke, or heart attack
- Liver impairment or disease
- Known protein C, protein S, or antithrombin deficiency
- Pregnancy
Established evidence
Common side effects
- Muscle spasms
- Nausea, diarrhea, indigestion, abdominal pain
- Throat pain
- Dizziness
- Neck pain
Duavee vs estrogen plus progestogen
| Feature | Duavee | Estradiol + micronized progesterone |
|---|---|---|
| Uterine protection | Bazedoxifene (SERM) | Progesterone or progestin |
| Estrogen type | Conjugated estrogens | Estradiol (oral or transdermal) |
| Route | Oral only | Oral, patch, gel, or spray estrogen |
| Bone | Approved to prevent osteoporosis | Estrogen is approved to prevent osteoporosis |
| Breast tenderness or bleeding | Lower rates reported in trials | Varies by regimen |
Questions to ask a healthcare professional
- Would transdermal estradiol suit my clot risk better than an oral product?
- Is Duavee currently available at my pharmacy?
- How will we monitor my uterine lining and bone health?
Questions, answered
What people ask about Duavee
Does Duavee contain a progestin?+
No. It uses bazedoxifene, a SERM, to protect the uterine lining instead of a progestin.
Is Duavee hormone therapy?+
Yes. It contains conjugated estrogens. Its current label carries a boxed warning for endometrial cancer, cardiovascular disorders, and probable dementia.
Does Kindr Health offer Duavee?+
This page is educational and does not state or imply availability through Kindr Health.
Kindr Health does not claim to offer Duavee on this page. Availability and prescribing are not implied.
A broader care pathway
Explore menopause care
Learn how Kindr Health care pathways work. An educational page is not a statement that this medication is available or appropriate for you.
SOURCES & REFERENCES
Every clinical claim on this page is sourced.
- Duavee prescribing information (current label) (2026) — DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Duavee
- The 2022 hormone therapy position statement of The North American Menopause Society (2022) — The Menopause Society (Menopause journal). pubmed.ncbi.nlm.nih.gov/35797481
This resource is educational and does not replace individualized medical advice. Do not start, stop, or change a prescription without guidance from a licensed healthcare professional.