Duavee Disease Interactions
There are 23 disease interactions with Duavee (bazedoxifene / conjugated estrogens).
- Abnormal vaginal bleeding
- Breast cancer
- CV disorders
- Hepatic impairment
- Abnormal vaginal bleeding
- Carcinomas (estrogenic)
- Hypercalcemia in breast cancer
- Hypertension
- Thromboembolism/cardiovascular
- Hepatic neoplasms
- Hypothyroidism
- Renal dysfunction
- Angioedema
- Gallbladder disease
- Hypercalcemia
- Hyperlipidemia
- Liver disease
- Melasma
- Depression
- Fluid retention
- Glucose intolerance
- Retinal thrombosis
- Thyroid function tests
Bazedoxifene (applies to Duavee) abnormal vaginal bleeding
Major Potential Hazard, Moderate plausibility. Applicable conditions: Abnormal Uterine Bleeding
The use of bazedoxifene is contraindicated in women with any undiagnosed abnormal genital bleeding. There is an increased risk of endometrial hyperplasia and endometrial cancer in patients using estrogens. Adequate diagnostic measures should be undertaken to rule out malignancy in any postmenopausal woman with undiagnosed persistent or recurring abnormal genital bleeding.
Bazedoxifene (applies to Duavee) breast cancer
Major Potential Hazard, Moderate plausibility. Applicable conditions: Neoplasia -- Estrogen Dependent
Bazedoxifene has not been studied in women with breast cancer, therefore should not be used in women with known, suspected or with a history of breast cancer. Additionally, bazedoxifene is contraindicated in the presence of any known or suspected estrogen-dependent neoplasia.
Bazedoxifene (applies to Duavee) CV disorders
Major Potential Hazard, Moderate plausibility. Applicable conditions: Thrombotic/Thromboembolic Disorder, Hyperlipidemia, Smoking, Cardiovascular Disease, Lupus Erythematosus, Obesity, Diabetes Mellitus
The use of bazedoxifene, alone or in combination is known to increase the risk of venous thromboembolism (VTE). Bazedoxifene is contraindicated in women with active DVT, pulmonary embolism, active arterial thromboembolic disease (such as stroke or myocardial infarctions), or a history of any of these conditions. Other risk factors for cardiovascular disorders and/or venous thromboembolism such as hypertension, diabetes, smoking, hypercholesterolemia, obesity, lupus erythematosus (in personal or family history), should be evaluated and managed appropriately.
Bazedoxifene (applies to Duavee) hepatic impairment
Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease
The use of bazedoxifene in combination with conjugated estrogens is contraindicated in patients with known hepatic impairment or disease. The pharmacokinetics of conjugated estrogens in combination with bazedoxifene tablets have not been evaluated in women with hepatic impairment.
Estrogens (applies to Duavee) abnormal vaginal bleeding
Major Potential Hazard, High plausibility. Applicable conditions: Abnormal Uterine Bleeding
The use of estrogens is contraindicated in patients with undiagnosed, abnormal vaginal bleeding. Prolonged (> 1 year), unopposed estrogen use (i.e. estrogen without concomitant progestin therapy) has been associated with a significant, dose-related risk of endometrial carcinoma. The risk may be offset substantially by the addition of a progestin but may not be completely abolished. Prior to initiating estrogen therapy, appropriate diagnostic tests should be performed in patients with abnormal vaginal bleeding to rule out endometrial malignancy. The same applies if recurrent or persistent bleeding develops during estrogen therapy.
Estrogens (applies to Duavee) carcinomas (estrogenic)
Major Potential Hazard, High plausibility. Applicable conditions: Neoplasia -- Estrogen Dependent
The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.
Estrogens (applies to Duavee) hypercalcemia in breast cancer
Major Potential Hazard, Moderate plausibility.
When treated with an estrogen, patients with breast cancer and bone metastases may develop severe hypercalcemia, in which case the drug should be stopped and measures be taken to reduce serum calcium levels.
Estrogens (applies to Duavee) hypertension
Major Potential Hazard, High plausibility.
The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.
Estrogens (applies to Duavee) thromboembolism/cardiovascular
Major Potential Hazard, Moderate plausibility. Applicable conditions: Migraine, History - Thrombotic/Thromboembolic Disorder, Cerebral Vascular Disorder, Ischemic Heart Disease, Thrombotic/Thromboembolic Disorder
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic or thromboembolic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Although the clinical significance of these effects is unknown, epidemiological data suggest it may be dose-dependent. The risk is probably slight with the use of newer, low-dose oral contraceptives in the absence of known risk factors (e.g., smoker, particularly over the age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40). However, a much more significant risk has been reported with higher dosages, such as those used to treat prostate or metastatic breast cancer or those used in older formulations of birth control pills. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of breast or prostatic malignancy.
Estrogens/progestogens (applies to Duavee) hepatic neoplasms
Major Potential Hazard, High plausibility. Applicable conditions: Hepatic Tumor
The use of oral contraceptives is contraindicated in patients with liver tumors. An increased risk of benign hepatic adenomas and hepatocellular carcinomas has been associated with long-term, oral estrogen- progestin contraceptive use of at least 4 years and 8 years, respectively. Although these tumors are rare and have not been reported with other types of estrogen or progestogen therapies, any preparation containing estrogens and/or progestogens should probably be avoided in patients with existing tumors of the liver. Hepatic hemangiomas and nodular hyperplasia of the liver have been reported with isolated estrogen therapy.
Bazedoxifene (applies to Duavee) hypothyroidism
Moderate Potential Hazard, Moderate plausibility.
The use of bazedoxifene in combination with conjugated estrogens leads to increased thyroid-binding globulin (TBG) levels. Women dependent on thyroid hormone replacement therapy who are also receiving estrogens may require increased doses of their thyroid replacement therapy. Care should be exercised when using this agent in patients with hypothyroidism. It is recommended to monitor thyroid function in order to maintain their free thyroid hormone levels in an acceptable range.
Bazedoxifene (applies to Duavee) renal dysfunction
Moderate Potential Hazard, Moderate plausibility.
The pharmacokinetics, safety, and efficacy of bazedoxifene in combination with conjugated estrogens have not been evaluated in women with renal impairment. The use of bazedoxifene in combination with conjugated estrogens is not recommended for use in patients with renal impairment.
Estrogens (applies to Duavee) angioedema
Moderate Potential Hazard, Moderate plausibility.
The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.
Estrogens (applies to Duavee) gallbladder disease
Moderate Potential Hazard, Moderate plausibility.
A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease.
Estrogens (applies to Duavee) hypercalcemia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperparathyroidism, Renal Dysfunction
Estrogens influence the metabolism of calcium and phosphorus. Intestinal absorption and retention of calcium are increased, which may occasionally result in hypercalcemia. Therapy with estrogens should be administered cautiously in patients with preexisting hypercalcemia, renal dysfunction, or metabolic bone diseases that are associated with hypercalcemia.
Estrogens (applies to Duavee) hyperlipidemia
Moderate Potential Hazard, Moderate plausibility.
Although estrogens have generally favorable effects on plasma lipids, including increases in HDL and decreases in total cholesterol and LDL, they have also been associated with significant elevations in triglyceride levels, particularly when high dosages are used. Severe hyperlipidemia is known to sometimes cause pancreatitis. Patients with preexisting hyperlipidemia may require closer monitoring during estrogen therapy, and adjustments made accordingly in their lipid-lowering regimen.
Estrogens (applies to Duavee) liver disease
Moderate Potential Hazard, High plausibility.
Estrogens are primarily metabolized by the liver. Patients with impaired hepatic function may be at increased risk for adverse effects associated with estrogen administration due to decreased drug clearance. Therapy with estrogens should be administered cautiously in patients with liver disease. In addition, clinicians should be aware that estrogen therapy may affect liver function tests. Increased sulfobromophthalein retention has been reported with the use of estrogen-containing oral contraceptives and may be expected with larger doses of estrogens.
Estrogens (applies to Duavee) melasma
Moderate Potential Hazard, Moderate plausibility.
The use of exogenous estrogens may occasionally cause chloasma, especially in women with a history of chloasma gravidarum. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet radiation while taking combination oral contraceptives.
Estrogens/progestogens (applies to Duavee) depression
Moderate Potential Hazard, Moderate plausibility.
The use of oral contraceptives has been associated with an increased incidence of depression. It is uncertain whether this effect is related to the estrogenic or the progestogenic component of the contraceptive, although excess progesterone activity is associated with depression. Patients with a history of depression receiving estrogen and/or progestogen therapy should be followed closely. The manufacturer of medroxyprogesterone recommends monitoring patients who have a history of depression and to not re- administer medroxyprogesterone if depression recurs.
Estrogens/progestogens (applies to Duavee) fluid retention
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures, Migraine, Congestive Heart Failure, Asthma, Renal Dysfunction
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Estrogens/progestogens (applies to Duavee) glucose intolerance
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus
Impaired glucose tolerance has been observed in some patients administered oral contraceptives and appears to be related primarily to the estrogen dose. However, progestogens can increase insulin secretion and produce insulin resistance to varying degrees, depending on the agent. Patients with diabetes mellitus should be monitored more closely during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen.
Estrogens/progestogens (applies to Duavee) retinal thrombosis
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Visual Defect/Disturbance
Estrogens and progestogens may cause retinal thrombosis. Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision; onset of proptosis or diplopia; papilledema; or retinal vascular lesions. Therapy with these agents should be administered cautiously in patients who have preexisting ocular problems and appropriate diagnostic and therapeutic measures should be instituted. Contact lens wearers who develop visual changes or changes in lens tolerance should be assessed by an ophthalmologist.
Estrogens/progestogens (applies to Duavee) thyroid function tests
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Thyroid Disease
When administering estrogen and/or progestogen therapy in patients with thyroid disorders, clinicians should be aware that these hormones may affect thyroid function tests. Changes have mostly been reported with the use of combination oral contraceptives. Specifically, thyroid-binding globulin (TBG) may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI (protein-bound iodine), T4 by column or radioimmunoassay, or T3 by radioimmunoassay. Free T3 resin uptake may be decreased. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only (norethindrone) oral contraceptives.
Switch to professional interaction data
Duavee drug interactions
There are 354 drug interactions with Duavee (bazedoxifene / conjugated estrogens).
Duavee alcohol/food interactions
There are 5 alcohol/food interactions with Duavee (bazedoxifene / conjugated estrogens).
More about Duavee (bazedoxifene / conjugated estrogens)
- Duavee consumer information
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (33)
- Imprints, shape & color data
- Side effects
- Dosage information
- Patient tips
- During pregnancy
- FDA approval history
- Drug class: sex hormone combinations
- En español
Related treatment guides
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
See also:
Paxil
Paxil is used to treat depression, obsessive-compulsive disorder and anxiety. Learn about side ...
Prolia
Prolia (denosumab) is an injection that is administered subcutaneously (under the skin) once every ...
Evenity
Evenity (romosozumab) injection is used to treat osteoporosis in postmenopausal women to reduce the ...
Fosamax
Fosamax (alendronate) is used to treat or prevent postmenopausal osteoporosis and steroid-induced ...
Calcium carbonate
Calcium carbonate systemic is used for duodenal ulcer, erosive esophagitis, GERD, hypocalcemia ...
Paroxetine
Paroxetine is used treat depression, obsessive-compulsive disorder and anxiety disorders. Learn ...
Estradiol
Estradiol is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning ...
Alendronate
Alendronate systemic is used for aseptic necrosis, osteoporosis, paget's disease, prevention of ...
Premarin
Premarin is used to treat symptoms of menopause such as hot flashes, and vaginal dryness. Learn ...
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.