Duavee Is a Prescription Hormone Therapy That Combines Estrogen with Bazedoxifene to Treat Menopausal Hot Flashes and Prevent Osteoporosis

If your doctor has mentioned Duavee — or you've been researching menopause treatments — you probably have questions. What exactly is it? How is it different from other hormone therapies? And is it right for you?

This guide covers everything you need to know about Duavee in 2026, from what it's used for to how much it costs and where to find it.

What Is Duavee?

Duavee is a brand-name prescription medication that contains two active ingredients:

• Conjugated estrogens (0.45 mg) — a type of estrogen derived from natural sources
• Bazedoxifene (20 mg) — a selective estrogen receptor modulator (SERM)

The generic name is conjugated estrogens/bazedoxifene, sometimes abbreviated as CE/BZA. It is manufactured by Pfizer.

Duavee was approved by the FDA in October 2013. It was the first medication to combine an estrogen with a SERM for menopausal hormone therapy. This approach was a significant departure from traditional hormone replacement therapy (HRT), which pairs estrogen with a progestin.

Duavee is not a controlled substance and is available only by prescription.

What Makes Duavee Unique?

In traditional HRT for women with a uterus, a progestin is added to estrogen to protect the uterine lining from overgrowth (hyperplasia) that can lead to cancer. Duavee replaces the progestin with bazedoxifene, which blocks estrogen's effects on the uterus while allowing estrogen to work where it's needed — like reducing hot flashes and protecting bones.

This matters because many women experience unwanted side effects from progestins, including bloating, breast tenderness, and mood changes. Learn more about how Duavee's mechanism of action works.

What Is Duavee Used For?

Duavee is FDA-approved for two specific uses in postmenopausal women with an intact uterus:

1. Treatment of moderate-to-severe vasomotor symptoms (hot flashes) — These include hot flashes, night sweats, and flushing associated with menopause.
2. Prevention of postmenopausal osteoporosis — Duavee helps maintain bone density in women at risk of osteoporosis after menopause.

Important: Duavee is only for women who still have their uterus. If you've had a hysterectomy, your doctor will likely prescribe estrogen alone (such as Premarin) instead, since you don't need the uterine protection that bazedoxifene provides.

How Is Duavee Taken?

Duavee comes in one strength: a single tablet containing 0.45 mg conjugated estrogens and 20 mg bazedoxifene.

Dosing Instructions

• Take one tablet by mouth once daily
• Can be taken with or without food
• Swallow the tablet whole — do not crush, chew, or break it
• Take it at the same time each day for best results
• If you miss a dose, take it as soon as you remember — unless it's almost time for your next dose, in which case skip the missed one

Your doctor will prescribe Duavee at the lowest effective dose for the shortest time needed. Regular check-ups (at least annually) are recommended to evaluate whether you still need treatment.

Who Should Not Take Duavee?

Duavee is not safe for everyone. It is contraindicated in the following situations:

• Undiagnosed abnormal uterine bleeding
• Known or suspected estrogen-dependent cancers
• Active or history of blood clots (DVT or pulmonary embolism)
• Active or recent stroke or heart attack
• Known liver disease or hepatic impairment
• Known clotting disorders (protein C, protein S, or antithrombin deficiency)
• Known or suspected pregnancy (Category X)
• Known allergy to Duavee or any of its components

Duavee also carries a boxed warning about increased risks of endometrial cancer, cardiovascular events, breast cancer, and probable dementia (especially in women 65 and older). Read our detailed guide on Duavee side effects for more.

How Much Does Duavee Cost?

Duavee is a brand-name medication with no generic available as of 2026. That means it tends to be expensive:

• Cash price: $300–$500 per month (30 tablets)
• With insurance: Coverage varies widely. Many plans require prior authorization or step therapy with lower-cost HRT options first. If covered, it's often placed on Tier 3 (non-preferred brand) or specialty tier.
• Medicare Part D: May cover Duavee with a higher-tier copay.

Ways to Save

• Pfizer co-pay savings card: Eligible commercially insured patients may pay as little as $30–$50 per month.
• Pfizer RxPathways: Patient assistance for uninsured or underinsured patients. Apply at PfizerRxPathways.com or call 1-844-989-7284.
• Discount cards: Sites like GoodRx and SingleCare may offer some savings at participating pharmacies.

For the complete breakdown, see our guide on how to save money on Duavee.

Finding Duavee in 2026

One of the biggest challenges with Duavee isn't the cost — it's actually finding it. The medication has experienced intermittent supply issues since its launch, and many retail pharmacies don't keep it in stock.

If you're struggling to fill your prescription, use Medfinder to check which pharmacies near you have Duavee available. Specialty and mail-order pharmacies tend to be more reliable sources.

Final Thoughts

Duavee is a unique and effective option for menopausal women dealing with hot flashes or at risk for osteoporosis. Its estrogen-plus-SERM approach offers an alternative to traditional progestin-based HRT, which can be a major advantage for women who don't tolerate progestins well.

The downsides? It's brand-name only, can be expensive, and may be hard to find at your local pharmacy. But with the right savings programs and tools like Medfinder, these obstacles are manageable.

Talk to your doctor about whether Duavee is the right fit for your symptoms and health history. And if you need help finding a prescriber, check out our guide on how to find a doctor who can prescribe Duavee.