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[Rosie63]

Morning ladies.  I have a question which some of you knowledgeable ladies might be able to answer for me.  I've been looking at the characteristics of Duavive but it's all a bit scientific for me 😱 

I was wondering what the difference could be between the progesterones that are listed in the tab above and Bazedoxifene.  Also it mentions SERMS relating to the Bazedoxifene which I don't understand either !

Is anyone able to help with this please ?

Thank you.

Rosie63 x

[CLKD]

That's technical  - have you put the names into the search box to see what pops up?  If you have a local pharmacist perhaps go along for a chat?

[Rosie63]

Thanks CLKD. Yes, I did think of calling into a pharmacist.  I've done a search on here but I don't think many ladies are taking it so not much info.  It seems it might be quite a new thing in the UK.  I thought perhaps someone like Hurdity might be able to shed a bit of light on it for me 😊

Have a good weekend.

Rosie x

[CLKD]

Tnx.   Weekend good thus far ;-)

[Hurdity]

Morning ladies.  I have a question which some of you knowledgeable ladies might be able to answer for me.  I've been looking at the characteristics of Duavive but it's all a bit scientific for me 😱 

I was wondering what the difference could be between the progesterones that are listed in the tab above and Bazedoxifene.  Also it mentions SERMS relating to the Bazedoxifene which I don't understand either !

Is anyone able to help with this please ?

Thank you.

Rosie63 x

The main difference between Bazedoxifene and progestogens is that Bazedoxifene is tissue selective in its mechanism of action. So - we have receptors for oestrogens and progesterone in various organs and tissues in our body and most oestrogens and progestogens will latch onto these wherever they occur. (Some synthetic progestogens act differently on different tissues....).

Bazedoxifene only acts on the receptors in the uterus to prevent the lining growing in response to oestrogen, but doesn't bind to the other receptors in the body that cause the progestogenic side effects. This is a very simplified explanation as the details involve complex cell biology and physiology so would need a lot more specialised reading that I don;t have time for at the moment!

Here is an extract from the product info:

"DUAVIVE pairs CE with the selective oestrogen receptor modulator (SERM), bazedoxifene, which is defined as a tissue selective oestrogen complex (TSEC).The active ingredients of CE are primarily the sulphate esters of estrone, equilin sulphates and 17α/β- estradiol. These substitute for the loss of oestrogen production in menopausal women, and alleviate menopausal symptoms. As oestrogens promote the growth of the endometrium, unopposed oestrogens increase the risk of endometrial hyperplasia and cancer. The addition of bazedoxifene, acting as an oestrogen receptor antagonist in the uterus, greatly reduces the oestrogen-induced risk of endometrial hyperplasia in non-hysterectomised women"

Here is a thread on Duavive:
https://www.menopausematters.co.uk/forum/index.php/topic,36795.msg591388.html#msg591388

As far as I'm concerned the major drawback of Duavive is the fact that the Bazedox.. is paired with equine oestrogens (you know - the horse pee ones?) - why they did this I don't know since this seems to be being phased out in favour of bio-identical estradiol.

Also the oestrogen dose is quite low so is insufficient for some women - and it is not possible to increase the dose as it only comes as one preparation.

Also being tablet HRT then could well reduce libido.

Not sure what a pharmacist would know? You have great faith in these people CLKD but they don't necessarily know any more than GPs - we have had instances on here of the wrong calculations being made when comparing products and doses for example!

Hope this helps but if it doesn't answer your question please ask again and I will try again

Hurdity x

[CLKD]

They should know a lot more than GPs because they are on the front line of all medications.  The ones local to me will contact the manufacturers on my behalf to check if they don't know enough.  Also one of my besties is a Pharmacist and our GP News letter asks patients to go to the Chemist: there is a list of what they no longer prescribe on the Surgery Web-site.

I know several occasions when GPs have given incorrect advice - it's mentioned on here often. 

It's about asking the question.  Pharmacists have private rooms and more time than GPs.  At the end of the day it is up to the patient to make the decision whether/not to take the medication suggested or do ask more questions.

Let us know how you get on!

[Rosie63]

Morning Hurdity.  Your reply is very helpful and has explained exactly what I wanted to know in language I can understand 😊

Thank you very much for taking the time to answer my questions.

Rosie63 xx

[Hurdity]

I have just read that even though it has only fairly recently been launched in UK, Duavive is going to be discontinued in UK for commercial reasons. Not sure about the rest of the EU...this is what it says on the BMS latest shortages list:

"Duavive. Conjugated equine estrogen 0.45 mg + 20 mg bazedoxifene. Discontinued August 2018. Stocks expected to be available until end of 2019 / early 2020."

So obviously not very popular - maybe because it contained Premarin, or too low an oestrogen dose - otherwise it would have been tempting I imagine for many women who wanted low dose HRT post-menopause but without all the prog side effects....

Hopefully there will be other products developed using this SERM though...

Hurdity x

[Kathleen]

Hello ladies

My consultant mentioned this product to me some time ago. She had heard it was likely to be withdrawn as it wasn't selling as well in the UK as the drug company had hoped. Of course all these treatments have to be profitable so even if they are perfect for some of us they may not be available. All down to market forces I expect.

Take care everyone.

K.

[Rosie63]

Thanks for the update ladies.  I'm not surprised to hear this as you very rarely hear or read about Duavive so I'm guessing not many ladies are using it for one reason or another.

Rosie x