A SERM, often combined with conjugated oestrogens for the menopause
Bazedoxifene
A selective oestrogen receptor modulator, often combined with conjugated oestrogens, used to ease menopausal symptoms and help protect the bones.
What is Bazedoxifene?
Bazedoxifene is a selective oestrogen receptor modulator (a SERM), which means it acts like oestrogen in some tissues, such as bone, but blocks it in others, such as the womb lining. In the UK it is most often used combined with conjugated oestrogens to ease menopausal symptoms like hot flushes in women who still have a womb, with the bazedoxifene part protecting the womb lining in place of a progestogen. It is taken as a tablet by mouth. The most important safety point is a raised risk of blood clots, so it is avoided in people with a clotting history and stopped before long periods of immobility.
Education and reference only. This is a plain-language guide to Bazedoxifene — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Bazedoxifene is a selective oestrogen receptor modulator, or SERM, a type of medicine that mimics oestrogen in some parts of the body while blocking it in others. In the UK it is mainly used as part of a combined tablet with conjugated oestrogens, where the oestrogen eases menopausal symptoms such as hot flushes and night sweats, and the bazedoxifene protects the lining of the womb so that a separate progestogen is not needed. It is taken by mouth as a tablet and is used in women who still have their womb and are past the menopause.
How it works
Bazedoxifene attaches to oestrogen receptors around the body and behaves differently depending on the tissue: in bone it acts like oestrogen, helping to keep bone strong, while in the womb lining it blocks oestrogen, stopping it from being overstimulated. This is why, when combined with conjugated oestrogens, it can let the oestrogen relieve menopausal symptoms while keeping the womb lining protected, taking the place of a progestogen. Because it is taken every day, it keeps this balanced effect going over time.
Company & origin
Originated / developed by: Specialist manufacturers.
A medicine used in the UK, usually combined with conjugated oestrogens, to ease menopausal symptoms in women with a womb, and as a SERM to help protect bone.
What it treats
Conditions Bazedoxifene is used for
Practical use
How to take Bazedoxifene
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as a tablet once a day, at about the same time, with or without food.
- Take it every day rather than only when symptoms are troublesome, as it works steadily over time.
- Stop it and seek advice well before planned surgery or a long period of being unable to move, because of the clot risk.
- Report any unexpected vaginal bleeding to your doctor so it can be checked.
- Keep your reviews so the benefits and risks can be checked over time.
Weighing it up
Advantages & disadvantages of Bazedoxifene
Advantages
- Eases menopausal symptoms such as hot flushes when combined with conjugated oestrogens.
- Protects the lining of the womb, so a separate progestogen is not needed in women with a womb.
- Acts like oestrogen in bone, helping to keep bone strong.
Disadvantages
- Raises the risk of blood clots in the veins, so it does not suit everyone.
- Needs to be stopped before surgery or long periods of immobility.
- Can cause muscle cramps and other oestrogen-related effects in some people.
Practical use
Good to know
The most important thing to understand about bazedoxifene is the raised risk of blood clots in the veins, such as in the legs or lungs, which it shares with oestrogen-based treatments and other SERMs. Because of this it is not suitable for people who have had a clot or who are at high risk, and it is usually stopped for a while before planned surgery or any long period of being unable to move about, such as a long-haul flight. When combined with conjugated oestrogens, the bazedoxifene part protects the womb lining so a separate progestogen is not needed, which is one reason this combination is used. Any unexpected vaginal bleeding should always be reported, as should signs of a clot such as a swollen, painful calf or sudden breathlessness. It is prescribed and reviewed by a doctor, who weighs the benefits against the risks for each person.
Who should not take it / use with caution
- People who have had a blood clot, or who are at high risk of one, should not take it.
- Women who are or could be pregnant or who are breastfeeding should not take it.
- People with unexplained vaginal bleeding, certain hormone-related cancers, or active liver disease should not take it.
Monitoring
- Reviewing menopausal symptoms and whether treatment is still needed.
- Watching for any signs of a blood clot or unexpected vaginal bleeding.
- Checking blood pressure and overall health at routine reviews.
Side effects
- Muscle cramps, particularly in the legs.
- Hot flushes, which can still occur, and sometimes breast tenderness or stomach upset.
- Rarely but seriously, blood clots in the legs or lungs, which need urgent medical attention.
Key interactions
- Tell your prescriber about all your medicines, as some can affect how the combination works.
- It should not be used together with separate oestrogen, progestogen or other SERM treatments.
- Medicines that affect clotting risk should be reviewed, as bazedoxifene can add to that risk.
Available as: Tablets taken by mouth, usually combined with conjugated oestrogens.
Answers
Bazedoxifene: frequently asked questions
What is bazedoxifene used for?
It is a SERM most often combined with conjugated oestrogens to ease menopausal symptoms in women who still have a womb, with the bazedoxifene protecting the womb lining.
Why is it combined with conjugated oestrogens?
The oestrogen relieves symptoms such as hot flushes, while bazedoxifene protects the lining of the womb, taking the place of a separate progestogen.
What is the main risk to be aware of?
Like oestrogen treatments and other SERMs, it can raise the risk of blood clots, so it is avoided in people at high risk and stopped before long periods of immobility.
What should I do before surgery or a long flight?
Tell your doctor in advance, as it is usually stopped for a while before surgery or long periods of being unable to move, to reduce the clot risk.
What if I have unexpected bleeding?
Any unexpected vaginal bleeding should always be reported to your doctor so it can be checked.
Authoritative sources
- BNF
- NICE CKS
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