SERMS

Question 1

FDA approved for breast cancer prevention

Answer 1

Tamoxifen

Raloxifene

Question 2

FDA approved for bone loss prevention

Answer 2

Raloxifene

Bazedoxifene/CEE (Duavee)

Question 3

FDA approved for post-menopausal dyspareunia

Answer 3

Osphena

Question 4

Major contraindication for all SERMS

Answer 4

Risk or history of blood clots

Question 5

FDA approved for hot flashes

Answer 5

Bazedoxifene/CEE (Duavee)

Question 6

Raloxifene

• FDA approved for
• Agonist/Antagonist in
• Adverse events/side effects

Answer 6

FDA for bone loss and breast cancer prevention

Agonist in bone and heart
Antagonist in breast

Increased hot flashes, leg cramps. Watch for blood clots, fatal stroke

60 mg dose

Question 7

Bazeodoxifene/Conjugated equine estrogen (Duavee)

• What kind of drug is this
• FDA approved for
• Agonist/Antagonist in
• Adverse events/side effects

Answer 7

Tissue Selective Estrogen Complex

FDA for hot flashes and bone loss
(at higher doses of CEE may help vaginal atrophy but not FDA approved. Breast neutral. No increased bleeding profile)

Agonist on bone
Antagonist on endometrium No need for progestin bazeodoxifene is the only SERM with sufficient endometrial antagonist effect to be paired with estrogen

Question 8

Ospemifene (Osphena)

• FDA approved for
• Agonist/Antagonist in
• Adverse events/side effects

Answer 8

FDA for moderate - severe dyspareunia

Agonist in vagina (and probably bone)
Antagonist in probably breast

Mild increase in hot flashes.
BBW: VTE/stroke and endometrial stimulation