Two new women’s health products are now available by prescription in Canada

Knight Therapeutics in Montreal, QC is introducing two new products for managing menopausal or postmenopausal symptoms. Bijuva capsules contain estradiol (as estradiol hemihydrate) and progesterone (micronized) in two strengths: 0.5/100 mg and 1 mg/100 mg. The product is indicated for the treatment of moderate to severe vasomotor symptoms associated with menopause in women with an intact uterus.1,2Estrogen replacement therapy with estradiol reduces the number and intensity of hot flushes associated with menopause. The progesterone component opposes the development of endometrial hyperplasia caused by estrogens.1The recommended dosage of Bijuva is one capsule, taken orally each evening with food.1The most common adverse effects of Bijuva are headache, nasopharyngitis, breast tenderness, upper respiratory tract infection, nausea, back pain, abdominal pain, sinusitis and dizziness. Bijuva also carries similar risks to other oral estrogens.1The manufacturer notes that Bijuva is the first fixed-dose combination of the two bioidentical hormones that are most often preferred by women with vasomotor symptoms (estradiol and micronized progesterone).2Imvexxy (estradiol 4 µg and 10 µg) vaginal inserts are indicated for the treatment of postmenopausal moderate to severe dyspareunia (difficult or painful sexual intercourse), a symptom of vulvar and vaginal atrophy. The product may be used in women with or without an intact uterus.3,4The softgel vaginal formulation releases a low dose of estradiol into the vagina. There is minimal systemic absorption, with average plasma estradiol levels not exceeding postmenopausal levels.3Patients should generally start with the 4 µg dosage strength, inserted once daily at about the same time each day for two weeks. This is then followed by a maintenance dosage of one vaginal insert twice weekly, every three to four days (e.g., Monday and Thursday). The lowest effective dose should be used for the shortest duration.3Patients should be instructed to insert the product manually (without an applicator) by placing the smaller end of the insert into the vaginal canal, to a depth of about two inches (5 cm).3The most common adverse effects of Imvexxy are headache, vaginal discharge, nasopharyngitis, urinary tract infection and back pain.3 The manufacturer notes that Imvexxy is the only product in its therapeutic class to offer 4 µg and 10 µg doses of 17β-estradiol, with the 4 µg strength providing the lowest effective Health Canada-approved dose of vaginal estradiol.4In press releases accompanying the launch of these two new products, Dr. Vivien Brown, a family physician recognized for her national and international advocacy efforts in promoting women's health, commented that “The introduction of Bijuva in Canada offers an option of hormone therapy (combination of estradiol and progesterone), to add to our toolbox of prescription choices, for the patient in need.”2 Furthermore, she noted that “The launch of Imvexxy provides a safe, simple, easy to use and effective treatment to add to our armamentarium.”4References1. Knight Therapeutics Inc. Bijuva (estradiol and progesterone capsule) product monograph. Montreal, QC; September 1, 2023. (accessed February 9, 2024).2. Knight Therapeutics Inc. Knight Therapeutics announces launch of Bijuva in Canada. February 06, 2024. (accessed February 9, 2024).3. Knight Therapeutics Inc. Imvexxy (estradiol vaginal inserts) product monograph. Montreal, QC; April 30, 2023. (accessed February 9, 2024).4. Knight Therapeutics Inc. Knight Therapeutics announces product launch for Imvexxy in Canada. January 04, 2024. (accessed February 9, 2024).

Two new women’s health products are now available by prescription in Canada

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