7 Things to Know About Veozah (Fezolinetant), the Hormone-Free Menopause Medication

Menopause comes with many symptoms. Hot flashes and night sweats (vasomotor symptoms, or VMS) are two of the most common. And they can be bothersome enough to affect your quality of life. Hormone replacement therapy (HRT) is a popular and effective treatment option. But not everyone can or wants to take hormones.

In May 2023, the FDA approved Veozah (fezolinetant), a hormone-free medication for hot flashes. Veozah was the first medication in its class to be approved for these menopause symptoms. And it may be an alternative if HRT isn't right for you.

So what makes Veozah different from the menopause treatments currently available? Let's take a look at seven things to know about it.

1. Veozah (fezolinetant) is a hormone-free medication

Veozah is a hormone-free menopause treatment. It's a neurokinin 3 (NK3) receptor antagonist and doesn't contain estrogen. Veozah is approved to treat moderate to severe VMS due to menopause. Veozah comes as a 45 mg oral tablet. It's taken once daily by mouth with or without food. It's best to take it at about the same time every day.

2. Veozah works by blocking a chemical in the brain that helps regulate body temperature

Veozah works by blocking a chemical called neurokinin B (NKB) from attaching to its primary receptor (chemical binding site). NKB is a brain chemical that's involved in body temperature regulation. And experts believe there's a link between menopause and NKB.

During menopause, estrogen levels fall. This drop in estrogen is the main driver for the symptoms you experience. Estrogen helps keep NKB's activity in check. When estrogen levels fall, this balance gets thrown off. NKB becomes more active, your body temperature rises, and hot flashes happen. By blocking NKB, Veozah helps stop the chemical from triggering a hot flash.

3. Veozah doesn't help with vaginal menopause symptoms

Veozah works in a specific part of your brain to help regulate body temperature. Because of how it works, it doesn't have any effect on vaginal menopause symptoms, such as vaginal dryness.

If you're experiencing vaginal dryness or pain during sex, vaginal lubricants and moisturizers may help relieve those symptoms. Low-dose vaginal estrogen creams and suppositories are also common treatment options.

4. Veozah works differently from hormone replacement therapy

Veozah works differently from HRT. As described above, Veozah doesn't contain hormones; it blocks a brain chemical called NKB. HRT replaces some of the estrogen your body is no longer making. Raising estrogen levels helps relieve menopause symptoms.

Unlike Veozah, many forms of HRT can treat both hot flashes and vaginal symptoms. So if you're experiencing multiple types of symptoms, Veozah may not be as helpful as HRT.

While HRT is effective, it may cause several rare, but serious, side effects, such as a higher risk for breast cancer. Veozah may be helpful for women whose risks with HRT outweigh the benefits. For example, HRT is usually avoided if you have a history of:

• Breast or other estrogen-based cancers

• Blood clots

• Blood clotting disorders, such as factor V Leiden

• Heart attack or stroke

• Chronic liver disease

• Migraine with aura

Veozah doesn't carry the same risks as HRT. So it may be safer for certain women who can't take HRT.

5. Veozah starts providing noticeable benefits within 4 weeks

Veozah's FDA approval was based on two clinical trials (SKYLIGHT 1 and SKYLIGHT 2). In these studies, Veozah was compared to a placebo (a pill with no medication in it).

Within 4 weeks, women taking Veozah experienced more than a 50% reduction in the number of hot flashes they experienced. This was compared to a 30% reduction for those taking placebo. The severity of hot flashes also significantly decreased within about 4 weeks.

At 12 weeks (about 3 months), Veozah provided about a 65% reduction in hot flashes. Those taking placebo reported a 45% reduction. People taking Veozah continued to experience symptom relief until the studies ended at 52 weeks (1 year).

6. Veozah's side effects were generally mild in clinical trials

Like with all medications, Veozah can cause side effects. But the medication was well tolerated overall in clinical trials. Keep in mind that many people experienced no side effects while taking it. If anything seems unusual or excessive, let your prescriber know.

Veozah's most common side effects include:

• Stomach pain

• Diarrhea

• Trouble sleeping

• Back pain

• More or worsened hot flashes

• Elevated liver enzymes (a lab value that can help indicate liver function)

In rare cases, Veozah can cause serious liver damage. It's possible for this side effect to happen at any time while you're taking this medication. Your prescriber should ask you to go for routine blood work so they can watch for signs of liver damage. Because of the risk of liver damage, you shouldn't take Veozah if you have cirrhosis of the liver.

Veozah hasn't been well-studied in people with severe kidney problems. If you have severe kidney problems, such as end-stage kidney disease, Veozah may not be the best option for you.

7. There are ways to help you save on Veozah

There are ways to save on Veozah, which is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for your first month of Veozah using a savings card from the manufacturer. Each prescription after that could be as low as $30 per month with the card.

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Veozah's patient assistance program, which offers the medication free of cost.