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Is the New Hot Flash Drug Right for You?

Corey Whelan

Written by Corey Whelan

Corey Whelan

Written by Corey Whelan

Vasomotor symptoms of menopause (VMS), like hot flashes and night sweats, affect over 80% of menopausal women,1 with data showing that some may experience moderate-to-severe hot flashes and night sweats for an average of 7.4 years or longer.2

These common vasomotor symptoms range from mild and bothersome, to intense and debilitating. Several prescription treatments are currently available, which work to provide relief, including VeozahTM (fezolinetant), a new, FDA-approved drug designed to treat moderate to severe vasomotor symptoms due to menopause.

In May 2023, the U.S. Food and Drug Administration (FDA) approved Veozah for use as an oral, non-hormonal treatment for addressing moderate-to-severe VMS due to menopause.

The more options available to treat menopausal symptoms, like hot flashes and night sweats, the better; since no solution is a one-size-fits-all. So, if you’re wondering whether Veozah is the best management option for hot flashes in your case, read on. Here we’ll dig into specifics about how Veozah works, its benefits and some alternatives.

What is Veozah and How Does It Work?

The generic name for Veozah, is fezolinetant, which is a neurokinin 3 (NK3) receptor antagonist.

So, what exactly does that mean? In the simplest of terms, there are receptors in the brain that are called NK3 receptors. These are responsive to both neurokinins, a chemical messenger in the brain, and estrogen. As estrogen levels decline during the menopause transition, neurokinins show increased activity, making it harder for them to respond accurately to internal or external changes in body temperature. By binding to and blocking the action of NK3 receptors, fezolinetant works to stop this activity, reducing the severity of hot flashes associated with menopause.3

While fezolinetant is the first FDA approved NK3 receptor antagonist, several others are currently being studied for the treatment and relief of VMS due to menopause.4

Who Makes Veozah and Have Clinical Studies Been Done?

Veozah is a product of Astellas Pharma, Inc., a global pharmaceutical company with roots in Japan. In trial studies funded by Astellas, fezolinetant was shown to effectively reduce the severity and frequency of hot flashes and night sweats. Study participants typically experienced relief from these symptoms in four weeks. Some experienced relief in as little as one week.5

A report published by the Institute for Clinical and Economic Review rated the evidence from these studies as promising, but still inconclusive.6 As is common with any new drug, additional data, sourced from independent studies, are still needed to further understand the efficacy of this product.

How Much Does Veozah Cost?

Veozah is not currently covered by health insurance and may be prohibitively expensive for many people.

Astellas has set the price for Veozah, a once-daily pill, at $550 a month.7 It’s likely that this medication will eventually be covered by at least some health insurance plans, but its ultimate cost, copay, and deductible, for at least a portion of its potential users, may remain prohibitive.

Side Effects and Risks of Veozah

Because Veozah is new, it hasn’t been used extensively by the general public just yet. However, based on the evidence from its initial clinical studies, possible side effects of using this medication can include:8

  • Elevated liver enzymes (increased liver blood test values)
  • Jaundice (yellowing of the eyes or skin)
  • Insomnia
  • Hot flashes
  • Back pain
  • Stomach pain
  • Diarrhea
  • Nausea
  • Vomiting

Damage to the liver or kidneys is also possible from taking Veozah. If you currently have liver disease, a liver infection, or kidney disease, it’s recommended that you avoid this drug. Additionally, frequent blood testing for liver enzymes is recommended at beginning of use as well as at 3, 6 and 9 months of starting Veozah.9

Veozah is also not recommended for people who take certain medications or supplements, including oral contraceptives, antibiotics, such as ciprofloxacin, and CYP1A2 inhibitors, including fluvoxamine.10 As always, if you’re interested in taking any new medication, it’s important to first check with your healthcare provider to determine what option is best for you. 

Alternative Treatment Options for Hot Flashes and Night Sweats

The most effective management option for menopausal hot flashes will vary from person to person. It’s also important to note that there are effective management options for VMS that do not require prescription medication, in many instances.

If you do decide to consider prescription medications, your healthcare provider can work with you on choosing the right treatment.

Hormone replacement therapy (HRT) may be recommended to alleviate severe hot flashes and night sweats, particularly in women under 60. HRT is effective for many women, but may not be right for everyone. Potential risks include blood clots in areas of the body such as the legs or lungs; some women may also have an increased risk of breast cancer from these types of hormone-based therapies.11 You and your healthcare provider should discuss the benefits of HRT versus the risks in your specific case. Your age, overall health, medical history, and family medical history may all play a role in determining whether HRT is right for you.

Other prescription drugs used to reduce menopausal vasomotor symptoms include:

  • Antidepressants, such as paroxetine, a selective serotonin-reuptake inhibitor (SSRI)12
  • Gabapentin, a medication often used for nerve pain and epilepsy13
  • Oxybutynin, typically used for overactive bladder14

Additionally, incorporating certain lifestyle changes, such as sipping on cold water throughout the day, moderating your intake of spicy foods, caffeine and alcohol, or wearing lightweight, moisture-wicking clothes, may have a significant positive impact for some women. You may also find that taking hormone-free supplements, specifically those that are clinically studied and have been shown to be effective in reducing the frequency and intensity of menopausal hot flashes and night sweats, like Relizen®*, may help.

If you are plagued by moderate-to-severe VMS during menopause, don’t’ hesitate to discuss your options, questions and concerns with your healthcare provider. They will be able to work with you on determining the best type of solution to try.

Resources

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/
  2. https://www.swanstudy.org/up-to-14-years-of-hot-flashes-found-in-menopause-study/
  3. https://www.sciencedirect.com/science/article/abs/pii/B9780128199756000297
  4. https://www.sciencedirect.com/science/article/abs/pii/B9780128199756000297
  5. https://pubmed.ncbi.nlm.nih.gov/36924778/
  6. https://icer.org/news-insights/press-releases/icer-publishes-evidence-report-on-fezolinetant-for-vasomotor-symptoms-associated-with-menopause/
  7. https://healthmatters.nyp.org/a-new-menopause-drug-for-hot-flashes-your-questions-answered/#:~:text=How%20much%20does%20Veozah%20cost,but%20it%20will%20take%20time
  8. https://www.veozah.com/
  9. https://www.drugs.com/veozah.html
  10. https://www.veozah.com/
  11. https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372
  12. https://www.nejm.org/doi/full/10.1056/nejmp1402080
  13. https://www.kemh.health.wa.gov.au/~/media/HSPs/NMHS/Hospitals/WNHS/Documents/Patients-resources/Menopausal-Symptoms---Gabapentin.pdf?thn=0#:~:text=Why%20have%20you%20been%20prescribed,and%20frequency%20of%20hot%20flushes.
  14. https://www.kemh.health.wa.gov.au/~/media/HSPs/NMHS/Hospitals/WNHS/Documents/Patients-resources/Menopausal-Symptoms---Oxybutynin.pdf?thn=0#:~:text=Oxybutynin%20is%20a%20medication%20used,as%20a%20patch%20or%20tablet.&text=Regular%20use%20will%20give%20the%20most%20benefit%20from%20oxybutynin

Comments

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My doctor prescribed Veozah, but my insurance does not cover it. At Costco, my out-of-pocket cost would have been $660 for a thirty day supply!

Joan on

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