Rankings / Hormones & Endocrine
Fezolinetant (Veozah)
Hormones & Endocrine · NK3 receptor antagonist (non-hormonal)
Tier B
Bottom line
Read Off Label grades Fezolinetant (Veozah) as B (6.8/10) based on strong evidence, high benefit magnitude, and a med-risk safety profile.
First-in-class non-hormonal therapy for moderate-to-severe vasomotor symptoms (hot flashes/night sweats) of menopause.
Typical use: 45 mg PO once daily — Rx.
What this is
First-in-class non-hormonal therapy for moderate-to-severe vasomotor symptoms (hot flashes/night sweats) of menopause. Major option for women with breast cancer history or other contraindications to estrogen. Liver-enzyme monitoring requirement is the practical adoption barrier. Astellas; brand Veozah. A 2026 review of pooled post-marketing data raised an emerging, not-yet-confirmed signal of increased non-benign neoplasms — suggestive only, causality not established, long-term follow-up needed.
Mechanism
Selective neurokinin 3 (NK3) receptor antagonist; blocks NK3 signaling on KNDy neurons in the hypothalamic thermoregulatory center; corrects the dysregulated firing pattern that drives hot flashes after estrogen decline
Dose & route
45 mg PO once daily
Citations
- https://doi.org/10.1007/s40265-025-02231-8
- https://pubmed.ncbi.nlm.nih.gov/40299712/
- https://www.fda.gov/news-events/press-announcements/fda-approves-novel-drug-treat-moderate-severe-hot-flashes-caused-menopause
- https://doi.org/10.1210/jendso/bvag082
- https://clinicaltrials.gov/study/NCT06206408
- https://pubmed.ncbi.nlm.nih.gov/40482564/
- https://pubmed.ncbi.nlm.nih.gov/41493963/
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Common questions
- Does Fezolinetant (Veozah) work?
- Read Off Label rates the evidence for Fezolinetant (Veozah) as Strong and the benefit magnitude as high, producing an overall grade of B (6.8/10). First-in-class non-hormonal therapy for moderate-to-severe vasomotor symptoms (hot flashes/night sweats) of menopause.
- Is Fezolinetant (Veozah) safe?
- Fezolinetant (Veozah) has a med risk profile in published human data. Legal status: Rx (FDA-approved 2023). This is not medical advice — see the disclaimer.
- What is the typical dose for Fezolinetant (Veozah)?
- 45 mg PO once daily
- How does Fezolinetant (Veozah) work?
- Selective neurokinin 3 (NK3) receptor antagonist; blocks NK3 signaling on KNDy neurons in the hypothalamic thermoregulatory center; corrects the dysregulated firing pattern that drives hot flashes after estrogen decline
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.