Veozah (fezolinetant) is a prescription medication used to treat moderate to severe hot flashes caused by menopause. Approved by the FDA in 2023, it is a non-hormonal option, meaning it contains no estrogen or progesterone. Around 80% of menopausal women experience hot flashes, and Veozah was designed specifically for those whose symptoms are frequent and disruptive enough to affect daily life.
How Veozah Works
Hot flashes are not just a vague hormonal side effect. They originate from a specific group of nerve cells in the brain’s temperature-control center. During a woman’s reproductive years, estrogen keeps these neurons in check. When estrogen levels drop during menopause, these neurons lose that restraining signal and become overactive, essentially telling the brain the body is too warm when it isn’t. The result is a cascade of flushing, sweating, and heat that can last several minutes.
Veozah works by blocking the receptor these overactive neurons rely on to send their signals. Rather than replacing estrogen, it interrupts the faulty temperature message at its source. This makes it fundamentally different from hormone replacement therapy, which raises estrogen levels throughout the body. Because Veozah targets a narrow pathway in the brain, it avoids the hormonal effects that make some women ineligible for or uncomfortable with traditional treatments.
What the Clinical Trials Showed
Veozah’s approval was based on two large phase 3 trials, each lasting 12 weeks. Women in both trials were experiencing roughly 10 to 12 moderate-to-severe hot flashes per day at baseline.
By week 4, women taking Veozah saw their daily hot flash count drop by about 5 to 6 episodes, compared to a drop of 3 to 4 in the placebo group. By week 12, the reductions were even larger: women on Veozah experienced about 6 to 7.5 fewer hot flashes per day, while the placebo group saw a decrease of roughly 4 to 5. That translates to a meaningful difference of about 2.5 fewer hot flashes daily beyond what a placebo achieves. The severity of each individual hot flash also decreased significantly compared to placebo.
So while the drug doesn’t eliminate hot flashes entirely for most women, it substantially reduces both how often they happen and how intense they feel. Results were measurable within the first month of treatment.
How to Take It
Veozah is a once-daily tablet taken at the same time each day. The standard dose is 45 mg. You can take it with or without food, but it needs to be swallowed whole with liquid. Cutting, crushing, or chewing the tablet is not recommended.
Who It’s Designed For
Veozah is specifically for menopausal women with moderate to severe vasomotor symptoms. “Vasomotor symptoms” is the clinical term for the feelings of warmth in the face, neck, and chest, or sudden intense waves of heat and sweating that define hot flashes.
Its non-hormonal design is particularly relevant for women who cannot or prefer not to take estrogen-based treatments. This includes women with a history of certain cancers, blood clots, or other conditions where hormone therapy carries elevated risk. It’s also an option for women who simply want to avoid hormone-related side effects.
Possible Side Effects
The most commonly reported side effects in clinical trials were relatively mild: back pain and trouble sleeping. These often improved as the body adjusted to the medication.
The more serious concern with Veozah involves the liver. Some patients developed signs of liver stress, which can show up as dark urine, light-colored stools, yellowing of the skin or eyes, nausea, stomach pain, or vomiting. Liver function testing is typically part of the monitoring plan before and during treatment. Other less common but reported reactions include diarrhea, dizziness, headache, and fatigue.
Not everyone experiences side effects, and many women tolerate the drug well. But the liver-related signals are worth knowing about so you can recognize them early if they occur.
How Veozah Compares to Hormone Therapy
Hormone therapy remains the most effective treatment for hot flashes overall, but it is not suitable for every woman. Veozah fills a gap that has existed for years: a targeted, non-hormonal prescription option that goes beyond the older alternatives like certain antidepressants or blood pressure medications that were sometimes prescribed off-label for hot flashes. Those off-label options often came with their own side effect profiles and were not originally designed for menopausal symptoms.
Veozah works through a completely different pathway than any of these options. By acting directly on the brain’s thermostat rather than altering hormone levels or neurotransmitter activity, it represents a genuinely new class of treatment for menopausal hot flashes.