Veozah (fezolinetant) is a nonhormonal daily pill, FDA-approved in 2023, for moderate to severe hot flashes and night sweats caused by menopause. It works by calming an overactive brain pathway that drives hot flashes, without using estrogen or any other hormone — but it requires periodic liver blood tests while you're on it.
Veozah (fezolinetant) was the first medication in a new class — neurokinin 3 (NK3) receptor antagonists — approved specifically for menopausal hot flashes. It gives patients who can't or don't want to use hormone therapy an effective, non-hormonal option.
How Does Veozah Work?
As estrogen declines during menopause, a group of neurons in the brain's hypothalamus (the body's temperature control center) becomes overactive. This overactivity is what triggers the sudden waves of heat, flushing, and sweating known as hot flashes and night sweats. Fezolinetant blocks the neurokinin 3 (NK3) receptor on these neurons, calming that overactivity and helping restore normal temperature regulation — all without touching estrogen or any other hormone.
Who Is Veozah For?
Veozah is approved for moderate to severe vasomotor symptoms (hot flashes and night sweats) due to menopause. It's a good option for women who:
- Cannot take hormone therapy (for example, due to a history of breast cancer, blood clots, or certain cardiovascular conditions)
- Prefer not to use hormones for personal reasons
- Have tried hormone therapy without adequate relief
Dosing
| Detail | Instruction |
|---|---|
| Dose | 45 mg tablet by mouth, once daily |
| Food | Can be taken with or without food, at any consistent time of day |
| Swallowing | Swallow whole with liquid — do not cut, crush, or chew |
| Missed dose | Take it as soon as you remember if more than 12 hours remain before your next dose; otherwise skip it and resume your regular schedule the next day |
🔮 Liver monitoring is required. Veozah carries a rare risk of liver injury, so your provider will check liver blood tests (ALT, AST, ALP, and bilirubin) before you start, then monthly for the first 3 months, and again at 6 and 9 months. Veozah should not be started if your liver tests are already significantly elevated, and it may need to be stopped if levels rise too high during treatment.
- Call your provider immediately if you develop fatigue, loss of appetite, nausea, vomiting, yellowing of the skin or eyes (jaundice), dark urine, or pain in the upper right abdomen — these can be signs of liver injury.
Side Effects
The most common side effects reported in clinical trials include headache, abdominal pain, diarrhea, insomnia, back pain, hot flush, and elevated liver enzymes. Most side effects are mild; liver enzyme elevations are the reason for the monitoring schedule above.
Veozah vs. Lynkuet: Two Nonhormonal Options
Veozah isn't the only nonhormonal option anymore — Lynkuet (elinzanetant) was approved in 2025 and works on a related but broader pathway. See our Lynkuet guide for how the two compare, including dosing frequency, half-life, and side-effect differences. Your endocrinologist can help you decide which nonhormonal option (or whether hormone therapy) is the best fit for you.
Key Takeaways
- Veozah (fezolinetant) is a nonhormonal pill for moderate to severe menopausal hot flashes and night sweats
- Works by blocking an overactive brain pathway (NK3 receptor) that triggers hot flashes
- Taken as one 45 mg tablet daily, with or without food
- Requires liver blood test monitoring before starting and at regular intervals during treatment
- Report any signs of liver problems (fatigue, nausea, jaundice, dark urine) to your provider right away
- A good option for women who can't or prefer not to use hormone therapy
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