Veoza Information Sheet

What does Veoza help with and how does it work?

Hot flushes and night sweats are the most common symptoms of the menopause experienced by around 80% of women at some stage of the menopause transition. Hormone replacement therapy (HRT) is the most effective way of managing these for most – but what about if you have been advised not to take HRT or you don’t want to?

This is where Veoza comes in. It is a new, non-hormonal medication that is designed to help manage moderate to severe vasomotor symptoms (hot flushes and night sweats) that occur as a result of the menopause.

The active ingredient in Veoza is called fezolinetant. This is a neurokinin 3 antagonist that works by blocking the neurokinin 3 receptors in the brain that play an important role in the regulation of body temperature – so it works to block the source of the hot flush. This means that it may be suitable to use in some conditions where you have been advised not to take HRT. It is important to note that it has not been studied in women who have been diagnosed with breast or other cancers. A discussion with a menopause specialist or oncologist is important when deciding whether Veoza is suitable for you to take.

What’s the dosage and how do I take it? 

Veoza comes in a tablet form containing 45mg of fezolinetant that will be swallowed every day. One box contains 28 tablets.

How effective is it?

Hormone replacement therapy (HRT) is the most effective way of managing hot flushes and night sweats for most women, reducing symptoms frequency and intensity by up to 90%. A large clinical trial of fezolinetant published in March 2023 showed that after 12 weeks of use it reduced the frequency of hot flushes by about 60% in women with moderate or severe symptoms, compared with a 45% reduction in those who received a placebo ^[1].

Is there anyone who can’t take Veoza?

• Veoza has not been studied on women over the age of 65.
• Women with moderate to severe liver disease should not take it,
• nor should women with severe kidney disease (eGFR < 30 ml/min/1.73 m²).
• You should not take Veoza if you are pregnant or breastfeeding,
• if you are allergic to any of the other ingredients or
• if you are taking some medication that inhibit CYP1A2, an enzyme important in breaking down and processing many medications.
• Drugs that may interact with Veoza and therefore should not be taken alongside it, include ethinyl oestradiol containing contraceptives, mexiletine, enoxacin, ciprofloxacin containing antibiotics, methoxsalen, mexiletine, vemurafenib, acyclovir, allopurinol, cimetidine, peginterferon alpha, piperine, zileuton and fluvoxamine.
• Veoza has not been studied in women who are undergoing cancer treatment for oestrogen dependent cancers or a previous breast cancer diagnosis, or oestrogen dependent malignancy. The manufacturer therefore recommends that it is avoided in these circumstances. However, Veoza has not been shown to significantly affect most hormone levels and so a discussion with your clinician is important, weighing up the benefits of symptom control versus how you feel about the uncertainties with regards to lack of studies confirming safety.
• Veoza has not been studied on women taking HRT and who are still experiencing hot flushes. The manufacturer therefore recommends that it is avoided if you are taking HRT already and want to continue to take it.
• Veoza has not been studied in women who have epilepsy so there is no information to guide whether it will increase the risk of having another seizure or frequency of seizures. The decision whether to take Veoza should therefore be based on the benefits versus how you feel about the lack of studies into its impact on epilepsy.

Are there any risks to taking Veoza?

Studies have shown that liver function blood tests can become abnormal in women taking Veoza. The liver function returned to normal when the Veoza was stopped. There are no current recommendations in the UK to monitor liver function but, at My Menopause Centre we recommend checking the liver function before you start taking Veoza and then 3 months after it is started. It will be discussed whether further liver function testing is required after this time on an individual basis.

That is why you will need a follow up appointment up to 3 months after the initial prescription, including monitoring of liver function blood tests, and ongoing follow up during treatment as advised by your doctor.

Are there any side effects?

When Veoza was studied, the most common side effects included difficulty sleeping, diarrhoea, headache and abdominal pain, and some experienced abnormal liver function blood tests also. You should contact your prescribing doctor if you experience nausea, vomiting, yellowing of the eyes or skin (jaundice), pain in the right upper abdomen which may be signs of liver disease.

Is Veoza available in the UK and what does it cost?

Veoza is now available privately in the UK. Unfortunately, Veoza is not yet available on the NHS.  To be available on the NHS, a further appraisal of the clinical and cost-effectiveness by the National Institute of Clinical and Healthcare Agency (NICE) is required. The publication date of this is yet to be confirmed.

If you would like to discuss whether Veoza might be right for you, please book an appointment with one of the doctors in our clinic.

Costs

• A box of Veoza costs £60. It contains 28 tablets, so will last 4 weeks.
• It is recommended by the manufacturer that your liver function is checked before Veoza is started and monitored 3 months after it has been started. A blood test to check your liver function costs £35 with our partner, Medichecks. It will be discussed whether further liver function testing is required after this time on an individual basis.
• If you are a new patient, you will need to book an initial appointment (£290) and, within 3 months, a follow up appointment (£170) to check how you are getting on and monitor your liver function. A further follow up appointment is required at 12 months.
• A repeat prescription for Veoza costs £35 and this includes a review of your liver function blood test results by the doctor (but not the cost of the medication or the blood test). Prescriptions will be issued for 3 boxes – i.e. 3 * 28 days = 84 days (12 weeks).

For more information on Veoza, visit the electronic medicines compendium website here.