Menopause and the brain's thermostat
As oestrogen falls, the brain's temperature-control centre can react as if the body is overheating when it is not. The result is sudden heat, flushing and sweating, often at night.
Non-hormonal · Prescription only
Fezolinetant for menopausal hot flushes
Fezolinetant is a non-hormonal prescription tablet for moderate to severe hot flushes and night sweats. A doctor decides whether it suits you, and liver blood tests are part of treatment.
What is fezolinetant?
A non-hormonal prescription tablet for moderate to severe menopausal hot flushes.
Fezolinetant is a prescription medicine for moderate to severe hot flushes and night sweats caused by menopause. It contains no oestrogen or progestogen: it blocks a signal in the brain's temperature-control centre. In Singapore it is registered under the brand name Veoza, and a doctor must assess you before prescribing it.
It is only for hot flushes and night sweats, and it is not suitable for everyone. Liver disease, severe kidney disease, pregnancy and some medicines can rule it out, and liver blood tests are needed before and during treatment. If it does not suit you, other options, including menopause hormone therapy, can be discussed.
- Non-hormonal — no oestrogen or progestogen
- Prescription only — after a doctor's assessment
- Liver checks — blood tests before and during treatment
- Medicine review — some medicines cannot be taken with it
How it works
How does fezolinetant work?
Around menopause, falling oestrogen can make a signalling pathway in the brain's temperature-control centre overactive, which can set off hot flushes. Fezolinetant blocks the neurokinin 3 (NK3) receptors in that pathway. It does not replace hormones, and it does not treat other menopause symptoms or replace a wider health review.
A non-hormonal tablet
Fezolinetant blocks NK3 receptors in that pathway instead of replacing oestrogen. It is taken daily as prescribed. How well it works varies from person to person, so your doctor reviews it with you.
Liver tests are part of treatment
Rare but serious liver injury has been reported, so liver blood tests are done before you start, every month for the first three months, then as your doctor advises.
Hormonal and non-hormonal choices
Menopause hormone therapy is effective for hot flushes and may suit many healthy women under 60 or within 10 years of menopause. Your doctor explains how the options compare for you.
Is it for me?
Who might a doctor consider it for?
Fezolinetant may be considered when moderate to severe hot flushes or night sweats are the main problem and a non-hormonal treatment is preferred or needed. It is not suitable for everyone. Your doctor decides after checking your symptoms, liver and kidney health, and every medicine and supplement you take.
Yellow skin or eyes, dark urine or pale stools on treatment? Stop and seek advice.
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Frequent or severe hot flushes
Sudden heat that is frequent, disruptive or distressing.
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Night sweats that break your sleep
Sweats that wake you and affect how you function the next day.
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Hormones not suitable or not wanted
A non-hormonal prescription option your doctor can compare with hormone therapy.
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Had breast cancer?
It is not recommended while you are being treated for breast cancer, including with hormone-blocking tablets. After treatment ends, the decision is made case by case.
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Not sure it's menopause?
Your doctor first checks that your symptoms fit menopause.
Your treatment, step by step
Consult. Test. Start. Monitor.
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Consult
Talk through your symptoms, cycle history, health, preferences and other options with a doctor.
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Test
Baseline liver blood tests and a full medicines check. Bring a list of everything you take, including supplements.
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Start
If fezolinetant suits you, your doctor prescribes it and explains how to take it and what to watch for.
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Monitor
Monthly liver tests for the first three months, then regular reviews of the benefit, side effects and your ongoing need.
Safety & expectations
A non-hormonal option for some women, not for everyone. The decision is made with your doctor, after a liver and medicines check.
Bring a full list of your medicines and supplements, and tell us about any liver or kidney problems, pregnancy or breast cancer. Stop the medicine and seek advice promptly if you notice signs of liver problems.
VEOZAH: frequently asked questions
Is fezolinetant a hormone?
No. Fezolinetant is a non-hormonal medicine that contains no oestrogen or progestogen. It blocks neurokinin 3 (NK3) receptor signalling in the part of the brain that controls body temperature, a pathway involved in menopausal hot flushes. Because it is not a hormone, it is an option to discuss if hormone therapy is not suitable for you or not your preference.
Is fezolinetant available in Singapore?
Yes, on prescription. Fezolinetant is registered in Singapore as a prescription-only medicine, so it can be started only after a doctor has assessed your symptoms, health and medicines and arranged baseline liver blood tests. Our doctors at Wheelock Place can discuss whether it suits you.
Which symptoms does fezolinetant treat?
Fezolinetant is for moderate to severe hot flushes and night sweats (vasomotor symptoms) caused by menopause. It is not a treatment for other menopause symptoms, such as vaginal dryness or low mood, which need their own assessment. For other options, see our pages on menopause hormone therapy and on vaginal dryness and bladder leakage.
Who should not take fezolinetant?
Fezolinetant must not be taken with medicines that moderately or strongly block the liver enzyme CYP1A2, such as the antidepressant fluvoxamine or contraceptive pills containing ethinyl oestradiol, or during pregnancy. It is not recommended with moderate or severe liver disease, severe kidney disease, or while you are being treated for breast cancer, including with hormone-blocking tablets. Your doctor checks your history, every medicine and supplement you take, and your liver tests first.
Why are liver tests needed with fezolinetant?
Rare but serious drug-related liver injury has been reported with fezolinetant. Liver blood tests are done before you start, then every month for the first three months and afterwards as your doctor advises. Stop the medicine and seek medical advice promptly if you notice tiredness, nausea, vomiting, itching, yellowing of the skin or eyes, dark urine, pale stools or pain in the upper right abdomen.
What side effects can fezolinetant cause?
Possible side effects include diarrhoea, difficulty sleeping, abdominal discomfort, back pain and headache. Rarely, it can affect the liver, which is why blood tests are part of treatment. Tell your doctor about any side effect that bothers you, and stop the medicine and seek advice promptly if you notice signs of liver problems.
How long will I need to take fezolinetant?
There is no fixed length of treatment. Hot flushes last for different lengths of time in different women, so your doctor reviews at intervals whether you still need fezolinetant, whether it is helping and whether your liver tests remain normal.
Our doctors
Prescribed only after a doctor's assessment.
Appointments
Talk to a doctor about your hot flushes.
Book a menopause consultation at Wheelock Place. Your doctor goes through hormonal and non-hormonal options with you.