What is Veozah?
Veozah (fezolinetant) is a non-hormonal prescription medication approved by the FDA in 2023 to treat moderate to severe vasomotor symptoms (VMS) associated with menopause, such as hot flashes and night sweats. Unlike hormone replacement therapy (HRT), which relies on estrogen, Veozah works by targeting a neural pathway in the brain. It is a neurokinin 3 (NK3) receptor antagonist that blocks the activity of a specific brain chemical called neurokinin B (NKB). By doing so, it helps restore the brain's temperature-regulating control, reducing the frequency and severity of hot flashes.
The Absence of a Fixed Treatment Timeline
One of the most important takeaways for patients is that there is no set, predetermined limit for how long you can take Veozah. Instead, the duration of your treatment is a highly individualized decision made in collaboration with your healthcare provider. This approach recognizes that the experience of menopause, including the length and intensity of VMS, varies significantly from person to person. Your doctor will help determine the optimal duration based on the severity of your symptoms and how well the medication is working for you.
While some patients may find relief after a period and feel comfortable stopping, others may need to continue treatment for as long as they experience disruptive symptoms. In clinical trials, the longest duration of study was 52 weeks (one year). This is a crucial point, as it means data on safety and efficacy beyond one year is still being gathered. However, many women experience VMS for longer than a year, so extended use may be necessary under medical supervision.
The Critical Role of Liver Monitoring
Due to the risk of rare but serious liver injury, long-term Veozah use requires a strict and consistent monitoring schedule. In December 2024, the FDA issued a Boxed Warning to highlight this risk. To mitigate this, patients must undergo the following blood tests to check liver function:
- Before starting Veozah: A baseline liver function test is required.
- Monthly for the first 3 months: Consistent monitoring is needed during the initial treatment phase.
- At 6 and 9 months: Additional checks are scheduled to monitor ongoing liver health.
It is imperative to immediately stop taking Veozah and contact a healthcare provider if any symptoms of liver problems develop. These include new-onset or unusual fatigue, nausea, vomiting, abdominal pain (especially in the upper right side), itching, dark urine, pale stools, or yellowing of the skin or eyes (jaundice).
Veozah vs. Hormone Replacement Therapy (HRT)
| Feature | Veozah (fezolinetant) | Hormone Replacement Therapy (HRT) |
|---|---|---|
| Mechanism of Action | Blocks neurokinin 3 (NK3) receptor in the brain, restoring temperature control | Replaces declining estrogen levels during menopause |
| Hormones Involved | Non-hormonal | Involves estrogen and often progesterone |
| Suitability | Alternative for women who cannot or do not want to use hormonal therapy | Traditional treatment, but may not be suitable for all women, such as those with certain cardiovascular risks or a history of specific cancers |
| Long-Term Risk | Rare but serious risk of liver injury requiring ongoing monitoring | May be associated with an increased risk of certain cancers and cardiovascular problems, depending on type and duration |
| Key Side Effects | Abdominal pain, diarrhea, insomnia, back pain | Wide range, can include bloating, breast tenderness, headaches |
Factors Influencing Treatment Duration
When deciding how long to continue Veozah, a doctor will consider several key factors:
- Symptom Persistence: Many women will continue taking Veozah as long as they experience moderate to severe hot flashes. A reduction in symptoms after starting Veozah indicates its effectiveness, but if symptoms return after stopping, a patient may need to restart.
- Side Effect Profile: The presence and severity of side effects play a significant role. If a patient experiences significant or persistent issues, especially related to liver function, the medication may be discontinued.
- Routine Re-evaluation: Since the drug is relatively new, ongoing dialogue with a healthcare provider is essential. Patients can work with their doctor to periodically re-evaluate their need for the medication based on their symptoms and overall health status.
Conclusion
Ultimately, there is no fixed timeline dictating how long you can stay on Veozah. The treatment duration is highly individual, tied to the patient's experience with menopausal symptoms and potential side effects. The one-year clinical trial data provides a safety foundation, but ongoing monitoring for liver health, especially during the first nine months, is crucial for long-term use. Because menopausal symptoms can last for several years, some patients may be on Veozah for an extended period under their doctor's careful supervision. A collaborative approach between the patient and their healthcare provider, focused on managing symptoms effectively while ensuring safety, is the best path forward for long-term treatment.
For more information on Veozah's use and safety, you can consult the official FDA Drug Trials Snapshot.
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for any medical concerns or before making any decisions related to your treatment.
