How does the menopause drug Veoza work? And how is it different to hormone therapy?

Veoza, also known as fezolinetant, is a menopause drug that works by blocking signals in the brain's temperature-control system responsible for hot flushes and night sweats. The medication targets and inhibits neurokinin 3 receptors (NK3), which prevents the release of a signaling molecule called neurokinin B. This action quiets the overactive temperature regulation pathway, reducing hot flushes and night sweats.

Veoza is distinct from hormone replacement therapy (HRT), which replaces declining hormones like estrogen to alleviate menopausal symptoms. While Veoza doesn't replace hormones, it provides benefits for hot flushes and night sweats and may offer additional improvements in sleep, mood, and daytime function without the risk of estrogen-related side effects. HRT remains the preferred option when broader symptoms like vaginal dryness, reduced bone density, or hormone deficiency are present.

In Australia, Veoza is sold as a 45mg tablet taken daily. It isn't covered by the Pharmaceutical Benefits Scheme, so patients pay around A$75–80 monthly. Unlike HRT, Veoza has no maximum treatment duration.

The drug has shown effectiveness in reducing hot flushes and related symptoms in clinical trials involving more than 3,000 women. However, it doesn't eliminate symptoms completely. Common side effects include headaches, nausea, abdominal pain, and insomnia. Rare cases of liver injury have been reported, necessitating regular liver function testing during treatment.

While Veoza offers a non-hormonal alternative for women who can't take HRT due to side effects or hormone-sensitive cancers, its impact on other menopausal symptoms is limited. HRT remains the go-to treatment for those broader concerns. Newer medications, like Lynkuet, are also being developed to address the neurokinin system and may provide additional benefits in the future.