Fezolinetant – also known as Veoza – will now be available on NHS prescription following recommendations made by the National Institute for Health and Care Excellence (NICE). The once-daily 45mg tablet is a non-hormonal option for those who cannot or might not want to use HRT.
Below, Dr Rachel Hines, a women’s health GP and registered British Menopause Society menopause specialist explains how it works and what the NHS rollout means for you.
What is Veoza?
Veoza is a non-hormonal drug that has already been available to prescribe privately for a few years, says Dr Hines. ‘Now it has been approved by NICE, it will soon be available – within 90 days – for NHS Dr's to prescribe as well, so it should be available for all women.
‘Not all women can take HRT, and not everyone wants to use hormonal treatment so this offers a non-hormonal treatment designed to treat vasomotor symptoms – hot flushes and night sweats – which are common in the perimenopause and menopause and can be really debilitating.’
Who can take Veoza?
As Dr Hines says, soon, the treatment should technically be an option available for all women in England (while Wales and Northern Ireland often follow the same NICE guidance, Scotland’s independent body, the SMC, hasn’t recommended NHS rollout) experiencing moderate to severe vasomotor symptoms.
In its announcement, NICE said: ‘HRT remains the first-line treatment option and, given its established benefits and the range of formulations now available, it’s likely most people with moderate to severe vasomotor symptoms would continue to take it. However, fezolinetant addresses a real and important need for those who cannot or do not wish to use HRT.’
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It’s also important to note that because there’s currently no data available for how the drug affects women with breast cancer, other oestrogen-dependent cancers or liver disease, it’s not recommended to these populations. However, for women who have previously had breast cancer and completed treatment, use may be considered on an individual basis, and there are also ongoing trials investigating the use of fezolinetant in women with breast cancer, adds Dr Hines.
How does Veoza work?
‘Veoza is a non-hormonal treatment which acts on the thermoregulatory centre in the brain. Our sensitivity to temperature regulation narrows in the perimenopause and menopause, which is why slight changes in temperature can lead to having hot flushes and night sweats,’ explains Dr Hines. ‘Veoza works on the thermoregulatory centre by blocking the nerves that trigger hot flushes, reducing the number of hot flushes significantly.’
While there are existing non-hormonal treatments currently available that can help reduce hot flushes, including antidepressants, nerve stabilisers and medication for an overactive bladder, these are not specifically designed to treat hot flushes, says Dr Hines, whereas Veoza directly targets them.
‘It can impact liver function, so blood tests need to be checked before starting and at one, two and three months after starting,’ she notes.
How does it differ from HRT?
‘HRT contains oestrogen – and progesterone if you have a uterus,’ says Dr Hines. ‘Oestradiol is involved in our temperature regulation, and in perimenopause and menopause, levels fluctuate and fall, which impacts temperature regulation for many women, leading to hot flushes and night sweats. HRT contains oestradiol, which therefore increases the levels and improves temperature regulation.’
The bottom line
Dr Hines calls Veoza ‘an exciting addition to available non-hormonal treatments,’ with other alternative treatments also on route to approval. ‘The Medicines and Healthcare products Regulatory Agency (MHRA) has approved elinzanetant, which treats both hot flushes and insomnia. It’s awaiting NICE approval and for the treatment to be available more widely,’ she adds.
The process that goes into approving new drugs like Veoza is lengthy, says Dr Hines. ‘The drug is developed and undergoes clinical trials. Following that, they need to be approved by the MHRA to make sure it’s safe to use, effective and high quality. Following that, they are submitted to NICE who need to review all the evidence and then consider if it’s cost effective and suitable for wider use.’
Hannah Bradfield is a Senior Health and Fitness Writer for Women’s Health UK. An NCTJ-accredited journalist, Hannah graduated from Loughborough University with a BA in English and Sport Science and an MA in Media and Cultural Analysis. She has been covering sports, health and fitness for the last five years and has created content for outlets including BBC Sport, BBC Sounds, Runner’s World and Stylist. She especially enjoys interviewing those working within the community to improve access to sport, exercise and wellness. Hannah is a 2024 John Schofield Trust Fellow and was also named a 2022 Rising Star in Journalism by The Printing Charity. A keen runner, Hannah was firmly a sprinter growing up (also dabbling in long jump) but has since transitioned to longer-distance running. While 10K is her favoured race distance, she loves running or volunteering at parkrun every Saturday, followed, of course, by pastries. She’s always looking for fun new runs and races to do and brunch spots to try.
