Fezolinetant

What it is

Fezolinetant (brand name Veozah) is the first medication in a new class — neurokinin-3 (NK3) receptor antagonists — FDA-approved in 2023 for moderate-to-severe vasomotor symptoms.

It directly targets the KNDy neurons in the hypothalamus that mediate hot flashes, without using hormones.

How it works

In menopause, declining estrogen disinhibits NK3-expressing KNDy neurons, which fire and trigger the hypothalamic temperature dysregulation experienced as hot flashes. Fezolinetant blocks the NK3 receptor and quiets that signal.

Who it's for

• Women who cannot or prefer not to use estrogen
• Breast cancer survivors (coordinate with oncology)
• Women who failed or did not tolerate SSRI/SNRI options

Who should not take it

• Patients with cirrhosis
• Patients with severe renal impairment
• Patients on strong CYP1A2 inhibitors

Common side effects

• Headache, abdominal pain, diarrhea
• Liver enzyme elevation — periodic LFT monitoring is required

Evidence summary

• SKYLIGHT trials demonstrated significant reductions in hot flash frequency and severity at 4 and 12 weeks.

FAQ

Sources

• U.S. Food & Drug Administration
• NAMS 2022 Hormone Therapy Position Statement

Symptoms Fezolinetant can help treat

Other medications

This page is educational and is not a substitute for a clinical evaluation. Whether any medication is appropriate for you depends on your full medical history. Kindr providers make individualized prescribing decisions during a clinical visit.