II. Indications

  1. Refractory Vasomotor Symptoms of Menopause (Hot Flashes)
    1. Second-line option when hormonal therapy is contraindicated

III. Mechanism

  1. Neurokinin 3 Receptor Antagonist
  2. Blocks neurokinin B (NKB) at the infundibular nucleus of the Hypothalamus
  3. Neurokinin B (NKB) regulates temperarture and its blockade can decrease Vasomotor Symptoms of Menopause (Hot Flashes)

IV. Efficacy

  1. Fezolinetant 45 mg daily reduces Hot Flashes by 2 to 3 per day
    1. Less effective than hormonal therapy
    2. Similar to SNRIs, SSRIs and Gabapentin in hot flash reduction

V. Background

  1. Cost: $550 per month when released in 2023

VI. Dosing

  1. Fezolinetant (Veozah) 45 mg orally daily
    1. Obtain baseline hepatic panel prior to starting, then in 3, 6 and 9 months
    2. Stop periodically to assess continued need

VII. Adverse Effects

  1. Common
    1. Diarrhea
    2. Abdominal discomfort
    3. Insomnia
  2. Serious
    1. Liver Injury
      1. Obtain baseline hepatic panel prior to starting, then in 3, 6 and 9 months

VIII. Drug Interactions

  1. CYP1A2 Inhibitors (e.g. Allopurinol, Omeprazole)
    1. Increase Fezolinetant levels

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Related Studies

Cost: Medications

veozah (on 9/20/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
VEOZAH 45 MG TABLET $17.53 each