A new non‑hormonal treatment for menopausal hot flushes and night sweats is set to become available on the NHS, offering fresh hope to people who cannot take hormone replacement therapy.
Fezolinetant – also known by the brand name Veoza and manufactured by Astellas Pharma – has been recommended in final draft guidance by the National Institute for Health and Care Excellence for the treatment of moderate to severe vasomotor symptoms.
Hot flushes and night sweats are some of the most disruptive symptoms of menopause, affecting sleep, concentration, emotional wellbeing, relationships and the ability to work. Until now, treatment options for those unable to use HRT have been extremely limited.
Fezolinetant is a 45mg once‑daily tablet that works by blocking specific nerve pathways in the brain responsible for triggering hot flushes and night sweats. Unlike HRT, it does not alter hormone levels.
While HRT remains the first‑line treatment for menopausal vasomotor symptoms, given its well‑established benefits and wide range of available formulations, fezolinetant fills an important gap for those who cannot or do not wish to take hormones.
Helen Knight, Director of Medicines Evaluation at NICE, said:
“We know that menopausal hot flushes and night sweats can have a profound impact on quality of life and significantly affect overall wellbeing.
“For those who are unable to take HRT for varying reasons, options have historically been limited, and we have heard clearly from patients how difficult that can be.
“The evidence shows fezolinetant can meaningfully reduce symptoms, and was found to be cost effective, offering value for the taxpayer. This decision will give much-needed relief to those for whom HRT is unsuitable.”
NICE’s draft recommendation states that fezolinetant can be offered when HRT is medically unsuitable, such as in cases involving:
- Deep vein thrombosis (DVT)
- Pulmonary embolism (PE)
- Certain cases of diabetes or heart disease, following a clinical risk assessment
It may also be prescribed for individuals who choose not to take HRT for personal or medical reasons.
The arrival of fezolinetant marks a significant shift in menopause treatment, providing an alternative for thousands who have had few options for managing debilitating symptoms.
NICE’s final guidance is expected to confirm its use, paving the way for the treatment to be made available across NHS services.
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