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What is Veozah?
Veozah, also known by its generic name fezolinetant, is a relatively new prescription medication used to treat moderate to severe hot flashes associated with menopause. Unlike other hot flash treatments like hormones, Veozah is non-hormonal and works by blocking neurokinin B, a neuropeptide involved in thermoregulation (body temperature regulation).
Veozah was approved by the FDA in 2022 and is manufactured by the pharmaceutical company Acadia as the brand name product. It comes as a 45mg tablet taken orally once daily, with or without food.
How Does Veozah Work?
Veozah works by blocking the neurokinin-3 (NK3) receptor in the brain. Neurokinin B binds to this receptor and is involved in signaling hot flashes. By blocking the receptor, Veozah is able to reduce the frequency and severity of hot flashes and night sweats associated with menopause.
Neurokinin B interacts with neurons in the hypothalamus, an area of the brain that regulates body temperature. High levels of neurokinin B during menopause are thought to cause the hypothalamus to mistakenly signal that the body is overheating, triggering the physical symptoms of a hot flash like sweating and flushing.
Veozah’s mechanism of action is distinct from hormone therapies like estrogen, which aim to replace declining estrogen levels during menopause. As a non-hormonal treatment, Veozah provides an alternative option for women who want relief from hot flashes but are concerned about using hormone therapy.
Effectiveness of Veozah
Clinical trials have found Veozah to be effective at reducing the frequency and severity of hot flashes. In one pivotal 12-week study:
- Women taking Veozah experienced about 2.5 fewer moderate to severe hot flashes per day compared to 1 fewer for those taking a placebo.
Nearly 50% of women on Veozah reported a 50% or greater reduction in daily hot flash counts, versus 30% for placebo.
Veozah treatment also led to fewer nighttime awakenings from hot flashes compared to placebo.
Additional longer-term studies showed Veozah’s effects were maintained for up to 52 weeks with consistent dosage. While not as effective as hormonal treatments, Veozah provides noticeable relief from menopausal hot flashes and could be preferable for some women.
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Veozah Dosage & Administration
The standard dosage of Veozah is one 45mg tablet taken orally once per day, at about the same time each day. Veozah can be taken with or without food.
No dosage adjustments are typically needed based on age, kidney or liver function for most patients. However, people with severe kidney or liver impairment may require a lower starting dose that is monitored more closely by their healthcare provider.
It’s important to take Veozah exactly as prescribed and not stop treatment without first consulting your doctor. This helps maintain a consistent level in the body and avoid potential side effects from improperly stopping medication.
Potential Side Effects of Veozah
Like all medications, Veozah can produce side effects in some users. The most commonly reported side effects in clinical trials include:
- Stomach pain
- Back pain
Most side effects are mild to moderate in severity. Stomach/digestive issues are the most frequent but often go away within a few weeks as the body adjusts to the medication.
More serious potential side effects requiring immediate medical attention include signs of liver damage such as jaundice, abdominal pain, nausea, vomiting or clay-colored stools. Veozah use requires periodic liver enzyme monitoring by a doctor.
As with any new medication, be sure to discuss your full medical history including any pre-existing conditions with your healthcare provider before starting Veozah treatment. This helps minimize risk for potential drug interactions or contraindications.
Cost of Veozah Treatment
Since Veozah is currently only available as the brand name product, it tends to have a higher price tag than generic options. However, many pharmacies and insurance plans offer savings programs that can help reduce the cost of Veozah for eligible patients.
The wholesale acquisition cost (WAC) or list price for a monthly supply of Veozah (30 tablets) is approximately $810. However, the average out-of-pocket cost to a patient after insurance is usually lower thanks to rebates and coverage.
For the uninsured or underinsured, services like GoodRx can provide Veozah coupons to knock down costs at pharmacies even further. For example, at the time of writing a 30-day supply of Veozah averaged around $540 through GoodRx discounts without insurance.
Talk to your doctor and pharmacist about all the savings options available so you can find the most affordable approach to purchasing Veozah based on your insurance coverage and financial situation. Cost should not be a barrier to necessary treatment if there are programs to assist with medication access.
Alternatives to Veozah
While Veozah provides a hormone-free alternative for hot flash treatment, it’s certainly not the only option available. Here are a few potential non-hormonal or hormone alternatives your doctor may discuss:
- Brisdelle – Paroxetine (generic Prozac) is FDA approved to treat hot flashes. Side effects include nausea, fatigue and headache. Lower monthly cost compared to Veozah.
Osphena – Paroxetine combined with estrogen is another non-hormonal option but with a black box warning for increased breast cancer risk. More side effects than Veozah.
Low-dose birth control pills – Often effective at reducing hot flashes when progesterone level is low. Off-label use so insurance coverage varies. May interact with other medications.
Hormone therapy (HT) – Estrogen pills, patches or creams used “short term” to control symptoms in women without health contraindications. Can reduce bone loss and heart risks versus no treatment. Potential side effects include breast tenderness, headaches, mood issues.
Always discuss all pros and cons of options with your doctor to determine the best overall treatment approach given your medical history, lifestyle preferences and health goals. Alternatives expand choices when Veozah may not be quite right or too expensive.
Frequently Asked Questions about Veozah
Is Veozah safe to use long term?
While initial studies looked at Veozah for 12-52 weeks, long term safety data beyond 1-2 years is still limited as it’s a new medication. No safety issues have arisen so far. As with any treatment, discuss risks/benefits of long term use with your doctor given your individual circumstances.
Can I drink alcohol while taking Veozah?
Drinking alcohol is not strictly prohibited, but it’s best to limit intake or avoid it entirely while taking Veozah. Alcohol can sometimes make hot flashes worse or interfere with medication metabolism, raising levels in the body and side effect risks. Moderation is key.
How quickly does Veozah start working?
Most women notice a decrease in hot flash symptoms within 2-4 weeks after starting Veozah. The full effects may take 6-8 weeks to be achieved as the medication builds up in your system with consistent daily dosing. Stick with the treatment schedule prescribed by your doctor.
Can I still use vaginal estrogen if taking Veozah?
Low-dose vaginal estrogen used short-term is generally considered safe to use along with Veozah by doctors, as it provides localized treatment without raising estrogen levels systemically. However, always double check with your specific healthcare provider given your medical profile.
Veozah – A New Non-Hormonal Option for Hot Flashes
In summary, Veozah offers menopausal women experiencing bothersome hot flashes and night sweats due to low estrogen levels a non-hormonal treatment option proven to reduce symptoms in clinical trials. While not as effective as hormones for some, its diverse mechanism of action sets it apart from similar non-hormonal therapies on the market too.
By blocking neurokinin B in the brain rather than replacing estrogen levels, Veozah provides relief of menopausal symptoms without masking underlying hormone decline or carrying breast cancer concerns like estrogen. It allows natural biological changes to occur while improving quality of life through reduced uncomfortable symptoms during this transition period.
With costs continuing to decrease through manufacturer discounts and coupons, Veozah is becoming accessible to more patients. Its favorable side effect profile also makes it generally well tolerated by most. Always discuss candidly with your doctor whether Veozah may be the right treatment approach for managing your personal menopause experience based on individual goals, health history and lifestyle factors. Non-hormonal options broaden choices.