Key takeaways
Veozah is FDA approved for hot flashes during menopause, but it may cause liver problems and isn’t widely covered by insurance.
Hormonal alternatives like estrogen or estrogen/progestin therapy can effectively manage hot flashes for many women.
Non-hormonal options, including SSRIs and anticonvulsants, are often used off-label to treat menopause-related hot flashes.
Natural remedies like soy isoflavones, black cohosh, and lifestyle changes may help reduce hot flashes, but more research is needed.
Going through menopause can be stressful, especially when you’re experiencing constant night sweats and hot flashes. Veozah, known by its generic name fezolinetant, is a relatively new drug FDA approved to manage severe hot flashes and other vasomotor symptoms caused by menopause. It works as a neurokinin 3 (NK3) receptor antagonist that blocks the activity of a specific brain chemical involved in managing body temperature.
Though it’s an effective medication, it may not be right for everyone. For example, Veozah may cause an increase in liver enzymes and even severe liver injury in some cases. As a brand-name drug, it’s not typically covered by Medicare or other insurance plans. Therefore, many people might seek other options, including hormonal and non-hormonal medications, to treat menopausal symptoms.
If you’re considering Veozah alternatives, it’s best to consult a doctor or healthcare provider to find the most suitable treatment. Continue reading to learn more about potential options you can discuss with a healthcare provider.
What can I take in place of Veozah?
Postmenopausal women experiencing severe vasomotor symptoms, such as hot flashes, have several alternatives to Veozah. These options are typically divided into hormonal treatments and non-hormonal treatments.
Hormonal treatments
Hormone replacement therapy (HRT) is a common option for managing symptoms of menopause. HRT typically involves the use of estrogen or a combination of estrogen and progestin.
Hormonal treatment may be given as local or systemic hormones. Local hormone therapy targets specific areas, like using vaginal estrogen creams to relieve dryness. On the other hand, systemic hormones, such as pills or patches, work throughout the whole body to relieve symptoms like hot flashes.
Estrogen-only therapy is usually recommended for women who have had a hysterectomy (surgery to remove the uterus). Since there is no risk of uterine cancer in these women, estrogen alone can effectively relieve symptoms. Combination estrogen/progestin therapy may be recommended for women who still have their uterus, as progestin helps protect against the increased risk of uterine cancer linked to taking estrogen alone.
Non-hormonal treatments
HRT may not be suitable for everyone. Women with certain health risks, such as a history of breast cancer or cardiovascular issues, may want to explore non-hormonal alternatives.
Non-hormonal prescription treatments include antidepressants and anticonvulsants, which are often prescribed off-label for menopausal symptoms. This means they are not specifically approved for this use, but research indicates they can be effective choices. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that may also help improve mood changes that can occur during menopause.
Compare Veozah alternatives |
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Drug name | Uses | Dosage | Savings options |
Veozah (fezolinetant) |
|
45 mg once daily | Veozah coupons |
Brisdelle (paroxetine) |
|
7.5 mg once daily at bedtime | Paroxetine coupons |
Effexor XR (venlafaxine, extended-release) |
|
75 mg once daily | Effexor XR coupons |
Neurontin (gabapentin) |
|
300 mg three times daily | Neurontin coupons |
Ditropan (oxybutynin) |
|
5 mg two or three times daily | Ditropan coupons |
Catapres-TTS (clonidine) |
|
One patch once every week | Catapres-TTS coupons |
Duavee (conjugated estrogens/bazedoxifene) |
|
One 0.45 mg conjugated estrogens/bazedoxifene 20 mg tablet once daily | Duavee coupons |
Estrogel (estradiol) |
|
1.25 g per day applied to the arm | Estrogel coupons |
Celexa (citalopram) |
|
20 mg once daily | Celexa coupons |
Lexapro (escitalopram) |
|
10 to 20 mg once daily | Lexapro coupons |
Other alternatives to Veozah
- Estrogel (estradiol)
- Bijuva (estradiol/progesterone)
- Climara (estradiol)
- Vivelle-Dot (estradiol)
- Premarin (conjugated estrogens)
- Estrace (estradiol)
- Femring (estradiol acetate)
- Pristiq (desvenlafaxine)
- Prozac (fluoxetine)
- Lyrica (pregabalin)
Top 5 Veozah alternatives
The following are some of the most common alternatives to Veozah.
1. Brisdelle (paroxetine)
Brisdelle is a brand-name prescription drug that contains paroxetine, an SSRI commonly used for treating depression. It’s the only SSRI approved by the FDA specifically to treat hot flashes in menopausal women.
Clinical studies have shown that Brisdelle can reduce the frequency and intensity of hot flashes. One study found that taking 7.5 mg of paroxetine helped reduce hot flashes by around 65% after 12 weeks. Like many SSRIs, possible side effects may include nausea and headache.
2. Effexor XR (venlafaxine, extended-release)
Effexor XR contains the active ingredient venlafaxine, which may help manage menopause-related hot flashes. Venlafaxine belongs to a class of medications called serotonin-norepinephrine reuptake inhibitors (SNRIs).
It is often prescribed for depression and anxiety, but studies have shown it can also alleviate hot flashes. One study found that menopausal women with hot flashes who took venlafaxine saw a greater improvement in sleep than placebo. Side effects may include nausea, drowsiness, and dry mouth.
3. Neurontin (gabapentin)
Neurontin, known generically as gabapentin, is often used to treat seizures and nerve pain. It has gained attention as a treatment for hot flashes among menopausal women. Though initially not developed for this purpose, Neurontin has been shown to help reduce the frequency and severity of hot flashes in some patients.
Clinical studies have looked at how well gabapentin helps reduce hot flashes in women going through menopause who can’t or don’t want to use hormone therapy. Findings from one review showed that women taking gabapentin had a much greater decrease in hot flushes, with nearly three times more improvement than those taking a placebo.
4. Ditropan (oxybutynin)
Ditropan, or oxybutynin, is typically used to treat bladder conditions, but it has been found useful for hot flashes as well. Though not originally for this use, some clinical trials support its effectiveness for hot flashes.
One study found that women taking oxybutynin reported a significant decrease in hot flashes, with those on a higher dose (5 mg twice a day) experiencing an average reduction of around 17 hot flashes per week compared to around six in the placebo group. While oxybutynin was effective, it also caused more side effects like dry mouth and difficulty urinating.
5. Catapres (clonidine)
Catapres, which contains clonidine, is another prescription drug sometimes used off-label to control hot flashes. It’s known mainly for treating high blood pressure. However, clonidine has been found to also decrease the frequency and severity of hot flashes in menopausal women.
Results from a clinical trial showed that women using 0.1 mg clonidine patch experienced a 20% reduction in the frequency of hot flashes and a 10% reduction in their severity. However, many participants also reported side effects, including dry mouth, constipation, itchiness, and drowsiness.
Natural alternatives to Veozah
Various natural remedies and supplements may help manage hot flashes. However, the FDA has not approved these remedies, and more research is needed to confirm how well they work. It’s always a good idea to talk to a healthcare provider before trying them, as they can have uncomfortable side effects and may interact with other medications.
Natural alternatives to Veozah may include:
- Soy isoflavones: These plant compounds may help reduce hot flashes by mimicking estrogen in the body.
- Black cohosh: This herbal remedy is commonly used to relieve menopausal symptoms, including hot flashes.
- Vitamin E: Some studies suggest that vitamin E may help lessen the severity and frequency of hot flashes.
- Dong quai: Often used in traditional medicine, Dong Quai is believed to balance hormones and alleviate menopausal symptoms.
- Flaxseed: This natural source of omega-3 fatty acids may help reduce hot flashes and support overall health.
Along with herbal supplements and vitamins, making lifestyle changes may help manage menopause symptoms. Cutting back on alcohol consumption and eating a balanced, nutritious diet may help reduce hot flashes and improve overall health. Regular exercise may also be helpful for stabilizing mood and supporting bone health.
Some people might consider alternative therapies like yoga and acupuncture. These practices may help reduce stress and promote relaxation, which may reduce symptoms like anxiety and mood swings. While research on their effectiveness is still ongoing, many people may find these activities helpful for their mental and physical health during menopause.
How to switch to a Veozah alternative
Switching from Veozah to another medication may feel confusing, but with the right guidance, it doesn’t have to be a stressful process.
First, you’ll want to set up a meeting with a healthcare provider to discuss your specific symptoms and goals. You may want to bring up how the medication is affecting you, especially if you’re experiencing serious side effects. You can also mention if price and insurance coverage are factors for you.
You can then develop a plan. Work with the healthcare provider to create a plan for switching medications. They can help recommend alternatives for specific symptoms based on your medical condition.
Switching medications should be done under medical supervision. Avoid making changes to your treatment plan without talking to your healthcare provider first.
Sources
- DA adds warning about rare occurrence of serious liver injury with use of Veozah (fezolinetant) for hot flashes due to menopause, U.S. Food and Drug Administration (2024)
- Using HRT (Hormone Replacement Therapy), Breastcancer.org, (2024)
- Nonhormonal pharmacotherapies for the treatment of postmenopausal vasomotor symptoms, Cureus (2024)
- A clinical review on paroxetine and emerging therapies for the treatment of vasomotor symptoms, International Journal of Women’s Health (2022)
- Effects of estradiol and venlafaxine on insomnia symptoms and sleep quality in women with hot flashes, Sleep (2015)
- Gabapentin for the treatment of hot flushes in menopause: a meta-analysis, Menopause (2020)
- Oxybutynin vs placebo for hot flashes in women with or without breast cancer: a randomized, double-blind clinical trial (ACCRU SC-1603), JNCI Cancer Spectrum (2020)
- Transdermal clonidine for ameliorating tamoxifen-induced hot flashes, Journal of Clinical Oncology (1994)
- Complementary and alternative medicine for menopause, Journal of Evidence-Based Integrative Medicine (2019)
- Mayo Clinic Minute: Why alcohol and menopause can be a dangerous mix, Mayo Clinic News Network (2023)