What Is Fezolinetant (Veoza)?

A new non-hormonal treatment for menopausal hot flushes and night sweats has been approved for use on the NHS, offering an important alternative for women who are unable or unwilling to take hormone replacement therapy (HRT).

The medication, known as Fezolinetant and sold under the brand name Veoza, is a once-daily 45 mg tablet manufactured by Astellas Pharma. It has been specifically developed to treat moderate to severe vasomotor symptoms (VMS) — the clinical term for the hot flushes and night sweats that affect over 2 million women across the UK.

The decision was made by the National Institute for Health and Care Excellence (NICE), which published its Final Draft Guidance on 11 March 2026. It is estimated that around 500,000 women in England are eligible to benefit from NHS-funded access to this treatment.

How Does Fezolinetant Work?

Unlike HRT, Fezolinetant does not contain hormones. It belongs to a new class of medication known as neurokinin 3 (NK3) receptor antagonists — the first of its kind to be recommended by NICE.

During menopause, declining oestrogen levels disrupt the balance of a brain chemical called neurokinin B (NKB), which plays a key role in regulating body temperature. When NKB activity goes unchecked, it triggers the heat dissipation responses we experience as hot flushes and night sweats.

Fezolinetant works by selectively blocking neurokinin B from binding to NK3 receptors on specific neurons in the hypothalamus — the part of the brain responsible for thermoregulation. By interrupting this signalling pathway, the treatment reduces both the frequency and severity of vasomotor symptoms without affecting hormone levels.

The efficacy and safety of Fezolinetant were established through the BRIGHT SKY clinical trial programme, which included three Phase 3 trials involving over 3,000 women across the UK, US, Canada, and Europe.

Who Is Fezolinetant Suitable For?

HRT remains the first-line treatment for menopause symptoms and is widely used due to its effectiveness in managing a broad range of issues associated with the menopause. Given the established benefits and range of HRT formulations now available, most women with moderate to severe vasomotor symptoms will continue to take it.

However, HRT is not suitable for everyone. It may be medically contraindicated for women with a history of deep vein thrombosis (DVT), pulmonary embolism, or certain other conditions. Others may simply prefer a non-hormonal approach to managing their symptoms. The approval of Fezolinetant provides an additional NHS-funded option, helping to ensure that menopause care can be more personalised to individual needs and circumstances.

It is worth noting that Fezolinetant treats vasomotor symptoms specifically. It does not address other menopausal symptoms such as vaginal dryness, mood changes, brain fog, or joint pain, and it has not been directly compared with HRT in head-to-head clinical trials.

Who Should Not Take Fezolinetant?

Fezolinetant is not suitable for everyone. NICE guidance states that it is not recommended for women with current breast cancer, other oestrogen-dependent cancers, or liver disease.

Women who have previously had breast cancer or oestrogen-dependent cancers and have completed treatment should undergo an individual risk assessment before being considered for Fezolinetant, as clinical trial data in this group is not yet available.

Before starting treatment, patients will need liver function blood tests. These are required before commencing the medication and at regular intervals during treatment — monthly for the first three months, and then at six and nine months — to ensure it remains safe and appropriate.

What This Means for Menopause Care

The introduction of Fezolinetant represents a meaningful step forward in the range of treatment options available to women experiencing the menopause. As the British Menopause Society noted, the next steps involve integrating this medication into primary and secondary care settings through local formularies and care pathways.

As awareness of the menopause continues to grow, so too does the importance of offering safe, effective, and individualised treatment. Fezolinetant is a welcome addition to the options available for managing vasomotor symptoms, particularly for women seeking alternatives to hormone-based therapies.

If you are experiencing menopausal symptoms and would like to explore your treatment options, book an initial menopause consultation, get in touch with our team today to book your appointment.