What is Fezolinetant?
It is a neurokinin 3 antagonist that works by blocking the neurokinin 3 receptors in the brain that trigger the thermoregulatory centre responsible for causing vasomotor symptoms such as hot flushes and sweats. One example is Veoza brand.
It is non-hormonal option for treating moderate to severe vasomotor symptoms that occur because of menopause and therefore may be an option for you do not wish to or advised not to take HRT as a first line treatment.
It is important to know that there are limited or no trials to date for its use in those with active or previous breast cancer, or other oestrogen dependant cancers. However, we do know that Fezolinetant has not been shown to significantly affect most hormone levels. Therefore, this may still be a good option for you and its important you have support with your menopause specialist so that together you can weigh up the benefits of symptom control versus how you feel about the uncertainties with regards to lack of studies confirming safety.
What’s the dosage of fezolinetant for menopause symptoms and how do I take it?
Fezolinetant comes in a single 45mg tablet to be taken once a day, swallowed whole, with or without food.
Do I need any monitoring?
Liver injury has been observed in some women taking Fezolinetant and therefore careful monitoring of your liver functions is required, via blood tests, at the following points in your treatment journey:
– Prior to starting treatment
– Once a month for the first 3 months plus more frequently if your liver functions tests m=become abnormal or if you develop any signs of liver injury such as abdominal pain, ongoing nausea, vomiting, jaundice (yellowing of the skin or eyes), dark urine, pale faeces.
– At 3 months combined with a follow up appointment.
– Thereafter, blood test monitoring will be advised based on your individual case.
Are there any side effects?
Some women may experience diarrhoea and trouble sleeping. If you experience any of the following symptoms, its is important you discuss this with your specialist as you may need more rigorous liver function test monitoring to check for lover damage (abdominal pain, ongoing nausea, vomiting, jaundice (yellowing of the skin or eyes), dark urine, pale faeces).
Who should not take Fezolinetant?
The following patients should not take the medication: Moderate to severe liver disease; severe kidney disease; if you are pregnant or breastfeeding, if you are taking some medication that inhibit CYP1A2 enzyme (for example ethinyl oestradiol containing contraceptives, some antibiotics, and some statins. Your doctor can find a list of interacting medications on the MRHA website.
Some caution should be taken in the following, as there are limited or no studies, and therefore it is important you speak with a menopause specialist to weigh up the benefits of symptom control versus how you feel about the uncertainties with regards to lack of studies confirming safety
-Those who are still experiencing hot flushes on HRT. The manufacturer recommends Fezolinetant is avoided if you are taking HRT already and want to continue taking it.
-Those who have epilepsy. There is no information to guide whether it will increase the risk of having another seizure or frequency of seizures.
– Those with active or previous breast cancer, or other oestrogen dependant cancers.
If you would like to discuss whether Fezolinetant may be an option for you, please book an appointment with our specialist.
