Does Voezah help with night sweats and hot flashes?

Veozah (Fezolinetant) for Night Sweats and Hot Flashes

Yes, Veozah (fezolinetant) effectively treats both night sweats and hot flashes, which are collectively known as vasomotor symptoms of menopause. 1

Mechanism and Efficacy

Veozah (fezolinetant) is a neurokinin 3 receptor antagonist that was approved by the FDA in March 2023 specifically for treating vasomotor symptoms of menopause. It works differently than hormonal therapies by targeting the brain mechanisms that regulate body temperature, rather than replacing estrogen. 1

Non-Hormonal Treatment Options for Vasomotor Symptoms

When considering treatments for vasomotor symptoms like night sweats and hot flashes, several options are available:

First-Line Non-Hormonal Pharmacological Options:

1. Veozah (fezolinetant) - The newest FDA-approved non-hormonal treatment specifically for vasomotor symptoms 1

2. Gabapentin - Recommended as a first-line treatment at 300 mg/day, gradually increasing to 900 mg/day over 1-3 weeks

   • Reduces hot flash frequency by 46-51% compared to 15-26% with placebo
   • Particularly useful for patients with sleep disturbances 2

3. Venlafaxine - Recommended at 37.5-75 mg daily

   • Reduces hot flash scores by 61% compared to 27% with placebo 2
   • Effective alternative when other options aren't suitable 2

4. Other antidepressants:

   • Paroxetine (7.5 mg daily) - Effective but use with caution due to CYP2D6 inhibition
   • Citalopram - May be effective when venlafaxine fails
   • Fluoxetine - Moderate efficacy with variable response 2

Lifestyle Modifications:

• Weight loss of ≥10% of body weight can eliminate hot flash symptoms 3, 2
• Smoking cessation improves frequency and severity of hot flashes 3, 2
• Avoiding triggers: spicy foods, caffeine, alcohol 2
• Environmental changes: cool rooms, dressing in layers 2
• Cognitive Behavioral Therapy (CBT) can reduce perceived burden of hot flashes 3, 2

Complementary Approaches:

• Acupuncture shows equivalence or superiority to some drug treatments 3, 2
• Relaxation techniques, slow-breathing, and hypnosis show clinical benefit 2
• Yoga may improve quality of life but has mixed results for direct hot flash reduction 2

Important Considerations and Cautions

• Hormonal therapies (estrogen/progestin) are the most effective treatments for vasomotor symptoms but are contraindicated in women with:

  • History of stroke 2
  • Hormone-dependent cancers 3, 2
  • Abnormal vaginal bleeding 2
  • Active liver disease 2

• For breast cancer survivors, hormonal treatments are generally not recommended, making non-hormonal options like Veozah particularly valuable 3

• Some supplements like black cohosh are not recommended due to reports of liver failure and lack of proven benefit 2

Clinical Decision Algorithm

1. Assess severity and impact of night sweats and hot flashes on quality of life
2. Rule out contraindications for hormonal therapy
3. Consider Veozah as a non-hormonal FDA-approved option, especially if:
   • Patient has contraindications to hormone therapy
   • Patient prefers non-hormonal treatment
   • Previous treatments have failed
4. Recommend lifestyle modifications concurrently to enhance treatment effect
5. Monitor response and adjust treatment as needed

Veozah represents an important addition to the treatment arsenal for menopausal vasomotor symptoms, offering relief for both night sweats and hot flashes without the risks associated with hormonal therapies.