Fezolinetant (Veozah): the new non-hormonal pill, and its PH status

• What it is: fezolinetant, a neurokinin 3 (NK3) receptor blocker (US label).
• Rx status: prescription only where approved.
• US approval: 12 May 2023 (Drugs.com).
• Australia: assessed for the PBS (PBS document).
• Philippines: Not available in PH retail as of October 2026. No FDA PH registration found. Prices checked October 2026.
• Used for: moderate to severe hot flashes and night sweats.
• Not a hormone: it does not help vaginal dryness or bone loss.

We will re-check the FDA Philippines verification portal (verification.fda.gov.ph) regularly.

When estrogen falls, a group of brain cells that help control body temperature becomes overactive. These cells use a signal called neurokinin B. Fezolinetant blocks the receptor for that signal, which calms the temperature centre without adding any hormone. The US label describes it as blocking neurokinin B on brain cells that regulate the body's temperature centre (US label).

This makes it different from the older non-hormonal options, which were borrowed from other uses (antidepressants, nerve-pain medicines). Fezolinetant was designed for hot flashes.

The Menopause Society 2023 nonhormone statement recommends fezolinetant, with the strongest level of evidence (Level I) (Menopause 2023). The US label lists one 45 mg tablet once daily (US label).

In November 2025, when the US FDA announced changes to HRT boxed warnings, it also announced approval of another non-hormonal hot flash drug (RAPS). New options are arriving abroad faster than in the PH.

Since December 2024 the US label carries a boxed warning: liver injury has been reported after approval. The label asks for liver blood tests before starting, then monthly for the first 3 months and again at 6 and 9 months (US label). Stop and see a doctor for new tiredness, loss of appetite, nausea or vomiting, itching, yellow skin or eyes, pale stools, dark urine or belly pain.

The US label says not to use it with:

• Known cirrhosis of the liver
• Severe kidney disease or kidney failure
• Medicines that block the CYP1A2 liver enzyme, whether weak, moderate or strong (fluvoxamine is one example). Ask your pharmacist to check your other medicines.

The most common side effects in the US label are stomach pain, diarrhoea, trouble sleeping, back pain, hot flushes and raised liver enzymes (US label). Because it is new, long-term data are more limited than for HRT.

Prices checked October 2026. Unit prices are not monthly costs; see the cost calculator.

The Menopause Society 2023 recommends all three non-hormonal medicines in this table (Level I). Paroxetine and gabapentin were borrowed from other uses and come with side effects such as nausea or drowsiness. Fezolinetant was built for hot flashes, but it is new, needs liver checks, and is not here yet.

• I read about fezolinetant. Is there anything similar I can get in the PH?
• Is hormone therapy safe for me, or is there a reason to avoid it?
• Which non-hormonal option fits my other medicines (for example tamoxifen)?
• I take fezolinetant from abroad. How do we plan a switch before my supply runs out?
• Would CBT for hot flashes help me, and where can I find it?

If you started fezolinetant abroad and are moving home:

• Bring a personal supply. Under Joint Circular No. 1 s. 2015, travellers may bring prescription medicines for personal use with the prescription (showing the doctor's licence number), a doctor's letter stating the condition and dose, and only the prescribed quantity (Philippine Embassy Berlin). We could not find whether this covers a product that is not registered in the PH, so ask FDA PH before you travel.
• Plan a switch with a PH doctor before your supply runs out. Do not buy from online sellers; unregistered medicines bought online may be fake.

Locally available alternatives:

• Paroxetine and gabapentin
• CBT for hot flashes and sleep
• Hormone therapy if it suits you: HRT for menopause and estradiol

See all choices on non-hormonal treatments and current prices on costs. Then find a doctor, or read our expat guide.