Non-hormonal pill for menopause hot flushes approved by NHS

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NHS approves a non-hormonal pill for menopause hot flushes and night sweats, offering a new treatment option for women who cannot or prefer not to use HRT

A new non-hormonal pill for menopause hot flushes and night sweats has been approved for NHS use, potentially helping around 500,000 women in England. The treatment offers an alternative for those who cannot take, or choose not to use, traditional hormone replacement therapy, marking a significant step forward in menopause care and quality of life.

What is Fezolinetant, and who will benefit?

Fezolinetant (also known as Veoza and made by Astellas Pharma) is recommended for the treatment of moderate-to-severe symptoms in the final draft of NICE guidance. It comes in a 45mg tablet and is taken once a day. Fezolinetant works by blocking nerve pathways in the brain that trigger hot flushes and night sweats.

HRT is the first line of treatment, and it’s likely that most people with moderate to severe hot flushes will continue to take it. However, fezolinetant offers a new line of treatment for those who cannot or do not wish to use HRT.

Fezolinetant is specifically recommended for women who cannot have HRT due to contraindications, such as a history of deep vein thrombosis or pulmonary embolism. It may also be prescribed after a clinical risk assessment in certain cases involving diabetes or heart disease.

Expert reaction to the NICE decision

“We know that menopausal hot flushes and night sweats can have a profound impact on quality of life and significantly affect overall well-being.

For those who are unable to take HRT for varying reasons, options have historically been limited, and we have heard clearly from patients how difficult that can be.

The evidence shows fezolinetant can meaningfully reduce symptoms, and was found to be cost effective, offering value for the taxpayer. This decision will give much-needed relief to those for whom HRT is unsuitable,” commented Helen Knight, director of medicines evaluation at NICE.

“Symptoms of menopause including hot flushes and night sweats can affect every part of a women’s life, so this is very welcome news especially for women who are unable to or don’t wish to take hormone replacement therapy.

It’s another vital treatment option which could help hundreds of thousands of women experiencing menopause to better manage their symptoms and feel more in control of their health,” added Dr Sue Mann, National Clinical Director in Women’s Health for NHS England.

Paul Simpson, British Menopause Society Chair Elect, said: “Great news! The BMS welcomes the decision by NICE to support NHS use of fezolinetant for treating moderate to severe vasomotor symptoms. Whilst hormonal treatment is appropriate for many women, it is not suitable for all – having NHS funded access to a new class of non-hormonal medication will offer the opportunity for symptom relief in these circumstances. The positive impact this class of drug can have on menopause care has been on the horizon for some time, with many women patiently awaiting this approval. The next steps are to integrate this medication into primary and secondary care settings through our local formularies and care pathways.”