Hormones and menopause | 6 min read
Nonhormonal Hot Flash Treatments: Lynkuet, Veozah, and Other Options
Editorial draft — clinical review pending.
Short answer: Yes, there are prescription hot flash treatments that don't contain hormones. Two newer medicines, Veozah (fezolinetant) and Lynkuet (elinzanetant), work by blocking signals in the brain area that controls body temperature. Older options include low-dose paroxetine. "Nonhormonal" does not mean side-effect free, and each medicine has its own safety checks. [1,2,3]
Key takeaways
- Lynkuet was approved on October 24, 2025, for moderate to severe hot flashes due to menopause. It is taken once daily at bedtime. [1,3]
- Veozah was approved in 2023. The FDA later added a boxed warning about rare but serious liver injury and requires liver blood tests. [2]
- These medicines are an option for women who can't or don't want to take hormones, including some with a history of breast cancer or blood clots, but suitability must be checked individually.
How the new medicines work
Hot flashes start in the hypothalamus, the part of the brain that regulates temperature. As estrogen falls, signaling through receptors called neurokinin receptors increases, and the brain's thermostat becomes oversensitive. Veozah blocks the neurokinin 3 (NK3) receptor. Lynkuet blocks both NK1 and NK3 receptors. [3]
Lynkuet (elinzanetant)
Lynkuet's approval was based on the OASIS clinical trials. In two 12-week trials of nearly 800 women, it reduced how often and how severely hot flashes occurred compared with placebo. A third trial followed women for up to a year to study safety. [1]
The recommended dose is two 60 mg capsules at bedtime. It can cause drowsiness, so the label advises avoiding driving or other tasks needing alertness until you know how it affects you. It also interacts with some other medicines, which your prescriber and pharmacist should check. [3]
Veozah (fezolinetant)
Veozah was the first NK3 blocker approved. After reports of serious liver injury, the FDA added a boxed warning and requires liver blood tests before starting and at regular intervals in the first months of treatment. Stop it and seek care if you notice yellowing skin or eyes, dark urine, pale stools, itching or pain in the upper right abdomen. [2]
Other nonhormonal options
- Low-dose paroxetine: an antidepressant approved at a low dose for hot flashes. It interacts with some medicines, including tamoxifen.
- Other antidepressants and gabapentin are sometimes used off label.
- Lifestyle measures such as layered clothing, a cool bedroom and avoiding personal triggers can help mild symptoms but rarely resolve severe ones.
Questions to ask before starting
- Which option fits my health history and other medicines?
- What tests do I need before and during treatment, and who orders and reviews them?
- How soon should I expect to notice a difference?
- What side effects should make me call?
- Is hormone therapy an option for me, and how would it compare?
Track your symptoms first
For a week before your appointment, note roughly how many hot flashes you have, whether they wake you, and what they interrupt. This helps set a starting point so you and your clinician can judge whether treatment works.
Frequently asked questions
Is Lynkuet better than hormone therapy?
They work differently and haven't been compared directly in major trials. Hormone therapy is generally the most effective treatment for hot flashes. Nonhormonal options matter for women who can't or prefer not to use hormones.
Can I take Lynkuet if I had breast cancer?
This needs an individual review with your clinician and possibly your oncologist. Lynkuet's label has its own list of conditions and interactions to check.
Do I need blood tests on Veozah?
Yes. Liver tests are required before starting and during treatment. [2]
Next step
HerScripts clinicians can review hormone and nonhormonal options side by side based on your history. Get help with hot flashes and night sweats.
Sources
[1] FDA, Drug Trials Snapshot: Lynkuet
[2] FDA, Veozah liver injury safety communication
[3] Lynkuet prescribing information, DailyMed
Educational information, not personal medical advice. Care decisions require an individual clinical evaluation.