New hot flash drug approved

[Tall_Allen]

The FDA today approved Veozah (fezolinetant) for women's hot flashes during menopause. It acts on the thermoregulatory mechanism in the brain. I would expect it to work on men taking ADT too, although it has not been proven. I hope that Medicare/Insurance will cover it in men.

fda.gov/news-events/press-a...

[Happle58]

Thank you!

[carbide]

Sounds great! I've been on Eligard for 4-1/2 years and still get hot flashes. Not as bad as when first started.Thx

[tango65]

It may be approved by Medicare based in medical necessity.

This drug may cause some undesirable side effects and also interacts with CYP1A2 inhibitors.

accessdata.fda.gov/drugsatf...

"Concomitant use of VEOZAH with drugs that are weak, moderate, or strongCYP1A2 inhibitors, increase the plasma Cmax and AUC of VEOZAH [see Clinical Pharmacology (12.3)]. VEOZAH is contraindicated in individuals using CYP1A2 inhibitors."

go.drugbank.com/categories/...

I will keep dealing with my nocturnal hot flashes using the remote controlled fan close to my bed.

[Merlin1960 in reply to tango65]

oxybutynin stopped my husbands It’s worth a try

[Hidden in reply to Merlin1960]

Bladder issues?

[Merlin1960 in reply to Hidden]

Yes for bladder issues and hot flashes

[TheWizardofWesley in reply to tango65]

Alexia, Turn on master fan! 😜

[tango65 in reply to TheWizardofWesley]

Exactly, and it works.

[Medline]

"Neurokinin-3 (NK3) receptor antagonists like Fezolinetant have been found to dose-dependently suppress luteinizing hormone (LH) secretion, though not that of follicle-stimulating hormone (FSH), and consequently to dose-dependently decrease estradiol and progesterone levels in women and testosterone levels in men. As such, they are similar to GnRH modulators, and present as a potential clinical alternative to them for use in the same kinds of indications. However, the inhibition of sex hormone production by NK3 receptor inactivation tends to be less complete and non-castrating relative to that of GnRH modulators, and so they may have a reduced incidence of menopausal-like side effects such as loss of bone mineral density."

en.wikipedia.org/wiki/Fezol...

[tarzan11]

This is good news. Thank you.

[Huzzah1]

I've been getting severe hot flashes, full body sweats hourly. Dr has tried Paxil and Effexor without effect. Hope I can try this next if I can get it under the suggested price of $550/month

[No_stone_unturned in reply to Huzzah1]

Same here. I keep hearing that I’m more the exception than the rule. All I know is it’s barely worth living with how bad I get these. I’m on this medicine with inconclusive results. I’ve actually thought about doubling the dose to see if that worked. To date the only relief I get is with the use of estrogen gel. Without that, I probably would have gave up the fight. Good luck Huzzah, I’d love to hear how you’ve been doing with this as well.

[Tall_Allen in reply to No_stone_unturned]

My friend is getting great results with Veozah.

[No_stone_unturned in reply to Tall_Allen]

I’m jealous. Perhaps there’s a contradiction with the Protac I’m on.

[Huzzah1 in reply to No_stone_unturned]

I Finally started Acupuncture, something my MO suggested from the get go. I thought good old Drugs were the best option.

OMG, it has done wonders for me! I’m sure the practitioner has a lot to do with it. I live just NE of Atlanta which has a large Asian population. I talked to some folks and started going to a great practice. Has done wonders.

[Sweetjessie in reply to Huzzah1]

I live in Atlanta, and have terrible hot flashes. Can you give me the name of the acupuncturist? I've been having some acupuncture at Emory, but doesn't seem to help very much. Sweetjessie

[Huzzah1 in reply to Sweetjessie]

jilinacu.com/

[Tall_Allen]

Why do you think it binds to estrogen receptors? It binds to NK3 receptors.

[tsim]

Thanks for the info, I have a friend that has had problems with this since she started menopause.

[j-o-h-n]

"I hope that Medicare/Insurance will cover it in men."

All we have to do is go into a Medicare office and show them our tits....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 05/13/2023 6:14 PM DST

[Bonehead1171]

What can you tell me about your friend that is taking Veozah

[Tall_Allen in reply to Bonehead1171]

He swears.by it. Went from 7/day dripping with sweat to 0-1/day mild. No side effects.

[jackwfrench in reply to Tall_Allen]

TA - My local MO has one patient on Veozah now (successful) and is willing to prescribe for me - estimates it at $400/month. So, since it's not tested for men yet - how do you think of the possible downside of trying it? Comments indicate some reduced anxiety and some mood modification which would be helpful to me.

[Tall_Allen in reply to jackwfrench]

Financial toxicity only.

[jackwfrench]

I did get a reading from my Hopkins MO - Veozah is a drug you have to be careful with Abiraterone. Abi is a cyp1a2 inhibitor and the veozah label says it’s contraindicated in people taking cyp1a2 inhibitors- of course I am on abi.

[Tall_Allen in reply to jackwfrench]

It is contraindicated because abiraterone has been found to increase the plasma concentration of CYP1A2 substrates and Veozah is a CYP1A2 substrate. But, in the Zytiga prescribing details, it says:

"In a clinical study to determine the effects of abiraterone acetate 1,000 mg daily (plus prednisone 5 mg twice daily) on a single 100 mg dose of the CYP1A2 substrate theophylline, no increase in systemic exposure of theophylline was observed. "

This leads me to doubt whether the contraindication is warranted for all CYP1A2 substrates. At any rate, it's easy enough to just stop taking it if there is any hint of toxicity. My friend takes both and has no toxic symptoms and his liver panels are fine.