Veoza vs Lynkuet

If hot flushes and night sweats are making life difficult and HRT isn’t an option for you, there are now two prescription medicines that can help without using hormones: Veoza and Lynkuet.

This guide explains what they are, how they differ, and what to talk to your prescriber about. It’s general information. It can’t tell you which one is right for you.

The short version

Both medicines work on the part of your brain that controls body temperature. Both reduce hot flushes and night sweats more than a dummy tablet in clinical trials.

They have never been tested against each other, so nobody can honestly say one is better overall. What differs is the practical detail:

• Veoza is one tablet a day. It needs regular blood tests to check your liver during the first three months. It can’t be taken with certain contraceptive pills.
• Lynkuet is two capsules at bedtime. It needs fewer routine blood tests, but it may make you drowsy, and it can’t be taken with certain antibiotics and antifungals.
• In the UK, Veoza is available on the NHS; Lynkuet is private prescription only.
• Lynkuet is licensed for hot flushes caused by breast cancer hormone treatment. Veoza is not.

What are hot flushes, and why do these medicines help?

Deep in your brain sits a small cluster of nerve cells that acts like a thermostat. Oestrogen normally helps keep it steady.

As oestrogen falls during menopause, those cells become over-active and the thermostat gets twitchy. It starts reacting to tiny temperature changes as though you’re overheating, so your body does what it does when you’re too hot. Blood rushes to the skin, you flush, you sweat. That’s a hot flush.

Both Veoza and Lynkuet calm those over-active nerve cells down. They don’t replace oestrogen and they aren’t hormones. Doctors call this class of medicine neurokinin receptor antagonists.

The small difference between them: the nerve cells have two relevant “switches”, called NK1 and NK3. Veoza blocks NK3. Lynkuet blocks both NK1 and NK3. Blocking both may help more with sleep, but as you’ll see below, the evidence on that is suggestive rather than settled.

How do you take them?

Veoza (fezolinetant)

One 45 mg tablet once a day, at roughly the same time each day. With or without food. Swallow it whole. Don’t break, crush or chew it.

If you miss a dose, take it as soon as you remember, unless your next dose is due within 12 hours. In that case skip it and carry on as normal.

Lynkuet (elinzanetant)

Two 60 mg capsules, 120 mg in total, once a day at bedtime. With or without food. Swallow them whole with water; don’t cut, chew or crush them.

It’s taken at bedtime because it can make you sleepy.

If you miss a dose, don’t double up. Just take your next dose at the usual time the following evening.

Worth double-checking. Lynkuet comes as 60 mg capsules, but the usual dose is two of them. A single capsule a day is a reduced dose, only used if you’re also taking certain other medicines. If your prescription says one capsule, ask your pharmacist whether that’s intended.

How well do they work?

Both have been tested in large trials against a dummy capsule or tablet.

Veoza was studied in over 1,000 women who were having at least seven moderate or severe hot flushes a day. After 12 weeks, women taking Veoza had around 63% fewer hot flushes than when they started, compared with around 40% for women on the dummy tablet. Improvements began within the first week.

Lynkuet was studied in around 800 women having at least 50 hot flushes a week. It significantly reduced hot flushes at 4 and 12 weeks, with a measurable improvement by week 1. It also improved sleep and quality of life. A separate 52-week study confirmed the benefit lasts.

So which works better?

Honestly, nobody knows. They have never been compared head to head.

Researchers have tried to compare them indirectly using statistics. Two separate analyses, one funded from each side of the commercial fence, reached broadly the same answer: similar effect on hot flushes, with a consistent hint that Lynkuet helps more with sleep. NICE, the body that decides what the NHS funds, also concluded that indirect comparisons like these remain uncertain.

You may see claims that one works “faster” than the other. There’s no reliable evidence for that. Both start working within about a week.

Side effects

Most people tolerate both medicines well. These are the ones reported most often in trials.

Veoza: diarrhoea (about 3 in 100 people) and difficulty sleeping (about 3 in 100). Stomach pain and raised liver blood tests are also common.

Lynkuet: headache (about 8 in 100) and tiredness (about 5 in 100). Dizziness, sleepiness, stomach pain, diarrhoea, rash and muscle spasms are also common.

Both medicines are marked with a black triangle (▼), which means UK regulators are collecting extra information about them because they’re new. If you get any side effect, you can report it yourself at yellowcard.mhra.gov.uk. You don’t need to go through a doctor.

Drowsiness and driving

Lynkuet can cause tiredness, dizziness and sleepiness. That’s why it’s taken at bedtime. In a driving simulator study it didn’t reach the threshold for impaired driving, but if you feel drowsy, don’t drive or operate machinery until it’s passed.

Veoza has no meaningful effect on driving.

Seizures

Lynkuet carries a warning about seizures. A seizure happened in one person during the trials, and a small number of cases have been reported since it went on sale. If you’ve ever had a seizure, or have a condition that makes seizures more likely, tell your prescriber. It doesn’t automatically rule the medicine out. It means the decision needs more care.

Veoza hasn’t been studied in people with a history of seizures, and none occurred in its trials.

Blood tests: an important difference

Both medicines can affect the liver, and this is where they differ most in day-to-day practice.

Veoza needs:

• a blood test before you start
• a blood test every month for the first three months
• further tests based on your doctor’s judgement after that
• an extra test any time you get symptoms

Lynkuet needs:

• a blood test before you start
• a blood test if you develop symptoms

If you can’t easily get to a blood test appointment every month, that’s a genuinely relevant thing to raise when choosing.

Stop and get medical help urgently if you notice

• yellowing of your skin or the whites of your eyes
• dark urine, or unusually pale stools
• itching all over
• feeling unusually tired, sick, or off your food
• pain under your ribs on the right side

These can be signs of liver problems. Stop the medicine and contact a doctor straight away. Don’t wait for your next scheduled test.

Can I take them with my other medicines?

This is often what decides which medicine is possible, and the two are almost opposites.

Veoza cannot be taken with:

• contraceptive pills containing ethinylestradiol. This catches a lot of people who are still perimenopausal and need contraception. Your prescriber may suggest a non-hormonal method instead.
• fluvoxamine (an antidepressant), mexiletine (a heart medicine), enoxacin (an antibiotic)

Smoking reduces how much Veoza gets into your system, though the dose doesn’t need changing.

Lynkuet cannot be taken with:

• certain antifungals and antibiotics, including itraconazole and clarithromycin
• some HIV medicines, including ritonavir and cobicistat
• grapefruit juice, which you should avoid

With some other medicines, such as erythromycin, ciprofloxacin, fluconazole and verapamil, Lynkuet can still be used, but at the lower 60 mg dose.

Medicines like rifampicin, carbamazepine and St John’s wort can make Lynkuet less effective.

Take a full list of everything you take to your appointment, including anything you’ve bought yourself and any herbal remedies. St John’s wort in particular is easy to forget because it’s sold in health food shops.

Can I take these if I’ve had breast cancer?

This is where the two medicines genuinely differ, and it’s worth being precise.

Many women who’ve had hormone-sensitive breast cancer take tablets such as tamoxifen or an aromatase inhibitor afterwards to reduce the risk of it coming back. Those tablets often cause severe hot flushes, and HRT usually isn’t an option.

Lynkuet is licensed in the UK for exactly this situation. Its licence covers hot flushes caused by adjuvant endocrine therapy related to breast cancer. This is based on a trial in women taking tamoxifen or an aromatase inhibitor.

Veoza is not. Women having cancer treatment weren’t included in its trials, so it isn’t recommended while you’re on that treatment. If you finished cancer treatment some time ago, it becomes an individual decision with your doctor.

Two things to keep in mind about Lynkuet. The trial wasn’t designed to measure whether the medicine affects the risk of cancer returning, so that longer-term question is still open. And if you’re on cancer medicines other than the ones studied, the decision needs individual assessment.

Always make this decision with your oncology team as well as whoever manages your menopause care. Don’t start either medicine without telling your cancer team.

Can I take them alongside HRT?

Not alongside HRT tablets, patches or gels that contain oestrogen. The combination hasn’t been studied, so it isn’t recommended for either medicine.

Vaginal oestrogen, such as creams, pessaries or rings used locally for dryness, is treated separately in the product information. Tell your prescriber exactly which product and dose you use so they can advise.

Who shouldn’t take them?

Neither medicine should be taken if you are or might be pregnant, or while breastfeeding. If there’s any chance you could become pregnant, you’ll need reliable contraception. Remember that with Veoza, that shouldn’t be an ethinylestradiol-containing pill.

Neither is recommended if you have significant liver or kidney problems. Lynkuet must not be used if you have severe liver disease.

Neither has been studied in women starting treatment after age 65, so there’s no dosing advice for that group.

Can I get these on the NHS?

Veoza: yes, in most of the UK.

In England, NICE recommends it for moderate to severe hot flushes and night sweats where HRT isn’t suitable for you. In Scotland, the Scottish Medicines Consortium accepted it for NHS use on the same basis in July 2026. Note the condition: it’s for women who can’t take HRT, not for everyone.

Lynkuet: not yet. It’s available on private prescription only. NICE hasn’t started the process that could lead to NHS funding.

Which one is right for me?

There’s no universal answer, and be wary of anyone who gives you one.

Useful questions to bring to your appointment:

• Is HRT genuinely unsuitable for me, or is it worth another conversation? For most women who can take it, HRT is still the most effective option and treats more symptoms.
• Which of these can I actually have, given my other medicines?
• Can I realistically manage monthly blood tests for three months?
• Is disturbed sleep my main problem?
• Do I need contraception?
• Have I had breast cancer, or am I on treatment for it?
• Can I get this on the NHS, or would I be paying?

Take your medicines list. Be honest about how much the symptoms are affecting you. And don’t start, stop or combine any of this without advice from a prescriber.

If you’re in the United States

The main differences:

Lynkuet in the US is licensed only for hot flushes due to menopause. There is no breast cancer indication on the US label. That’s a UK and EU licence.

Lynkuet liver testing in the US is bloodwork before you start, and again three months after starting. That’s one follow-up test, not monthly.

Lynkuet’s US label carries a stronger drowsiness warning. Nervous system effects such as sleepiness, tiredness and dizziness were reported in about 12 in 100 people taking it, compared with about 4 in 100 on placebo. You’re advised not to drive or do anything hazardous until those effects have worn off.

Pregnancy: the US label states Lynkuet may cause pregnancy loss or stillbirth. Pregnancy must be excluded before starting, and effective contraception used during treatment and for two weeks after stopping.

Veozah (the US brand name for fezolinetant) carries a boxed warning, the FDA’s most serious, about rare but serious liver injury. US liver testing is before starting, then monthly for three months, then again at 6 and 9 months.

Follow the instructions for the country where you were prescribed, and use your local leaflet.

Sources

Lynkuet 60 mg soft capsules, Summary of Product Characteristics, Bayer plc. Text revised 8 July 2026. medicines.org.uk

Veoza 45 mg film-coated tablets, Summary of Product Characteristics, Astellas Pharma Ltd. Text revised 13 April 2026. medicines.org.uk

Lynkuet (elinzanetant) US Prescribing Information, Bayer HealthCare Pharmaceuticals, 2025.

Veozah (fezolinetant) US Prescribing Information, Astellas Pharma US, including boxed warning added December 2024.
NICE. Fezolinetant for treating moderate to severe vasomotor symptoms associated with menopause. Technology appraisal guidance TA1143, 2026.

Scottish Medicines Consortium. Fezolinetant (Veoza): resubmission. SMC2898. Advice published 13 July 2026.

Pinkerton JV, Simon JA, Joffe H, et al. Elinzanetant for the treatment of vasomotor symptoms associated with menopause: OASIS 1 and 2 randomized clinical trials. JAMA. 2024;332(16):1343–1354.

Panay N, Joffe H, Maki PM, et al. Elinzanetant for the treatment of vasomotor symptoms associated with menopause: a phase 3 randomized clinical trial (OASIS 3). JAMA Intern Med. 2025. doi:10.1001/jamainternmed.2025.4421

Cardoso F, Parke S, Brennan DJ, et al. Elinzanetant for vasomotor symptoms from endocrine therapy for breast cancer (OASIS 4). N Engl J Med. 2025. doi:10.1056/NEJMoa2415566

Lederman S, Ottery FD, Cano A, et al. Fezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause (SKYLIGHT 1). Lancet. 2023;401(10382):1091–1102.

Johnson KA, Martin N, Nappi RE, et al. Efficacy and safety of fezolinetant in moderate to severe vasomotor symptoms associated with menopause: a phase 3 RCT (SKYLIGHT 2). J Clin Endocrinol Metab. 2023;108(8):1981–1997.

Stute P, Shapiro CM, Morga A, et al. Fezolinetant compared with elinzanetant: a matching-adjusted indirect comparison. Maturitas. 2025.

Wojciechowski P, Kolonko K, Giannopoulou A, et al. Comparative efficacy of elinzanetant versus other non-hormonal pharmaceutical therapies: a network meta-analysis. BJOG. 2026. doi:10.1111/1471-0528.70213

MHRA/EMA. Direct Healthcare Professional Communication: Veoza (fezolinetant): risk of drug-induced liver injury, 2025.