3 Types of Veozah Interactions to Watch Out For

Veozah (fezolinetant) is a medication that treats hot flashes and night sweats caused by menopause. But it isn’t hormone-based. Instead, it blocks the binding of a chemical in the brain that contributes to these symptoms. So it’s a popular choice for those seeking a hormone-free treatment option.

But just because it’s hormone-free doesn’t mean that Veozah is risk-free. Just like any medication, Veozah has drug interactions that can raise the risk of unwanted side effects. Knowing what to watch out for can help protect your safety while taking Veozah.

Veozah interactions at a glance

Below is a list of Veozah interactions to be aware of. In some cases, you should avoid combining Veozah with certain medications. But in others, your prescriber may just recommend additional monitoring.

Possible Veozah interactions include:

• Amiodarone (Pacerone)

• Cimetidine (Tagamet HB)

• Ciprofloxacin

• Fluvoxamine

• Verapamil

• Acetaminophen (Tylenol)

• Antiseizure medications

• Methotrexate (Trexall)

• Risperidone (Risperdal)

• Oral antifungals

• Statins (medications that treat high cholesterol levels)

• Some antiviral medications that treat HIV

• Alcohol

• Caffeine

Let’s look at each type of Veozah interaction and the medications affected.

1. Medications that increase Veozah levels in the body

Veozah is broken down by a liver enzyme (protein) known as CYP1A2. Certain medications can block this enzyme from working, which can increase Veozah levels in the body. In turn, this can raise the risk of Veozah side effects, such as diarrhea, stomach pain, and liver problems.

It’s recommended to avoid combining Veozah with medications that block CYP1A2 in the body. These include:

• Amiodarone, a medication for irregular heart rhythm

• Cimetidine, a histamine-2 receptor blocker for heartburn and acid reflux

• Ciprofloxacin, a quinolone antibiotic

• Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) antidepressant

• Verapamil, a calcium channel blocker that treats heart-related conditions

It’s unlikely that you’ll know if a medication you’re taking blocks CYP1A2 in the body. So it’s important to present your medication list to your prescriber before you start taking Veozah to check for this interaction. In many cases, they may be able to switch you to a different medication in the same drug class that doesn’t have this Veozah interaction. You should also check with your prescriber before starting any new medications while you’re taking Veozah.

2. Medications that may raise the risk of liver problems with Veozah

Veozah can raise your risk of liver damage. This side effect isn’t common with Veozah. But combining it with other medications that can also harm your liver could increase your risk. These include:

• Acetaminophen, especially with large doses and regular use

• Antiseizure medications, such as valproic acid (Depakote), carbamazepine (Tegretol), and lamotrigine (Lamictal)

• Methotrexate, a medication for certain autoimmune conditions and cancers

• Risperidone, an antipsychotic

• Oral antifungals, such as fluconazole and terbinafine

• Statins, such as simvastatin and rosuvastatin

• Antiviral medications that treat HIV, such as efavirenz (Sustiva) and ritonavir (Norvir)

You may still be able to take Veozah with one or more of these medications. But your prescriber may check your liver enzymes more often to watch for any signs of liver problems. Let them know right away if any signs of liver problems appear while taking Veozah, such as:

• Jaundice (yellowing of the skin or eyes)

• Dark-colored urine

• Itchy skin

• Bloated or enlarged abdomen

• Clay-colored stools

3. Alcohol and caffeine

Caffeine can increase Veozah levels in the body. It can also worsen hot flashes. The FDA recommends keeping caffeine intake under 400 mg per day (2 to 4 cups of coffee). But caffeine can affect people differently. So it's best to talk to your healthcare team about how much, if any, caffeine is OK for you while taking Veozah.

Alcohol can worsen hot flashes and contribute to sleep problems during menopause. Drinking large amounts of alcohol can also raise the risk of liver problems. As mentioned, Veozah can affect the liver as well in rare cases. But the risk of combining it with alcohol hasn't been well studied. So it's a good idea to talk to your prescriber about how much, if any, alcohol is OK for you while taking Veozah.

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Written by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Ferras Bashqoy, PharmD, BCCCP, BCPPS

Ferras Bashqoy, PharmD, BCCCP, BCPPS, is a clinical pharmacotherapy specialist in the Neonatal Intensive Care Unit at Hassenfeld Children’s Hospital in NYC. He enjoys working with preterm newborns, as they are small but mighty.

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