Diarrhea, Insomnia, and More: 6 Veozah Side Effects to Consider

Menopause is when menstruation stops because of decreasing hormone levels. These lower hormone levels can cause many symptoms. Vasomotor symptoms (VMS), such as hot flashes and night sweats, are some of the most common.

You can often manage VMS at home with lifestyle changes. If symptoms have become too bothersome, you may want to consider a prescription medication. A common first-choice option is hormone replacement therapy. But not everyone can or wants to take hormonal medications.

Veozah (fezolinetant) was FDA approved in 2023 for the management of VMS due to menopause. It’s a nonhormonal medication that was the first medication in its class to be approved for this use.

Veozah side effects at a glance

Veozah is very well tolerated. In clinical trials, the most common side effects were reported by fewer than 5% of participants. Serious side effects were rare.

Common Veozah side effects include:

• Stomach pain

• Diarrhea

• Insomnia (trouble sleeping)

• Back pain

• Mildly elevated liver enzymes

Ironically, hot flashes can also be a side effect of Veozah.

Rare but serious Veozah side effects include:

• Severely elevated liver enzymes

• Liver damage

Below, we’ll take a closer look at six Veozah side effects and what to do if they happen to you.

1. Stomach pain

Stomach pain was the most commonly reported Veozah side effect. In some cases, this is mild and may resolve as your body adjusts to the medication. But stomach pain — especially pain on the upper-right part of the stomach — can be a symptom of liver damage. We’ll cover this rare but serious Veozah side effect later.

If you experience stomach pain that’s severe or persistent, tell your prescriber. You should also tell them if you experience stomach pain along with other symptoms, such as nausea or dark urine. Your prescriber may want to check your liver function with blood tests.

2. Diarrhea

Diarrhea is also a common Veozah side effect. This should be mild and go away as you take the medication. Be sure to stay well hydrated if you experience diarrhea from Veozah. You can also ask a healthcare professional if over-the-counter (OTC) antidiarrheal medications, such as loperamide (Imodium A-D), would be OK for you to take.

If diarrhea becomes bothersome or doesn’t improve, tell your prescriber. They might recommend a different VMS medication.

3. Back pain

Back pain is another common Veozah side effect. It should improve or resolve over time.

There are many at-home tips that you can try to help with back pain, such as:

• Applying a heat or ice pack to the area

• Performing gentle stretches or yoga

• Increasing your usual amount of exercise or movement if you can

• Using topical pain-relief gels, creams, or patches

Occasional use of oral OTC pain relievers, such as ibuprofen (Advil, Motrin), may also relieve back pain. But you should ask a healthcare professional before trying one. They come with their own risks and side effects.

In particular, acetaminophen (Tylenol) can contribute to or cause liver damage. The risk is greatest when people take higher-than-recommended doses of acetaminophen. But combining it with other medications that have a risk of liver damage, such as Veozah, may make this serious side effect more likely. You should avoid acetaminophen while taking Veozah unless a healthcare professional tells you otherwise.

4. Insomnia

Insomnia is another commonly reported Veozah side effect. But keep in mind that insomnia can also be a symptom of menopause itself. Usually, medications for menopause VMS (including Veozah) help improve sleeping problems — such as night sweats — that contribute to insomnia.

It may take about 4 weeks (1 month) for Veozah to start working. So if you haven’t been taking it that long, it’s more likely that your sleeping problems are due to menopause, not the medication. Try to stick it out until the medication takes effect.

If you think Veozah is causing insomnia, try taking your dose in the morning. Veozah is a once-daily medication. You can take it at any time of day, as long as you’re consistent. Taking your dose earlier in the day may help limit sleeping problems at night.

Practicing good sleep hygiene may also help with insomnia. This includes avoiding all screens at least 1 hour before bed. It’s also a good idea to avoid caffeine for at least 6 hours before bed. Exercising and getting outside for some sunlight during the day can help with insomnia too.

If insomnia continues after taking Veozah for about a month, tell your prescriber. They may recommend an alternative menopause treatment.

5. Hot flashes

Hot flashes were also reported as a Veozah side effect. But this is also a symptom of menopause itself. Keep in mind how long you’ve been taking Veozah. If it’s been less than a month, hot flashes are more likely a symptom of menopause.

Hot flashes can be frustrating and uncomfortable, but they’re not dangerous. Certain lifestyle changes, such as exercising and eating more fruits and veggies, may help reduce them. You may also want to opt for loose or cool clothing. Some people find that yoga or practicing mindfulness helps them too.

Ask a healthcare professional before taking OTC hot flash supplements while taking Veozah. Many women who take Veozah do so because they want to avoid hormone replacement therapy. Some OTC products contain plant-based estrogens, known as phytoestrogens. Phytoestrogens act like estrogen in the body. So even though they might improve hot flashes, they may not be right for you if you wish to avoid hormones.

6. Liver damage

Liver damage is a rare but serious Veozah side effect. Because of this, you’ll have to go for routine blood tests before starting and while taking the medication. If your liver function tests show signs of liver damage, your prescriber will likely ask you to stop taking Veozah.

More commonly, people taking Veozah may experience mildly elevated liver enzymes. This is typically symptom free and reversible if you stop Veozah. Severely elevated liver enzymes are more concerning and usually indicate liver inflammation or damage.

Symptoms of liver damage can include:

• Nausea or vomiting

• Stomach pain or swelling

• Dark-colored urine

• Yellowing of the skin or eyes (jaundice)

• Unexplained weight loss

• Personality or behavior changes

• Confusion

• Drowsiness

If you develop symptoms of liver damage while taking Veozah, seek immediate medical help. This is considered a medical emergency and requires urgent treatment to prevent serious complications.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She currently practices as a clinical pharmacist at Buffalo General Medical Center.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed 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.

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