Last checked September 2026 against 15 sources · Editorial policy
Lynkuet vs Veozah: two non-hormonal hot flash pills compared
Lynkuet vs Veozah: both are non-hormonal pills for moderate to severe hot flashes that block neurokinin signals in the brain. Veozah (fezolinetant) is one 45 mg tablet a day, with a boxed warning for rare liver injury and liver tests before starting and at months 1, 2, 3, 6 and 9. Lynkuet (elinzanetant) is two 60 mg capsules at bedtime and can cause sleepiness. No trial compares them directly.
Lynkuet and Veozah both block the brain signal behind hot flashes. Dose, results, liver tests, sleepiness, interactions and cost side by side.
Lynkuet vs Veozah side by side
| Lynkuet (elinzanetant) | Veozah (fezolinetant) | |
|---|---|---|
| FDA approval | 2025 | 2023 |
| How it works | Blocks neurokinin 1 and neurokinin 3 receptors. | Blocks the neurokinin 3 receptor. |
| Dose | Two 60 mg capsules once a day at bedtime. | One 45 mg tablet once a day, at about the same time. |
| Half-life | About 45 hours. | About 9.6 hours. |
| Fewer hot flashes a day than placebo, week 12 | 3.2 in OASIS 1 and 2. | 2.5 to 2.6 in two 12-week trials. |
| Most common side effects | Headache, fatigue, dizziness, sleepiness, abdominal pain, rash, diarrhea, muscle spasms. | Abdominal pain, diarrhea, insomnia, back pain, hot flash, raised liver enzymes. |
| Liver enzymes over 3 times normal in trials | 0.6%, vs 0.4% on placebo. | 2.3%, vs 0.9% on placebo. |
| Liver tests | Before starting and at 3 months. | Before starting and at months 1, 2, 3, 6 and 9; boxed warning. |
| Other warnings | Sleepiness and next-day impairment; seizure risk; not in pregnancy. | Not with cirrhosis, severe kidney disease or end-stage kidney disease. |
| Key interactions | Avoid grapefruit and strong CYP3A4 blockers such as itraconazole; one capsule with moderate ones. | Not with CYP1A2 blockers such as fluvoxamine. |
| Cash price, 30 days | Around $618.40 for 60 capsules. | Around $577.86 for 30 tablets. |
| Savings card, commercial insurance | As little as $25 a month. | $0 for the first month, then $30 a refill, up to $4,000 a year. |
FDA approval
- Lynkuet (elinzanetant)
- 2025
- Veozah (fezolinetant)
- 2023
How it works
- Lynkuet (elinzanetant)
- Blocks neurokinin 1 and neurokinin 3 receptors.
- Veozah (fezolinetant)
- Blocks the neurokinin 3 receptor.
Dose
- Lynkuet (elinzanetant)
- Two 60 mg capsules once a day at bedtime.
- Veozah (fezolinetant)
- One 45 mg tablet once a day, at about the same time.
Half-life
- Lynkuet (elinzanetant)
- About 45 hours.
- Veozah (fezolinetant)
- About 9.6 hours.
Fewer hot flashes a day than placebo, week 12
- Lynkuet (elinzanetant)
- 3.2 in OASIS 1 and 2.
- Veozah (fezolinetant)
- 2.5 to 2.6 in two 12-week trials.
Most common side effects
- Lynkuet (elinzanetant)
- Headache, fatigue, dizziness, sleepiness, abdominal pain, rash, diarrhea, muscle spasms.
- Veozah (fezolinetant)
- Abdominal pain, diarrhea, insomnia, back pain, hot flash, raised liver enzymes.
Liver enzymes over 3 times normal in trials
- Lynkuet (elinzanetant)
- 0.6%, vs 0.4% on placebo.
- Veozah (fezolinetant)
- 2.3%, vs 0.9% on placebo.
Liver tests
- Lynkuet (elinzanetant)
- Before starting and at 3 months.
- Veozah (fezolinetant)
- Before starting and at months 1, 2, 3, 6 and 9; boxed warning.
Other warnings
- Lynkuet (elinzanetant)
- Sleepiness and next-day impairment; seizure risk; not in pregnancy.
- Veozah (fezolinetant)
- Not with cirrhosis, severe kidney disease or end-stage kidney disease.
Key interactions
- Lynkuet (elinzanetant)
- Avoid grapefruit and strong CYP3A4 blockers such as itraconazole; one capsule with moderate ones.
- Veozah (fezolinetant)
- Not with CYP1A2 blockers such as fluvoxamine.
Cash price, 30 days
- Lynkuet (elinzanetant)
- Around $618.40 for 60 capsules.
- Veozah (fezolinetant)
- Around $577.86 for 30 tablets.
Savings card, commercial insurance
- Lynkuet (elinzanetant)
- As little as $25 a month.
- Veozah (fezolinetant)
- $0 for the first month, then $30 a refill, up to $4,000 a year.
Lynkuet vs Veozah: expectation vs reality
What people often expect
“Lynkuet is the new, better version of Veozah, so everyone should switch”
What the evidence shows
They're siblings, not an upgrade. Each beat placebo by a few hot flashes a day: 3.2 for Lynkuet in OASIS 1 and 2, and 2.5 to 2.6 for Veozah in its two 12-week trials. The trials enrolled different women at different times, so these numbers can't be compared head to head. The real differences are in timing, side effects, liver monitoring and interactions.
Lynkuet vs Veozah: the differences that matter
Same target, one extra receptor
Both drugs act on KNDy neurons in the brain's temperature control center, where signaling by neurokinin B helps set off hot flashes after estrogen falls. Veozah blocks the neurokinin 3 receptor only. Lynkuet blocks neurokinin 3 and also neurokinin 1, the receptor for substance P. Neither is a hormone, so neither treats vaginal dryness or replaces estrogen's other effects in the body.
Learn more →Lynkuet vs Veozah: which works better for hot flashes?
Nobody knows yet, because no trial has put them side by side. At week 12, Lynkuet beat placebo by 3.2 hot flashes a day in OASIS 1 and 2, and Veozah by 2.5 to 2.6 in its trials. The Lynkuet label itself warns that side effect rates can't be compared across different drugs' trials, and the same goes for benefits. Both started working by week 4.
Learn more →Sleep: Lynkuet at bedtime, Veozah any time
Lynkuet's most distinctive effect is on alertness: sleepiness, fatigue, dizziness or feeling faint affected 11.9% of women, against 3.5% on placebo, so it's taken at bedtime, and in trials it also improved sleep disturbance. Veozah has no such warning, but insomnia was more common than on placebo (3.9% vs 1.8%) in its one-year trial. Night sweats that wreck sleep are a reason to ask about Lynkuet.
Liver safety: Veozah's boxed warning vs Lynkuet's 3-month check
Veozah carries a boxed warning, added in December 2024 after a case of serious liver injury. It needs liver tests before starting and at months 1, 2, 3, 6 and 9. In trials, its liver enzymes rose above 3 times normal in 2.3% of women. Lynkuet needs a test before starting and one at 3 months, and enzymes rose above 3 times normal in 0.6%.
Learn more →Interactions: CYP3A4 for Lynkuet, CYP1A2 for Veozah
The two drugs are cleared by different liver enzymes, so different medicines clash with them. Lynkuet can't be taken with strong CYP3A4 blockers, such as itraconazole, or grapefruit, and drops to one capsule with moderate ones. Veozah can't be taken with any CYP1A2 blocker: fluvoxamine raised its exposure by 840%. If you take one of these long term, that may decide the choice.
Lynkuet and Veozah in perimenopause and pregnancy
Both were tested only in postmenopausal women, so there's no trial data in perimenopause. Lynkuet must not be taken in pregnancy, because it caused pregnancy loss in animal studies, and women who could conceive need contraception during treatment and for 2 weeks after. Neither drug is a contraceptive. If your periods haven't stopped for 12 months, ask about birth control before starting either.
Learn more →Lynkuet vs Veozah cost and savings cards
Both are brand-only, with no generic. Cash prices are around $618.40 for a month of Lynkuet and $577.86 for a month of Veozah. With commercial insurance, Lynkuet's copay card can bring it to $25 a month; Veozah's card offers $0 for the first month and then $30 a refill, up to $4,000 a year. Savings cards don't apply to Medicare or Medicaid.
Learn more →Switching between Veozah and Lynkuet
No study has tested switching from one to the other, so there's no data on whether one works when the other didn't. If you do switch, the new drug's starting rules apply: for Lynkuet, a fresh liver test and a pregnancy check before the first dose; for Veozah, liver tests before starting and through month 9. Give the new drug about 12 weeks before judging it.
Lynkuet and Veozah by the numbers
From the studies on this page
of women had liver enzymes above 3 times normal in trials of Lynkuet vs Veozah
0.6% vs 2.3%
had sleepiness, fatigue or dizziness on Lynkuet, vs 3.5% on placebo
11.9%
45 h vs 9.6 h
$618 vs $578
Rates come from different trials and can't be compared directly; neither drug has been tested against the other.
What people report to the FDA about Lynkuet and Veozah
Lynkuet (elinzanetant): 251 reports to the FDA, 58 serious · data through July 30, 2026
| Reaction | Reports | Share |
|---|---|---|
| Sleepiness | 48 | 19.1% |
| Fatigue | 32 | 12.7% |
| Dizziness | 28 | 11.2% |
| Wrong dose taken | 22 | 8.8% |
| Didn't work | 18 | 7.2% |
| Raised liver enzymes | 9 | 3.6% |
- Reports with any liver term: 23 of 251 (9.2%).
Veozah (fezolinetant): 2,122 reports to the FDA, 428 serious · data through July 30, 2026
| Reaction | Reports | Share |
|---|---|---|
| Didn't work | 250 | 11.8% |
| ALT (liver enzyme) increased | 192 | 9.0% |
| Liver enzymes increased | 191 | 9.0% |
| AST (liver enzyme) increased | 147 | 6.9% |
| Headache | 121 | 5.7% |
| Insomnia | 88 | 4.1% |
- Reports with any liver term: 607 of 2,122 (28.6%). Their share jumped to 50% and 69% in the two quarters after the December 2024 boxed warning, which is typical when a warning prompts more testing and more reporting.
Lynkuet, Veozah or something else: who each one suits
Lynkuet if night sweats break your sleep
Strong evidenceTaken at bedtime, it improved sleep disturbance in trials and has the lighter liver testing schedule. It's an option if a CYP1A2 medicine rules out Veozah (your pharmacist should check that medicine against CYP3A4 too), or if you're on endocrine therapy after breast cancer, where the OASIS 4 trial tested it. Skip it if you could get pregnant without contraception or have had seizures.
Related guide →Veozah if you need to be sharp every morning
Strong evidenceOne tablet a day with no sleepiness warning, and on the market since 2023. It suits women who take CYP3A4 medicines that clash with Lynkuet and who can keep up liver tests at months 1, 2, 3, 6 and 9. Skip it with cirrhosis, severe kidney disease or any CYP1A2 blocker.
Related guide →Estrogen HRT instead of Lynkuet or Veozah
Strong evidenceIf hormones are an option for you, they're more effective than either, cutting hot flash frequency by about 75%, and they also treat vaginal dryness and protect bone. They aren't suitable after hormone-sensitive breast cancer or with some clot and liver conditions, which is where Lynkuet and Veozah are used instead.
Related guide →SSRIs, SNRIs or gabapentin
Strong evidenceOlder non-hormonal options that cut hot flashes by about 40% to 65%. They're cheap generics with no liver testing, which matters if insurance won't cover Lynkuet or Veozah. Gabapentin at night can help sleep, and low-dose paroxetine is FDA-approved for hot flashes, though it's avoided with tamoxifen.
Related guide →
When to call a doctor on Lynkuet or Veozah
Urgent: Yellow skin or eyes, dark urine, pale stools, itching or unusual tiredness on either drug
Stop the medicine and contact your prescriber the same day for liver tests.
Urgent: A seizure or passing out on Lynkuet
Call 911 or get emergency care right away.
Urgent: You might be pregnant on Lynkuet
Stop it and tell your prescriber right away.
No improvement after 12 weeks
Ask about switching class: HRT if suitable, an SSRI or SNRI, gabapentin, or the other neurokinin blocker.
Lynkuet vs Veozah: questions women ask
Is Lynkuet better than Veozah?
Not proven. No trial has compared them. Against placebo, Lynkuet cut hot flashes by 3.2 a day and Veozah by 2.5 to 2.6 at week 12, but in different trials that can't be compared directly. The choice usually comes down to timing, sleepiness, liver monitoring, interactions and cost.
Which is safer for the liver, Lynkuet or Veozah?
On current labels, Lynkuet looks lighter: enzymes rose above 3 times normal in 0.6% of women, vs 2.3% on Veozah, and only Veozah has a boxed warning. Both need liver tests before starting, and both must be stopped at the first sign of liver problems.
Can you switch from Veozah to Lynkuet?
Yes, a prescriber can switch you, but no study has tested whether Lynkuet works when Veozah didn't. Before the first Lynkuet dose you'll need liver tests and, if you could be pregnant, a pregnancy test. Give it about 12 weeks before deciding.
Does Lynkuet or Veozah help with sleep?
Lynkuet improved sleep disturbance in its trials and is taken at bedtime, though it can cause next-day sleepiness. Veozah's main sleep benefit comes from fewer night sweats, and insomnia was slightly more common than on placebo, 3.9% vs 1.8%.
Which costs more, Lynkuet or Veozah?
Cash prices are close: around $618.40 a month for Lynkuet and $577.86 for Veozah. With commercial insurance, savings cards bring Lynkuet to as little as $25 a month and Veozah to $0 for the first month and $30 after. Neither has a generic yet.
Can I take Lynkuet or Veozah after breast cancer?
Both are non-hormonal, so they're options when estrogen isn't. Lynkuet has a dedicated trial, OASIS 4, in women on endocrine therapy, and it didn't meaningfully change tamoxifen levels. Discuss either with your oncology team and check every other medicine for interactions.
Can I take Lynkuet and Veozah together?
There's no evidence for it. They act on the same brain pathway and have never been tested together, so combining them would add side effects and liver monitoring without any known benefit. Prescribers use one or the other, sometimes alongside a non-drug approach such as CBT.
Do Lynkuet or Veozah cause weight gain?
Weight gain isn't listed among the common side effects of either drug. Weight often changes around menopause for other reasons, including muscle loss and shifting fat, so look at protein, strength training and sleep if the scale moves.
Related →Is there a generic for Lynkuet or Veozah?
Not yet. Both are sold as brand-name drugs only, which is why savings cards and patient assistance programs matter so much for the monthly cost. Uninsured women on lower incomes can apply to the Bayer or Astellas patient assistance programs.
Sources
- Prescribing information: Veozah (fezolinetant tablets). Astellas Pharma, 2026. DailyMed, US National Library of Medicine.
- US Food and Drug Administration. Drug safety communication: FDA adds warning about rare occurrence of serious liver injury with use of Veozah (fezolinetant). December 2024.
- Prescribing information: Lynkuet (elinzanetant capsules). Bayer HealthCare, 2026. DailyMed, US National Library of Medicine.
- 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):1343-54.
- Drugs.com. Lynkuet prices, coupons, copay cards and patient assistance. Accessed October 2026.
- Drugs.com. Veozah prices, coupons, copay cards and patient assistance. Accessed October 2026.
- Astellas Pharma. VEOZAH savings and support. Accessed October 2026.
- Cardoso F, Parke S, Brennan DJ, et al. Elinzanetant for Vasomotor Symptoms from Endocrine Therapy for Breast Cancer. N Engl J Med. 2025;393(8):753-763.
- Crandall CJ, Mehta JM, Manson JE. Management of Menopausal Symptoms: A Review. JAMA. 2023;329(5):405-420.
- NHS. About hormone replacement therapy (HRT).
- Prescribing information: Brisdelle (paroxetine 7.5 mg capsules). Legacy Pharma, 2025. DailyMed, US National Library of Medicine.
- National 911 Program. 911.gov.
- US Food and Drug Administration. FDA Adverse Event Reporting System (FAERS): reports for elinzanetant (Lynkuet), via openFDA. Data through July 30, 2026.
- US Food and Drug Administration. FDA Adverse Event Reporting System (FAERS): reports for fezolinetant (Veozah), via openFDA. Data through July 30, 2026.
- The North American Menopause Society. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-590.
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