Scotland accepts non-hormonal menopause treatment for restricted NHS use
- Jul 14
- 2 min read
A non-hormonal treatment for moderate to severe menopause symptoms has been accepted for restricted NHS use in Scotland.
The Scottish Medicines Consortium has accepted fezolinetant, sold under the brand name Veoza, for adults with moderate to severe vasomotor symptoms linked to menopause. Vasomotor symptoms include hot flushes and night sweats.
The restriction means the medicine should be used for patients who are not suitable for hormone replacement therapy.
Fezolinetant was licensed by the Medicines and Healthcare products Regulatory Agency in December 2023. NICE later recommended it as an NHS treatment option in England for moderate to severe vasomotor symptoms associated with menopause when HRT is unsuitable.
The SMC decision means the treatment is now available for prescribing on the NHS in Scotland for the restricted patient group.
The significance of non-hormonal choices
HRT is a common treatment for menopause symptoms, but it is not suitable or preferred for everyone.
There may be several reasons why HRT is unsuitable, including some cancer histories, blood clotting risks, untreated high blood pressure, liver disease or other individual health factors.
For women who cannot use HRT, treatment options for hot flushes and night sweats may be more limited. A non-hormonal option can therefore widen treatment choice for some patients.
Fezolinetant works differently from HRT. It does not replace hormones. It acts on brain pathways involved in body temperature control, which are linked with hot flushes and night sweats.
Safety and monitoring
Fezolinetant is not suitable for everyone.
The MHRA has issued safety advice about the risk of drug-induced liver injury. Liver function should be checked before and during treatment, and the medicine should be avoided in patients with known liver disease or a higher risk of liver disease.
NICE and SMC both place the treatment within a defined group of patients, rather than as a general menopause treatment for everyone experiencing symptoms.
The decision adds another option for some women whose menopause symptoms affect daily life, while keeping suitability and monitoring as part of the prescribing decision.