Fezolinetant (Veozah) Dosing and Liver Monitoring Guide

　　1.Overview and Indication

　　Fezolinetant(brand name Veozah)is an oral non-hormonal drug used to treat moderate to severe vasomotor symptoms associated with menopause,such as recurrent hot flashes,flushes,and night sweats.

　　2.Standard Dosing and Administration

　　Recommended dose:45 mg orally once daily,with or without food.

　　Administration:Swallow the tablet whole with liquid;do not cut,crush,or chew.

　　Timing:To maintain consistent drug exposure,take at approximately the same time each day.

　　Missed dose:If a dose is missed and more than 12 hours remain before the next scheduled dose,take it as soon as possible.If less than 12 hours remain,skip the missed dose and resume the regular schedule the next day.Do not double the dose.

　　3.Liver Function Monitoring

　　Liver monitoring is a critical safety requirement for fezolinetant.

　　1.Baseline before treatment

　　Before starting therapy,liver function tests(ALT,AST,ALP,total bilirubin,direct bilirubin)are required.If baseline ALT or AST is≥2 times the upper limit of normal(ULN),or total bilirubin is≥2×ULN,Veozah should generally not be initiated.

　　2.Periodic monitoring during treatment

　　After starting,liver function should be rechecked as per labeling:monthly during the first 3 months of treatment,then at months 6 and 9.This schedule is due to the potential for liver injury associated with the drug.

　　4.Recognizing and Responding to Liver Injury

　　Patients should stop taking fezolinetant and seek medical evaluation if they experience:

　　Unusual fatigue,loss of appetite,nausea,vomiting

　　Itching,dark urine

　　Yellowing of skin or eyes(jaundice)

　　Right upper abdominal discomfort

　　The FDA has recently strengthened the liver injury safety warning for Veozah,underscoring the need for vigilance.

　　5.Conclusion

　　Fezolinetant offers a non-hormonal option for menopausal vasomotor symptoms,but its potential hepatotoxicity necessitates strict adherence to baseline and periodic liver monitoring.Patients should follow proper dosing and missed-dose rules and promptly report any signs of liver problems.