Vioza (fizolintant) has recently been introduced as a treatment option for vasomotor symptoms of menopause, including hot flashes and night sweats. These symptoms affect nearly 40 percent of women during the perimenopausal period. Until 2024, treatment options were largely limited to hormone replacement therapy (HRT), which, while effective for many women, some cannot take due to side effects or specific health conditions.
Mechanism of Action of Vioza
Vioza is specifically approved for the treatment of vasomotor symptoms of menopause. Unlike HRT, which compensates for decreased hormones, Vioza works by blocking signals in the brain's temperature control system. During the perimenopausal period, decreased estrogen levels activate a group of brain cells known as KNDy cells, leading to stimulation of the temperature control system and the occurrence of hot flashes and night sweats. Vioza prevents the sending of neurokinin B signals by blocking the neurokinin 3 (NK3) receptor, thereby calming this temperature control pathway.
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Advantages and Disadvantages of Vioza
The Vioza drug was approved in March 2024 in Australia as 45 mg daily tablets, but due to lack of coverage by the pharmaceutical benefits scheme, it costs between 75 to 80 Australian dollars for women. However, Vioza only addresses vasomotor symptoms and cannot treat other side effects of estrogen deficiency such as vaginal dryness or decreased bone density. Therefore, HRT remains the preferred treatment for women facing broader symptoms.
Vioza is a suitable option for women who cannot take HRT due to side effects. In a large survey across Europe, the UK, the United States, and Japan, one-tenth of women with vasomotor symptoms were unable to take HRT, reinforcing the need for alternative treatments. Although Vioza can help many women, it cannot completely stop the symptoms and also has common side effects such as headaches, nausea, and insomnia. For this reason, monitoring liver function before and during treatment is essential.
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