FDA Approved
Oral Capsule LE
Lynkuet (Elinzanetant)
An FDA-approved daily pill that blocks NK1 and NK3 receptors for moderate-to-severe menopause hot flashes.
Hot Flash PillsFDA Approved
Prescription Medicine
Hot Flash Pills
A daily prescription pill (neurokinin receptor antagonist) that blocks NK3 receptors in the brain to reduce hot flashes and night sweats.
Last verified:
Method at a Glance
EfficacyRecommended
see detailsDurationDaily pill (ongoing)
Cost$0–$785
/monthlyUsed forHot flash & night sweat relief
PrescriptionRequired
Available Products
2 products in this category
Specific branded items that use this method. Compare manufacturer details, active ingredients, and regulatory status.
The details
What the evidence says
How well it works, what to watch for, who should avoid it, and the studies behind it.
How well it works
Recommended
Recommended by the Menopause Society for symptom relief.
How was this measured?▾
This method class covers NK3 antagonists and dual NK1/NK3 antagonists. In Phase 3 trials, fezolinetant 45 mg reduced moderate-to-severe hot flashes and night sweats by about 2.5 episodes per day versus placebo at week 12 (between-group difference, p<0.001), and elinzanetant 120 mg reduced them by about 3.2 episodes per day versus placebo (between-group difference, p<0.001). Responder rates also differ between products, so no single percentage captures the class. NAMS 2023 Level I recommendation.
Why we rate it this wayNAMS 2023 Nonhormone Therapy Position Statement
Cost & insurance
$0–$785/monthly
Monthly list price for neurokinin antagonist products is typically around $550-$625 for fezolinetant and about $785 for elinzanetant; actual cost depends on pharmacy, insurance, and discounts.
Insurance CoverageUsually
Duration & reversibility
Lasts forDaily pill (ongoing)
Reversibility
Reversible
The science
Clinical classNeurokinin receptor antagonist
How it works in the body
Blocks neurokinin-3 (NK3) and/or neurokinin-1 (NK1) receptors in the hypothalamus to interrupt the temperature-regulation pathway that triggers hot flashes and night sweats.
Regulatory status
StatusFDA Approved
Used forHot flash & night sweat relief
PrescriptionRequired
Special monitoring required
Hot Flash Pills requires blood tests (baseline and periodic liver function tests) to monitor safety during use.
Side effects
- Elevated liver enzymes (requires monitoring)
- Abdominal pain
- Diarrhea
- Insomnia
- Back pain
- Hot flush
- Headache
- Nausea
- Somnolence, dizziness, and fatigue (more common with dual NK1/NK3 antagonists)
Who shouldn't use this
- •Cirrhosis or severe liver disease(Severe liver damage or reduced liver function)
- •Severe renal impairment(Reduced kidney function or kidney disease)
- •Pregnancy(The treatment is not intended for use during pregnancy and may harm a fetus)
- •Concurrent use of CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin (for NK3 antagonists such as fezolinetant)(Taking medicines like fluvoxamine or ciprofloxacin that affect liver processing)
- •Moderate or severe hepatic impairment (for dual NK1/NK3 antagonists such as elinzanetant)(Severe liver damage or reduced liver function)
- •Strong CYP3A4 inhibitors including grapefruit juice (for dual NK1/NK3 antagonists)(Medicines or grapefruit juice that affect how the drug is processed)
- •Strong or moderate CYP3A4 inducers (for dual NK1/NK3 antagonists)(Medicines or grapefruit juice that affect how the drug is processed)
Clinical Guidelines
The full picture
What to know about Hot Flash Pills
How it works
Neurokinin receptor antagonists are a new class of non-hormonal prescription pills for menopause hot flashes and night sweats. They block neurokinin receptors in the hypothalamus, the part of the brain that regulates body temperature. By interrupting the pathway that triggers hot flashes, they reduce both the frequency and severity of vasomotor symptoms.
Research and approval status
Two neurokinin receptor antagonists are FDA-approved: fezolinetant, an NK3 antagonist approved in 2023, and elinzanetant, a dual NK1/NK3 antagonist approved in 2025. In SKYLIGHT 1 and SKYLIGHT 2, fezolinetant 45 mg reduced daily hot flash and night sweat frequency by about 2.5 episodes per day more than placebo at week 12 (p<0.001). In the OASIS 1 and 2 trials, elinzanetant 120 mg reduced daily frequency by about 3.2 episodes per day more than placebo at week 12. The Menopause Society (NAMS 2023) lists neurokinin receptor antagonists as a Level I recommendation.
Side effects and cautions
Fezolinetant carries an FDA boxed warning about the risk of hepatotoxicity (liver injury). Neurokinin antagonists can affect the liver, so you need baseline liver function blood tests before starting one. With NK3 antagonists such as fezolinetant, tests are repeated monthly for the first 3 months, then again at 6 and 9 months. With dual NK1/NK3 antagonists such as elinzanetant, a repeat test at 3 months is recommended. Do not take an NK3 antagonist if you have cirrhosis, severe kidney disease, or take CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin. Dual NK1/NK3 antagonists are not recommended in pregnancy, moderate or severe hepatic impairment, or with strong or moderate CYP3A4 inducers; avoid strong CYP3A4 inhibitors (including grapefruit juice), and if you take a moderate CYP3A4 inhibitor, reduce the dose to 60 mg (one capsule). Elinzanetant can cause sleepiness and affect your ability to drive or do hazardous activities the next day, and people with a history of seizures should talk to their clinician before using it.
Where to get it
You need a prescription, which you can get through telehealth or a menopause specialist. You take it as a daily pill.
The studies
Clinical trials behind Hot Flash Pills
The research that backs Hot Flash Pills, with links to the public trial records.
Phase 3Completed
SKYLIGHT 1 (fezolinetant)
ClinicalTrials.gov: NCT04003155Phase 3Completed
SKYLIGHT 2 (fezolinetant)
ClinicalTrials.gov: NCT04003142Phase 3Completed
OASIS 1 (elinzanetant)
ClinicalTrials.gov: NCT05042362Phase 3Completed
OASIS 2 (elinzanetant)
ClinicalTrials.gov: NCT05099159Phase 3Completed
OASIS 3 (elinzanetant long-term)
ClinicalTrials.gov: NCT05030584Keep exploring
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