Elinzanetant for Menopause-Related VMS: Onset of Relief and Adverse Effects

Primary care physicians prescribing elinzanetant for menopause-related vasomotor symptoms (VMS) should counsel patients about the potential for early symptom relief, continued improvements over time, and common adverse effects that may diminish with continued treatment, according to JoAnn V. Pinkerton, MD, MSCP, of University of Virginia Health.

In an interview with Patient Care Online at The Menopause Society 2026 Annual Meeting in San Diego, Pinkerton discussed practical considerations for clinicians initiating the nonhormonal neurokinin-1 and neurokinin-3 receptor antagonist, including how to set expectations about treatment response and manage potential adverse effects.

Fatigue, headache, and somnolence were among the adverse effects highlighted by Pinkerton. She noted that these symptoms generally improved over time in the clinical trials and discussed findings from a driving assessment that did not identify next-day impairment.

Pinkerton also emphasized the importance of counseling patients about the expected timeline of VMS improvement. According to the OASIS clinical trial findings she discussed, some women experienced reductions in hot flashes within the first week of treatment, with additional improvements observed at weeks 4, 12, 26, and 52.

For primary care physicians, understanding this treatment trajectory may help guide follow-up conversations with patients who experience a slower initial response. Rather than assessing efficacy based solely on the first several days of treatment, Pinkerton encouraged clinicians to recognize that improvements may continue with ongoing therapy.

She also stressed that patients should be informed about potential adverse effects before treatment begins and reassured that some may become less bothersome over time.

In the video above, Pinkerton explains what primary care physicians should discuss with patients before starting elinzanetant and how to approach follow-up care as treatment progresses.

Relevant disclosures for Pinkerton include Bayer.

References:

1. Simon JA, Nappi RE, Panay N, et al. Headache, fatigue, and somnolence as adverse events across elinzanetant’s clinical trials: a pooled safety analysis. Abstract S-3. Presented at: The Menopause Society 2026 Annual Meeting; San Diego, CA.
2. Pinkerton JV, Tough DeSapri K, Clark A, et al. Proportion of postmenopausal participants achieving ≥50% reduction in moderate-to-severe vasomotor symptom frequency with elinzanetant: pooled US population data from OASIS-1 and OASIS-2. Abstract S-5. Presented at: The Menopause Society 2026 Annual Meeting; San Diego, CA.