Elinzanetant: clinical use

Prescribing considerations

• Confirm the cause of vasomotor symptoms and review medical and family history.
• Use caution with a seizure history or conditions that lower the seizure threshold.
• Evidence is not established in women older than 65 years or people under 18 years.
• Other breast-cancer therapy combinations require individual benefit–risk assessment.
• Use is not recommended with moderate hepatic or severe renal impairment.

Contraindications and cautions

• Hypersensitivity to elinzanetant or an excipient
• Severe hepatic impairment
• Concomitant strong CYP3A4 inhibitor use
• Known or suspected pregnancy

Monitoring

• Check liver function before treatment and repeat testing if symptoms suggest liver injury.
• Review efficacy periodically and conduct routine follow-up.
• Review new medicines for CYP3A4 interactions.
• Discuss seizure risk and driving impairment from fatigue, dizziness or sleepiness.

Clinical pharmacology

A selective, non-hormonal NK1/NK3 receptor antagonist, primarily metabolised by CYP3A4 to active metabolites and eliminated mainly through faeces as metabolites.

Formulation and product differences

• The UK product is an opaque red, liquid-filled soft capsule marked “EZN60”.
• Capsules must be swallowed whole and contain sorbitol, which may affect absorption of other oral medicines taken concurrently.

Capsule

Route: Oral

Strengths: 60 mg