Orilissa (elagolix) has potential interactions with other medications and some supplements. These interactions could affect how well the drug works or cause harmful effects.
Orilissa is used in adults to treat moderate to severe pain related to endometriosis. With this condition, certain tissue is found and grows in places other than the uterus.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions also can occur if you have certain health conditions.
Keep reading to learn about Orilissa’s possible interactions. For a detailed overview of this drug, check out this in-depth Orilissa article.
Before you start taking Orilissa, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
The following table lists drugs that may interact with Orilissa. Keep in mind that this table does not include all drugs that may interact with Orilissa. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| certain antibiotics | • clarithromycin • erythromycin (Eryc, Ery-Tab, others) • rifampin (Rifadin, Rimactane) | can increase the risk of side effects from Orilissa (See the “When should I avoid Orilissa?” section to learn more.) |
| certain pyrimidine synthesis inhibitors | • leflunomide (Arava) • teriflunomide (Aubagio) | can increase the risk of side effects from Orilissa (See the “When should I avoid Orilissa?” section to learn more.) |
| certain proton pump inhibitors (PPIs) | • lansoprazole (Prevacid) • omeprazole (Prilosec) • rabeprazole (Aciphex) | can increase the risk of side effects from the PPI |
| hormonal birth control | • ethinyl estradiol/desogestrel (Cyclessa, Kariva, others) • ethinyl estradiol/etonogestrel (EluRyng, NuvaRing, others) • levonorgestrel (Kyleena, Mirena, others) | can make Orilissa or the hormonal birth control less effective |
| rosuvastatin (Crestor) | — | can make rosuvastatin less effective |
| gemfibrozil (Lopid) | — | can increase the risk of side effects from Orilissa (See the “When should I avoid Orilissa?” section to learn more.) |
| digoxin (Lanoxin) | — | can increase the risk of side effects from digoxin |
| diazepam (Libervant, Valium, others) | — | can increase the risk of side effects from diazepam |
| midazolam (Nayzilam, Seizalam) | — | can make midazolam less effective |
| cyclosporine (Gengraf, Sandimmune, others) | — | can increase the risk of side effects from Orilissa (See the “When should I avoid Orilissa?” section to learn more.) |
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
To learn whether Orilissa interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Orilissa?” section.
Certain health conditions or other factors could raise your risk of harm if you take Orilissa. In such cases, your doctor may not prescribe Orilissa for you. These are known as contraindications. Orilissa has some contraindications, as follows:
If you have osteoporosis: If you have osteoporosis, your doctor likely will not prescribe Orilissa for you. (With osteoporosis, you have a decrease in bone mass, leading to fragile bones.) This is because Orilissa may cause weakened bones, which could worsen osteoporosis.
Your doctor can recommend other treatment options that may be safe to take if you have osteoporosis.
If you have a severe liver problem: If you have a severe liver problem, such as liver failure, your doctor likely will not prescribe Orilissa for you. A severe liver problem could raise the level of Orilissa in your body. This may increase your risk of side effects from Orilissa.
Your doctor can recommend other treatment options that may be safe to take if you have a severe liver problem.
If you’re pregnant: If you’re pregnant, your doctor likely will not prescribe Orilissa for you. Taking Orilissa during pregnancy may increase the risk of pregnancy loss.
If you can become pregnant, your doctor may give you a pregnancy test before starting treatment. They also may recommend using nonhormonal birth control during Orilissa treatment and for at least 28 days after your final dose. (See the “Drug interactions explained” section to learn more about Orilissa’s interaction with hormonal birth control.)
If you become pregnant while taking Orilissa, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Orilissa. To learn more, call 833-782-7241 or talk with your doctor.
If you take certain drugs that affect how Orilissa is removed: Certain drugs affect how Orilissa is removed from the body. If you take any, your doctor likely will not prescribe Orilissa for you.
These drugs block a liver protein that helps remove Orilissa from your body. Taking Orilissa with these medications may raise your risk of side effects from Orilissa.
Examples of these medications include:
- gemfibrozil (Lopid)
- cyclosporine (Gengraf, Sandimmune, others)
- certain antibiotics, such as clarithromycin and erythromycin (Eryc, Ery-Tab, others)
- certain pyrimidine synthesis inhibitors, such as leflunomide (Arava) and teriflunomide (Aubagio)
Your doctor can review the medications you take before starting Orilissa. They may recommend an alternative treatment or adjust your medications to help avoid interactions.
If you’ve had an allergic reaction: If you’ve ever had an allergic reaction to Orilissa or any of its ingredients, your doctor likely will not prescribe Orilissa for you. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start taking Orilissa, talk with your doctor if any of these factors apply to you. Your doctor can determine whether Orilissa is safe for you to take.
Orilissa is not known to interact with alcohol. But Orilissa and alcohol can cause some similar side effects, such as headache and nausea. If you drink alcohol during your Orilissa treatment, you may have worsened side effects.
If you have questions about consuming alcohol while taking Orilissa, talk with your doctor or pharmacist.
Interaction with rosuvastatin
Orilissa can interact with rosuvastatin (Crestor). This drug is taken for high cholesterol and other heart-related risks.
Taking these drugs together can lead to a lower level of rosuvastatin in your body. This could make rosuvastatin less effective for managing high cholesterol and other heart-related risks.
What you can do
If you take Orilissa with rosuvastatin, your doctor may prescribe a dosage of rosuvastatin that’s higher than typical. This can help ensure that rosuvastatin remains effective. But you should not take a dose of either medication that’s higher than your doctor prescribes.
If you have questions about taking Orilissa with rosuvastatin, talk with your doctor or pharmacist.
Interaction with certain proton pump inhibitors (PPIs)
Orilissa can interact with certain PPIs, which are taken to ease symptoms of excess stomach acid.
Taking Orilissa with certain PPIs can lead to a higher level of the PPI in your body. This could increase your risk of side effects from the PPI.
Some PPIs that may interact with Orilissa are:
- lansoprazole (Prevacid)
- omeprazole (Prilosec)
- rabeprazole (Aciphex)
What you can do
Before taking a PPI with Orilissa, check with your doctor or pharmacist. They can recommend a PPI that’s less likely to interact with Orilissa.
Talk with your doctor or pharmacist if you have other questions about taking Orilissa with a PPI.
Interaction with hormonal birth control
Orilissa can interact with hormonal birth control. The effects of this interaction depend on the type of birth control used. Some hormonal birth control could make Orilissa less effective. On the contrary, Orilissa could make other hormonal birth control less effective.
Examples of hormonal birth control that may interact with Orilissa are:
- certain birth control pills, such as ethinyl estradiol/desogestrel (Cyclessa, Kariva, others)
- vaginal rings, such as ethinyl estradiol/etonogestrel (EluRyng, NuvaRing, others)
- certain intrauterine devices (IUDs), such as levonorgestrel (Kyleena, Mirena, others)
What you can do
Taking Orilissa during pregnancy may not be safe. (For details, see the “When should I avoid Orilissa?” section.) Because of this, your doctor may advise you to use birth control during Orilissa treatment and for at least 28 days after your final dose.
Due to Orilissa’s interaction with hormonal birth control, your doctor may recommend nonhormonal birth control options instead. Examples include the copper IUD (Paragard) or barrier methods, such as a condom or diaphragm.
If you have questions about taking Orilissa with hormonal birth control, talk with your doctor or pharmacist.
Orilissa may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests.
The interactions discussed here are not all other interactions possible with Orilissa.
Does Orilissa interact with supplements?
Before you start taking Orilissa, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Orilissa interactions with herbs
Orilissa can interact with St. John’s wort. This is an herbal supplement used to ease symptoms of depression and other conditions.
Taking Orilissa with St. John’s wort could lower the level of Orilissa in your body. This could make Orilissa less effective for treating your condition.
Check with your doctor or pharmacist before taking St. John’s wort with Orilissa. They can help determine whether it’s safe to take them together. If needed, your doctor or pharmacist may recommend an alternative to St. John’s wort.
Orilissa and vitamins
Orilissa currently has no reports of interacting with vitamins. But this doesn’t mean that interactions with vitamins won’t be recognized in the future.
For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while taking Orilissa.
Does Orilissa interact with food?
Orilissa may interact with grapefruit products. Grapefruit or grapefruit juice could slow your body’s breakdown of Orilissa. This could increase the level of the drug in your body, raising your risk of side effects from Orilissa.
Check with your doctor or pharmacist before consuming grapefruit products with Orilissa. They can recommend whether to limit or avoid grapefruit during Orilissa treatment.
Does Orilissa interact with vaccines or lab tests?
Orilissa currently has no reports of interacting with vaccines or lab tests. If you have questions about getting vaccines or lab tests during your Orilissa treatment, talk with your doctor.
Does Orilissa interact with cannabis or CBD?Orilissa currently has no reports of interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Orilissa.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Orilissa. Before taking Orilissa, talk with your doctor about your health history. They’ll determine whether Orilissa is right for you.
Health conditions or other factors that might interact with Orilissa include:
Osteoporosis: If you have osteoporosis, your doctor likely will not prescribe Orilissa for you. To learn more, see the “When should I avoid Orilissa?” section.
Liver problems: If you have a liver problem, talk with your doctor before taking Orilissa. They can recommend whether Orilissa is a safe treatment option. In some cases, your doctor may prescribe a lower Orilissa dosage to help reduce your risk of side effects.
If your liver problem is severe, such as liver failure, your doctor may not prescribe Orilissa for you. To learn more, see the “When should I avoid Orilissa?” section.
Mental health conditions: Having a mental health condition may increase the risk of certain side effects during Orilissa treatment. Examples include:
- worsened anxiety
- worsened depression
- increased suicidal thoughts and actions
If you have a mental health condition, talk with your doctor before taking Orilissa. They can tell you more about this risk and whether Orilissa is a safe option for you.
Pregnancy: It may not be safe to take Orilissa during pregnancy. To learn more, see the “When should I avoid Orilissa?” section.
Breastfeeding: It’s not known whether it’s safe to take Orilissa while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve ever had an allergic reaction to Orilissa or any of its ingredients, your doctor likely will not prescribe Orilissa. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you’re not in the same household, stay on the phone with them until help arrives.
Taking certain steps can help you avoid interactions with Orilissa. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your Orilissa treatment
It’s also important to understand Orilissa’s
If you did not get paperwork with Orilissa, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Taking Orilissa exactly as prescribed also can help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.