Gemfibrozil and Elagolix: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Elagolix
Gemfibrozil
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased elagolix exposure and an increased risk of elagolix-related adverse reactions
Interaction Deep Dive
Coadministration of elagolix (an OATP1B1 substrate) with OATP1B1 inhibitors that are known or expected to significantly increase elagolix exposure and an increase risk of elagolix-related adverse reactions is contraindicated. In a drug interaction study (N=12), administration of a single dose of rifAMPin 600 mg with a single dose of elagolix 150 mg significantly increased elagolix Cmax 4.37-fold (90% CI, 3.62 to 5.28) and AUC 5.58-fold (90% CI, 4.88 to 6.37). Administration of rifAMPin 600 mg once daily with a single dose of elagolix 150 mg significantly increased elagolix Cmax 2-fold (90% CI, 1.66 to 2.41) and AUC 1.65-fold (90% CI, 1.45 to 1.89); a single dose of rifAMPin inhibits OATP1B1, while once daily dosing inhibits OATP1B112.
Why it happens (mechanism)
Inhibition of OATP1B1-mediated metabolism of elagolix
Literature reports
1 report — tap to read
a) In a drug interaction study (N=12), administration of a single dose of rifAMPin 600 mg with a single dose of elagolix 150 mg significantly increased elagolix Cmax 4.37-fold (90% CI, 3.62 to 5.28) and AUC 5.58-fold (90% CI, 4.88 to 6.37). Administration of rifAMPin 600 mg once daily with a single dose of elagolix 150 mg significantly increased elagolix Cmax 2-fold (90% CI, 1.66 to 2.41) and AUC 1.65-fold (90% CI, 1.45 to 1.89); a single dose of rifAMPin inhibits OATP1B1, while once daily dosing inhibits OATP1B1 12.
Common questions
Can I take Gemfibrozil and Elagolix together?
Increased elagolix exposure and an increased risk of elagolix-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gemfibrozil and Elagolix interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Gemfibrozil or Elagolix need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: ORILISSA(R) oral tablets, elagolix oral tablets. AbbVie Inc (per FDA), North Chicago, IL, 2023. DailyMed
- Product Information: ORIAHNN oral capsules, elagolix, estradiol, norethindrone acetate oral capsules; elagolix oral capsules. AbbVie Inc (per FDA), North Chicago, IL, 2023. DailyMed
Keep reading about Elagolix
Keep reading about Gemfibrozil
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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