Omeprazole and Elagolix: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Elagolix
Omeprazole
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's going on: Elagolix (Orilissa) can slow down the liver enzyme (called CYP2C19) that normally breaks down omeprazole (Prilosec). When that enzyme is slowed, more omeprazole stays in your body, so its effects and any side effects can be a bit stronger.
The good news is this is usually easy to manage. At the common omeprazole dose of 40 mg once a day, no change is typically needed. If you take a higher dose, your care team may simply lower it a little. Please don't change anything on your own. Just let your pharmacist or doctor know you take both, and they'll tailor things for you.
Mechanism: Elagolix inhibits CYP2C19, the primary enzyme metabolizing omeprazole (a CYP2C19 substrate). This reduces omeprazole clearance and increases its exposure (AUC/Cmax). Omeprazole is an active drug, so higher exposure means enhanced/prolonged acid suppression and potential dose-related effects.
- Direction: increased omeprazole effect
- Evidence: established; severity major
- Onset: unspecified
Management: Omeprazole 40 mg once daily requires no adjustment when given with elagolix (including elagolix/estradiol/norethindrone). With higher omeprazole doses, consider a dosage reduction and individualize per response.
What happens
Increased omeprazole exposure
Interaction Deep Dive
Giving elagolix, which inhibits CYP2C19, together with omeprazole2, a substrate of CYP2C19 1, raised the exposure to omeprazole. For omeprazole 40 mg taken once daily alongside elagolix or the elagolix/estradiol/norethindrone combination, no dose change is needed; however, at higher omeprazole doses, a reduction in dosage should be considered 2.
Why it happens (mechanism)
Inhibition of CYP2C19 metabolism of omeprazole
How to manage this interaction
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This interaction is manageable.
- At omeprazole 40 mg once daily, no dose change is usually needed with elagolix.
- If you take a higher omeprazole dose, your care team may reduce it and individualize it for you.
- Tell your pharmacist or doctor that you take both so they can review your dose.
- Mention any new or stronger side effects, and don't stop or adjust either drug on your own.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a drug interaction study (N=20), giving a single 40 mg dose of omeprazole to participants who had been taking elagolix 300 mg twice daily for 9 days, compared with omeprazole given alone, produced a significant rise in omeprazole Cmax of 1.95-fold (90% CI, 1.5 to 2.53) and in omeprazole AUC of 1.78-fold (90% CI, 1.39 to 2.27) 2.
Common questions
Can I take Omeprazole and Elagolix together?
Elagolix raises omeprazole levels by slowing its breakdown; 40 mg daily needs no change, but higher omeprazole doses may be lowered by your care team. Keep taking both as prescribed and check with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Elagolix interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Omeprazole and Elagolix interaction managed?
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This interaction is manageable. At omeprazole 40 mg once daily, no dose change is usually needed with elagolix. If you take a higher omeprazole dose, your care team may reduce it and individualize it for you. Tell your pharmacist or doctor that you take both so they can review your dose. Mention any new or stronge… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Omeprazole 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: PRILOSEC(R) oral delayed-release capsules, omeprazole oral delayed-release capsules. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2018. DailyMed
- Product Information: ORIAHNN(TM) oral capsules, elagolix, estradiol, norethindrone acetate oral capsules; elagolix oral capsules. AbbVie Inc (per manufacturer), North Chicago, IL, 2020. DailyMed
Keep reading about Elagolix
Keep reading about Omeprazole
These medications also interact with supplements
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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