Relugolix and Desipramine: 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
Desipramine
Relugolix
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.
You're taking desipramine (Norpramin), a tricyclic antidepressant, together with relugolix (Orgovyx), a hormone medicine used in prostate cancer. Both of these can gently affect your heart's electrical rhythm, causing something called QT prolongation. When you take them together, that effect can add up.
For most people this is a theoretical concern, not something you'll feel. But it matters more if you have a heart condition, heart failure, or low potassium or magnesium levels. The good news is your care team can manage this easily by keeping an eye on your heart tracing (ECG) and blood minerals. Please don't stop either medicine on your own, just talk with your doctor or pharmacist.
Effect: Additive QT interval prolongation with concurrent desipramine (TCA, intrinsic QT liability) and relugolix (GnRH antagonist; androgen deprivation itself may prolong QT).
- Mechanism: Additive pharmacodynamic effect on cardiac repolarization; not a PK/enzyme interaction.
- Direction: Increased risk of QTc prolongation and torsadogenic potential.
- Evidence: Theoretical; severity rated major.
- Onset: Unspecified.
Management: Weigh benefits of ADT against risk, especially with congenital long QT, CHF, or recurrent electrolyte disturbance. Avoid combination when possible. If required, correct and avoid causing hypokalemia/hypomagnesemia, and obtain periodic ECG and electrolyte monitoring.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
When relugolix is given together with medications that prolong the QT interval, the effects on the QT interval are additive. GnRH agonists and antagonists can lengthen the QT interval through androgen deprivation. In patients who have congenital long QT syndrome, congestive heart failure, or recurring electrolyte disturbances, as well as those receiving drugs recognized to prolong the QT interval, weigh whether the advantages of androgen deprivation therapy such as relugolix are greater than the possible risks1. Whenever feasible, relugolix should not be used alongside QT prolonging agents. Should coadministration be necessary, steer clear of drugs that produce electrolyte disturbances (that is, hypokalemia or hypomagnesemia)2, correct any electrolyte disturbances, and think about performing periodic ECG and electrolyte monitoring1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Both medicines can add to each other's effect on your heart rhythm, so your care team may take a few simple steps to keep you safe.
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your team may check ECGs (heart tracings) and blood electrolytes (like potassium and magnesium) from time to time.
- They will watch for and correct any low potassium or magnesium, since these raise the risk.
- In some cases the doctor may consider an alternative medicine, and any dosing can be individualized by your care team.
Tell your pharmacist or prescriber about any fainting, dizziness, or palpitations, and share your full medication list.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A study examined male patients undergoing androgen deprivation therapy (ADT) using individual case safety reports from VigiBase, the international pharmacovigilance database, and found 184 cases of acquired long-QT syndrome (aLQTS) and/or torsades de pointes (TdP; 11% fatal cases), along with 99 cases of sudden death linked to ADT. The majority of aLQTS/TdP cases (62%) and sudden death cases (88%) related to ADT arose without concurrent use of other drugs recognized to raise TdP risk; nonetheless, use of 1 drug and of 2 or more drugs carrying conditional, possible, or known TdP risk was documented in a portion of aLQTS/TdP (23% or 43%) and sudden death (18% and 22%) events. The agents classified as ADTs included abiraterone, gonadotropin-releasing hormone agonists and antagonists, nonsteroidal androgen receptor inhibitors approved for prostate cancer, and 5-alpha-reductase inhibitors approved for androgenic alopecia and prostatism. Among the 10 ADTs assessed, 7 showed a disproportional association (reporting odds ratio, 1.4 to 4.7) with aLQTS, TdP, or sudden death, namely leuprorelin, goserelin, triptorelin, degarelix, bicalutamide, finasteride, and dutasteride. The median patient age was approximately 76 years, and the median time to onset was 170 days (range, 7 to 4884 days) for aLQTS/TdP events and 92 days (range, 0.25 to 4984 days) for sudden death events. Patients were primarily using ADT for prostate cancer, with some receiving it for prostatism and androgenic alopecia. Most patients were on ADT monotherapy (83%); 17% were receiving ADT combination therapy 3.
Common questions
Can I take Relugolix and Desipramine together?
Combining desipramine and relugolix can add to the risk of QT prolongation (a heart rhythm effect), so your care team may monitor your ECG and electrolytes; keep taking both as prescribed and report any dizziness, fainting, or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Desipramine 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 Relugolix and Desipramine interaction managed?
Both medicines can add to each other's effect on your heart rhythm, so your care team may take a few simple steps to keep you safe. Keep taking both as prescribed unless your doctor tells you otherwise. Your team may check ECGs (heart tracings) and blood electrolytes (like potassium and magnesium) from time to time. They will watch for and correct any low potassium or magnesium, since these raise… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Relugolix or Desipramine 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 (3)
- Product Information: ORGOVYX oral tablets, relugolix oral tablets. Sumitomo Pharma America, Inc (per FDA), Marlborough, MA, 2025. DailyMed
- Lyon AR, Lopez-Fernandez T, Couch LS, et al: 2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022; 43(41):4229-4361.
- Salem JE, Yang T, Moslehi JJ, et al: Androgenic effects on ventricular repolarization: a translational study from the international pharmacovigilance database to iPSC-cardiomyocytes. Circulation 2019; 140(13):1070-1080. PubMed
Keep reading about Desipramine
Keep reading about Relugolix
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