Relugolix and Diosmin: 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
Relugolix
Diosmin
No brand names on record
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.
Let me walk you through this one. Relugolix (Orgovyx) is carried out of your body with help from a transporter called P-gp. Diosmin, a supplement often taken for vein and circulation issues, can slow that transporter down. When that happens, more relugolix stays in your body than intended, which can raise the chance of side effects like hot flashes, fatigue, or diarrhea.
The good news is this is very manageable. Please don't stop or change anything on your own. Just let your pharmacist or doctor know you're taking both, and they can adjust timing, watch you more closely, or suggest another option.
Effect: Increased relugolix exposure. Relugolix is a P-gp substrate; diosmin is reported to inhibit P-gp, reducing relugolix efflux and increasing its AUC/Cmax.
- Direction: Increased relugolix effect and adverse-reaction risk (not a prodrug).
- Magnitude: Reference P-gp inhibitor erythromycin raised relugolix AUC 3.5-fold and Cmax 2.9-fold; diosmin effect likely smaller but unquantified.
- Evidence/onset: Probable; onset unspecified.
- Management: Avoid concurrent use. If unavoidable, give relugolix first, separate by at least 6 hours, and monitor for adverse effects more frequently. Follow labeled interruption/reloading (360 mg loading if held >7 days).
What happens
Increased relugolix exposure
Interaction Deep Dive
The combination of relugolix (a P-gp substrate) with P-gp inhibitors should be avoided, since it can raise relugolix exposure and thereby heighten the potential for adverse reactions linked to relugolix. When coadministration cannot be prevented, give relugolix or relugolix/estradiol/norethindrone acetate first, keep the doses at least 6 hours apart, and increase the frequency of monitoring for adverse reactions12. Relugolix therapy may be paused for as long as 2 weeks to accommodate a brief course of certain P-gp inhibitors. Once the P-gp inhibitor has been stopped, relugolix can be resumed. Should the interruption of relugolix exceed 7 days, reinitiate relugolix using a 360 mg loading dose on day one, followed by 120 mg once daily thereafter. A drug interaction study demonstrated that giving relugolix (P-gp substrate) together with erythromycin (P-gp inhibitor) raised relugolix AUC by 3.5-fold and Cmax by 2.9-fold1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of relugolix
How to manage this interaction
Here is how a care team usually handles this:
- Keep taking relugolix as prescribed and tell your pharmacist or doctor you are also using diosmin.
- They may prefer to avoid combining them, or if both are needed, take relugolix first and separate the two by at least 6 hours.
- Your team may watch you more closely for side effects such as hot flashes, tiredness, or stomach upset.
- If relugolix is paused for a short course of a P-gp inhibitor, your prescriber will guide restarting it (including a loading dose if it has been held more than 7 days).
Please don't adjust anything yourself; your care team can tailor this safely.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a drug interaction study, giving relugolix (a P-gp substrate) together with erythromycin (a P-gp inhibitor) raised the AUC of relugolix by 3.5-fold and its Cmax by 2.9-fold 1.
Common questions
Can I take Relugolix and Diosmin together?
Diosmin can raise relugolix levels and side-effect risk by blocking a transporter that clears it; it is best to avoid the combination, but if both are needed your care team can separate dosing by at least 6 hours and monitor you more closely. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Diosmin 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 Diosmin interaction managed?
Here is how a care team usually handles this: Keep taking relugolix as prescribed and tell your pharmacist or doctor you are also using diosmin. They may prefer to avoid combining them, or if both are needed, take relugolix first and separate the two by at least 6 hours. Your team may watch you more closely for side effects such as hot flashes, tiredness, or stomach upset. If relugolix is paused f… Management is individual — always follow your own care team's guidance.
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 Relugolix or Diosmin 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: ORGOVYX oral tablets, relugolix oral tablets. Sumitomo Pharma America, Inc (per FDA), Marlborough, MA, 2025. DailyMed
- Product Information: MYFEMBREE(R) oral tablets, relugolix, estradiol, norethindrone acetate oral tablets. Myovant Sciences Inc (per FDA), Brisbane, CA, 2021. DailyMed
Keep reading about Relugolix
Keep reading about Diosmin
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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