Relugolix and Ginkgo: 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
Ginkgo
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.
Here's what's going on. Relugolix (Orgovyx) is moved out of your body with the help of a little pump called P-gp. Ginkgo can slow that pump down. When the pump slows, more relugolix can build up in your body, and that can raise your chances of side effects.
The good news is this is very manageable. Please don't stop or change either one on your own. Just let your pharmacist or doctor know you're taking ginkgo (or thinking about it). They can space out the timing, watch you a little more closely, or adjust your plan so you stay safe.
Effect: Increased relugolix exposure. Relugolix is a P-gp substrate; ginkgo can inhibit intestinal P-gp-mediated efflux, reducing relugolix clearance and increasing AUC/Cmax. Neither drug is a prodrug, so this raises active relugolix levels and adverse-reaction risk.
- Direction: Increased relugolix effect/toxicity.
- Magnitude: Reference P-gp inhibitor erythromycin raised relugolix AUC 3.5-fold, Cmax 2.9-fold; ginkgo's magnitude is less defined.
- Evidence: Probable.
- Management: Avoid if possible. If unavoidable, give relugolix first, separate by at least 6 hours, and monitor for adverse reactions more frequently. Follow labeled loading-dose reinitiation (360 mg) if therapy is interrupted >7 days.
What happens
Increased relugolix exposure
Interaction Deep Dive
Concurrent administration of relugolix (a P-gp substrate) with P-gp inhibitors should be avoided, since this combination can raise relugolix exposure and thereby heighten the likelihood of relugolix-related adverse reactions. When the two cannot be avoided together, give relugolix or relugolix/estradiol/norethindrone acetate first, allow a gap of at least 6 hours between doses, and increase the frequency of monitoring for adverse reactions12. Relugolix therapy may be paused for as long as 2 weeks to permit a brief course of certain P-gp inhibitors, and it can be resumed once the P-gp inhibitor has been stopped. Should relugolix be interrupted for more than 7 days, it should be reintroduced with a 360 mg loading dose on day one, followed by 120 mg once daily thereafter. A drug interaction study showed that giving relugolix (P-gp substrate) together with erythromycin (P-gp inhibitor) raised relugolix AUC 3.5-fold and Cmax 2.9-fold1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of relugolix
How to manage this interaction
What your care team may do:
- Try to avoid combining ginkgo with relugolix when possible.
- If both are needed, take relugolix first and separate the ginkgo dose by at least 6 hours.
- Watch you more closely for relugolix side effects.
- Adjust your relugolix plan as needed, including the labeled loading dose if your treatment is paused for more than 7 days.
What you should do: Keep taking relugolix exactly as prescribed. Tell your pharmacist or prescriber that you take ginkgo (an over-the-counter supplement) so they can tailor timing and monitoring for you. Report any new or worsening symptoms.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During 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 Ginkgo together?
Ginkgo can raise relugolix levels and side-effect risk by slowing a transporter that clears it, so tell your pharmacist or doctor before combining them; they can space the doses at least 6 hours apart and monitor you more closely. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Ginkgo 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 Ginkgo interaction managed?
What your care team may do: Try to avoid combining ginkgo with relugolix when possible. If both are needed, take relugolix first and separate the ginkgo dose by at least 6 hours. Watch you more closely for relugolix side effects. Adjust your relugolix plan as needed, including the labeled loading dose if your treatment is paused for more than 7 days. What you should do: Keep taking relugolix exact… 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.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Relugolix or Ginkgo 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 Ginkgo
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist