Relugolix and Gonadorelin: 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
Gonadorelin
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.
Both relugolix (Orgovyx) and gonadorelin can affect the timing of your heartbeat. Doctors call this the QT interval. When two medicines that stretch this timing are used together, the effect can add up, which in rare cases can lead to an irregular heartbeat.
I want to be clear that this concern is based on theory, not on lots of real-world cases. Your care team can manage it easily. They may check your heart rhythm with an ECG and make sure your blood minerals (like potassium and magnesium) stay in a healthy range. Please keep taking both medicines as prescribed and just ask your pharmacist or doctor if you have questions.
Effect: Additive QT interval prolongation when relugolix is combined with another QT-prolonging agent. Gonadorelin/GnRH-axis modulation and the androgen deprivation produced by relugolix can each contribute to QT prolongation.
- Direction: Additive PD effect (increased arrhythmia risk); neither is a prodrug here.
- Evidence: Theoretical; severity rated major.
- Onset: Unspecified.
- Management: Weigh benefit vs risk in patients with congenital long QT, CHF, or electrolyte disturbances. Avoid combination when possible. If required, avoid agents causing hypokalemia/hypomagnesemia, correct electrolytes, and perform 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. The androgen deprivation produced by GnRH agonists/antagonists can itself lengthen the QT interval. In patients who have congenital long QT syndrome, congestive heart failure, or recurrent electrolyte disturbances, as well as those receiving drugs recognized to prolong the QT interval, weigh whether the benefits of androgen deprivation therapy, such as relugolix, exceed the possible risks 1. Where feasible, do not use relugolix at the same time as QT prolonging agents. If they must be given together, refrain from using drugs that produce electrolyte abnormalities (that is, hypokalemia or hypomagnesemia) 2, correct any electrolyte abnormalities, and consider periodic ECG and electrolyte monitoring 1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team can manage this combination safely. Typical steps include:
- Weighing the benefits of relugolix therapy against your personal heart-risk factors, such as a family history of long QT, heart failure, or frequent electrolyte problems.
- Using an alternative when possible to avoid combining two QT-prolonging drugs.
- Checking and correcting blood minerals (potassium and magnesium) if they are low.
- Doing periodic ECGs and electrolyte checks if both drugs are needed together.
What you should do: Keep taking both as prescribed, and tell your pharmacist or doctor about any dizziness, fainting, or palpitations, plus all other medicines you take.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A study assessed male patients treated with androgen deprivation therapy (ADT) using individual case safety reports from VigiBase, the international pharmacovigilance database, and identified 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 agents known to raise TdP risk; nevertheless, some aLQTS/TdP events (23% or 43%) and sudden death events (18% and 22%) involved exposure to 1 drug or to 2 or more drugs carrying conditional, possible, or known TdP risk. The agents classified as ADTs included abiraterone, gonadotropin-releasing hormone agonists and antagonists, nonsteroidal androgen receptor inhibitors indicated for prostate cancer, and 5-alpha-reductase inhibitors indicated 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 received ADT mainly for prostate cancer, while some were treated for prostatism and androgenic alopecia. Most patients were on ADT monotherapy (83%); 17% were on ADT combination therapy 3.
Common questions
Can I take Relugolix and Gonadorelin together?
Combining relugolix and gonadorelin may add to QT-interval prolongation, so your care team may run ECGs and keep your electrolytes in check; keep taking both as prescribed and report any palpitations or fainting. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Gonadorelin 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 Gonadorelin interaction managed?
Your care team can manage this combination safely. Typical steps include: Weighing the benefits of relugolix therapy against your personal heart-risk factors, such as a family history of long QT, heart failure, or frequent electrolyte problems. Using an alternative when possible to avoid combining two QT-prolonging drugs. Checking and correcting blood minerals (potassium and magnesium) if they are… 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 Gonadorelin 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 Relugolix
Keep reading about Gonadorelin
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