Relugolix and Indinavir: 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
Indinavir
No brand names on recordRelugolix
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've been prescribed indinavir and relugolix (Orgovyx) together. Here's what that means. Indinavir blocks a 'pump' in your gut called P-gp that normally limits how much relugolix gets into your body. With that pump slowed down, more relugolix can build up. In a study using a similar blocker, relugolix levels rose about 3 to 4 times higher.
Higher levels can mean more side effects, like hot flashes, tiredness, or joint aches. The good news: this is very manageable. Your care team can space out the doses, watch you more closely, or adjust your plan. Don't stop either medicine on your own, just talk with your pharmacist or doctor.
Effect: Increased relugolix exposure. Indinavir inhibits intestinal P-glycoprotein (P-gp), reducing efflux of relugolix (a P-gp substrate) and raising its systemic exposure. Neither agent's activity depends on prodrug conversion here.
- Magnitude: With erythromycin (P-gp inhibitor), relugolix AUC increased ~3.5-fold and Cmax ~2.9-fold; expect a similar direction with indinavir.
- Severity/evidence: Major; probable.
- Management: Avoid coadministration if possible. If unavoidable, give relugolix first, separate doses by at least 6 hours, and monitor for relugolix adverse effects. For short indinavir courses, relugolix may be interrupted up to 2 weeks; if interrupted >7 days, restart with a 360 mg loading dose then 120 mg daily.
What happens
Increased relugolix exposure
Interaction Deep Dive
Concurrent administration of relugolix (a P-gp substrate) with P-gp inhibitors should be avoided, since it can raise relugolix exposure and thereby heighten the likelihood of adverse reactions linked to relugolix. When coadministration cannot be avoided, 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 accommodate a brief course of certain P-gp inhibitors. Once the P-gp inhibitor has been stopped, relugolix can be resumed. If relugolix has been interrupted for more than 7 days, reinitiate it with a 360 mg loading dose on day one and then continue at 120 mg once daily. In a drug interaction study, giving relugolix (P-gp substrate) together with erythromycin (P-gp inhibitor) raised the AUC and Cmax of relugolix by 3.5-fold and 2.9-fold, respectively1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of relugolix
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. Here's how teams typically handle this combination:
- They may try to avoid using them together when another option exists.
- If both are needed, they may have you take relugolix first and separate the doses by at least 6 hours.
- They may monitor you more closely for relugolix side effects.
- For a short course of indinavir, they may briefly pause relugolix and restart it afterward (with a loading dose if paused more than 7 days).
Ask your pharmacist or prescriber before changing anything, and report new or worsening side effects.
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 relugolix AUC by 3.5-fold and Cmax by 2.9-fold 1.
Common questions
Can I take Relugolix and Indinavir together?
Indinavir can raise relugolix levels several-fold by blocking the P-gp pump, so your team may avoid the combo, separate the doses by at least 6 hours, or monitor you more closely. Do not change either medicine on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Indinavir 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 Indinavir interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. Here's how teams typically handle this combination: They may try to avoid using them together when another option exists. If both are needed, they may have you take relugolix first and separate the doses by at least 6 hours. They may monitor you more closely for relugolix side effects. For a short course of indinav… 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 Indinavir 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 Indinavir
Keep reading about Relugolix
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