Relugolix and Influenza Virus Vaccine, Live: 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
Influenza Virus Vaccine, Live
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.
Relugolix (Orgovyx) is a treatment used for certain cancers, and it can be part of a treatment plan that weakens your body's defenses against germs. The live flu vaccine (the nasal spray type) contains a weakened but living flu virus. It works well in people with a normal immune system, but if your defenses are lowered, that weakened virus could actually cause an infection instead of just teaching your body to fight it.
The good news is that this is easy to plan around. Your care team can pick a flu shot that does not contain live virus, which is a safe option for you. Please talk with your doctor or pharmacist before getting any vaccine so they can choose the right one.
Effect: Increased risk of vaccine-derived infection from live attenuated influenza vaccine (LAIV) in patients who may be immunocompromised in the context of relugolix-based cancer therapy.
Mechanism: A blunted immune response permits the live attenuated virus to replicate and cause clinical infection rather than a protective response (PD interaction, not metabolic; neither agent is enzymatically dependent).
- Direction: Reduced vaccine safety / potential active infection.
- Severity: Major. Evidence: Established.
- Management: Severely immunocompromised patients generally should not receive live vaccines; use inactivated influenza vaccine instead. LAIV may be considered only in patients with restored immunocompetence (e.g., malignancy in remission, chemotherapy discontinued at least 3 months).
What happens
An increased risk of infection by the live vaccine
Interaction Deep Dive
As a rule, live vaccines should be withheld from patients who are severely immunocompromised2. In immunocompromised individuals, the efficacy of the live influenza virus vaccine has not been evaluated 3. Live vaccination is permissible for patients with leukemia, lymphoma, or other malignancies once their disease is in remission, their immunocompetence has been restored, and at least 3 months have elapsed since chemotherapy was stopped 1.
Why it happens (mechanism)
Decreased immune response allows live vaccine to produce infection
How to manage this interaction
What your care team typically does:
- Avoids the live flu vaccine (nasal spray) if your immune system may be weakened, and instead offers an inactivated (not live) flu shot, which is a safe alternative.
- Considers a live vaccine only if immune function has recovered, such as when a cancer is in remission and chemotherapy has been stopped for at least 3 months.
What you should do:
- Keep taking your relugolix (Orgovyx) as prescribed.
- Before any flu vaccine or other vaccination, tell your pharmacist or prescriber that you are on relugolix so they can choose the right type for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Relugolix and Influenza Virus Vaccine, Live together?
If you are on relugolix (Orgovyx) and may be immunocompromised, avoid the live (nasal spray) flu vaccine because the weakened virus could cause infection; ask your pharmacist or doctor for the inactivated flu shot instead. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Influenza Virus Vaccine, Live 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 Influenza Virus Vaccine, Live interaction managed?
What your care team typically does: Avoids the live flu vaccine (nasal spray) if your immune system may be weakened, and instead offers an inactivated (not live) flu shot, which is a safe alternative. Considers a live vaccine only if immune function has recovered, such as when a cancer is in remission and chemotherapy has been stopped for at least 3 months. What you should do: Keep taking your rel… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Relugolix or Influenza Virus Vaccine, Live 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)
- Centers for Disease Control and Prevention (CDC): Vaccines & Immunizations: altered immunocompetence. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024.
- National Center for Immunization and Respiratory Diseases (NCIRD): Vaccines & immunizations: contraindications and precautions. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024.
- Product Information: FluMist(R) intranasal spray, influenza vaccine live intranasal spray. MedImmune LLC (per FDA), Gaithersburg, MD, 2024. DailyMed
Keep reading about Relugolix
Keep reading about Influenza Virus Vaccine, Live
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