Relugolix and Nilotinib: 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
Nilotinib
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.
Both of these medicines can affect your heart's rhythm. Nilotinib (a cancer medicine) and relugolix (Orgovyx, used for prostate cancer) can each stretch out a part of your heartbeat called the QT interval. When you take them together, that effect can add up, which in rare cases can lead to a dangerous irregular heartbeat.
The good news is that this is a known concern your care team plans for. They can check your heart rhythm with an EKG and watch your blood minerals like potassium and magnesium. Please keep taking both medicines as prescribed, and talk with your doctor or pharmacist about the best way to stay safe.
Effect: Additive QT interval prolongation with concomitant nilotinib and relugolix.
Mechanism: Both agents prolong the QT interval independently (nilotinib carries a boxed warning for QT prolongation/sudden death; androgen deprivation therapy with relugolix can also prolong QT). This is a pharmacodynamic, additive interaction, not a metabolic one. Neither activation nor inhibition of clearance applies here.
Severity/Evidence: Major; evidence is theoretical. Onset unspecified.
Management:
- Avoid concomitant use when possible; weigh benefit versus risk.
- Higher caution with congenital long QT, CHF, or electrolyte disturbances.
- Correct and maintain K+ and Mg2+; avoid other QT-prolonging or hypokalemia-inducing drugs.
- 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 QT duration are additive. GnRH agonists and antagonists can lengthen the QT interval through androgen deprivation. 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 advantages of androgen deprivation therapy such as relugolix are greater than the possible hazards 1. Where feasible, do not use relugolix at the same time as agents that prolong the QT interval. Should combined use be necessary, refrain from using medications that produce electrolyte disturbances (that is, hypokalemia or hypomagnesemia) 2, correct any electrolyte abnormalities, and consider periodic monitoring of ECGs and electrolytes 1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
This is manageable with monitoring and planning. Here is what a care team typically does:
- Weighs the benefits of relugolix against the risk, especially if you have a known heart rhythm condition, heart failure, or frequent electrolyte problems.
- Avoids combining these two when a safer option exists.
- If both are needed, keeps your potassium and magnesium in a healthy range and avoids other drugs that lower them.
- May check your heart rhythm (ECG) and blood minerals from time to time.
What you should do: Keep taking both as prescribed. Tell your pharmacist or prescriber about all your medicines, and report fainting, dizziness, or a racing or fluttering heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A study looked at male patients receiving androgen deprivation therapy (ADT) using individual case safety reports from the international pharmacovigilance database VigiBase, identifying 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%) associated with ADT arose without exposure to other agents known to raise TdP risk; nevertheless, exposure to 1 drug and to 2 or more drugs carrying conditional, possible, or known TdP risk was reported in a portion of aLQTS/TdP (23% or 43%) and sudden death (18% and 22%) events. The agents regarded 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 patients had a median age of about 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 were taking ADT chiefly to manage prostate cancer, with some treated for prostatism and androgenic alopecia. The majority of patients were on ADT monotherapy (83%); 17% were receiving ADT combination therapy 3.
Common questions
Can I take Relugolix and Nilotinib together?
Taking nilotinib and relugolix together can add up to more QT prolongation, so your care team may space out safer choices, keep your electrolytes in check, and monitor your heart rhythm. Keep taking both as prescribed and report any dizziness or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Nilotinib 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 Nilotinib interaction managed?
This is manageable with monitoring and planning. Here is what a care team typically does: Weighs the benefits of relugolix against the risk, especially if you have a known heart rhythm condition, heart failure, or frequent electrolyte problems. Avoids combining these two when a safer option exists. If both are needed, keeps your potassium and magnesium in a healthy range and avoids other drugs tha… 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 Nilotinib 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 Nilotinib
Keep reading about Relugolix
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