Relugolix and Risperidone: 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
Risperidone
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. Relugolix (Orgovyx) lowers testosterone as part of prostate cancer treatment, and that hormone change can slightly stretch out the heart's electrical cycle, something doctors call the QT interval. Risperidone (Risperdal) can do the same thing. When you take them together, those effects can add up, which in rare cases can lead to an abnormal heartbeat.
The good news is this is very manageable. Your care team can check your heart with an ECG and keep an eye on your blood minerals like potassium and magnesium. Please keep taking both exactly as prescribed, and talk with your doctor or pharmacist about any dizziness, fainting, or palpitations.
Interaction: Additive QT interval prolongation (pharmacodynamic, not metabolic). Neither agent is dependent on the other for activation; the concern is combined repolarization delay. Androgen deprivation from relugolix can prolong QTc, and risperidone carries independent QT-prolonging potential.
- Direction: Additive QT prolongation, increased torsades risk.
- Evidence: Theoretical; magnitude and onset unspecified.
- Higher-risk patients: congenital long QT, CHF, electrolyte disturbance, other QT-prolonging drugs.
- Management: Avoid combination when feasible. If required, correct and maintain normal K+/Mg2+, avoid agents causing hypokalemia/hypomagnesemia, and obtain 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 or antagonists can itself lengthen the QT interval. In patients who have congenital long QT syndrome, congestive heart failure, or recurrent electrolyte abnormalities, as well as in 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 risks1. Where feasible, do not use relugolix at the same time as QT prolonging agents. When such combined use cannot be avoided, refrain from using medications that produce electrolyte abnormalities (that is, hypokalemia or hypomagnesemia)2, correct any electrolyte abnormalities, and consider periodic monitoring of ECGs and electrolytes1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
How your care team typically handles this:
- They will weigh the benefits of relugolix against the risk, especially if you have heart failure, an inherited long QT syndrome, or frequent electrolyte problems.
- Where possible, they may choose an alternative so the two are not used together.
- If both are needed, they may check periodic ECGs and keep your potassium and magnesium in a healthy range.
What you should do: Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Ask your pharmacist or doctor before adding any new medicine, and report fainting, palpitations, or severe dizziness right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A study assessed male patients undergoing androgen deprivation therapy (ADT) using individual case safety reports drawn from VigiBase, the international pharmacovigilance database. It 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%) tied to ADT arose without concurrent use of other agents recognized to elevate TdP risk; nevertheless, use of 1 drug and 2 or more drugs carrying conditional, possible, or known TdP risk was noted 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 median patient age was 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 receiving ADT chiefly for prostate cancer, with some treated for prostatism and androgenic alopecia. Most patients were on ADT monotherapy (83%); 17% were receiving ADT combination therapy 3.
Common questions
Can I take Relugolix and Risperidone together?
Taking relugolix and risperidone together can add up to affect your heart rhythm (QT interval). Your care team can manage this with ECG and electrolyte monitoring, so keep taking both as prescribed and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Risperidone 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 Risperidone interaction managed?
How your care team typically handles this: They will weigh the benefits of relugolix against the risk, especially if you have heart failure, an inherited long QT syndrome, or frequent electrolyte problems. Where possible, they may choose an alternative so the two are not used together. If both are needed, they may check periodic ECGs and keep your potassium and magnesium in a healthy range. What y… 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 Risperidone 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 Risperidone
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