Relugolix and Smallpox Monkeypox Vaccine: 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
Smallpox Monkeypox Vaccine
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.
Let's talk about taking Orgovyx (relugolix) along with the smallpox/monkeypox vaccine. This particular vaccine can be a live vaccine, which means it contains a weakened form of the virus that your immune system normally clears easily. If your body's defenses are weakened, that live vaccine can actually cause the very infection it's meant to prevent.
Relugolix is used in cancer care, and people being treated for cancer may have a weaker immune system for a time. That's why this combination is flagged as something to avoid unless your care team says otherwise. The good news is this is very manageable. Your doctor will look at your immune status and timing before giving any live vaccine.
Interaction: Live smallpox/monkeypox vaccine in a patient who may be immunocompromised (e.g., relugolix used in advanced prostate cancer or in the context of malignancy) carries a risk of vaccine-derived (disseminated) infection.
- Mechanism: Reduced immune response permits uncontrolled replication of the live attenuated/replication-competent vaccine virus.
- Direction: Increased risk of active infection from the vaccine (neither agent is metabolic; no PK interaction).
- Evidence: Established. Severity: Contraindicated in severe immunodeficiency.
- Management: Avoid live vaccine in severe immunodeficiency. Patients with malignancy in remission, restored immunocompetence, and chemotherapy discontinued at least 3 months may receive it. Consider non-replicating alternatives.
What happens
An increased risk of infection by the live vaccine
Interaction Deep Dive
The smallpox and monkeypox vaccine should not be given to people who have severe immunodeficiency 2. A live vaccine may be given to patients with leukemia, lymphoma, or other malignancies provided their disease is in remission, their immunocompetence has been restored, and chemotherapy has been stopped for a minimum of 3 months 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 giving the live smallpox/monkeypox vaccine to anyone with a severely weakened immune system.
- Reviews your immune status and cancer treatment history before any live vaccine.
- May wait until your disease is in remission, your immune function has recovered, and chemotherapy has been stopped for at least 3 months.
- May consider a non-live vaccine option where available.
What you should do: Keep taking your relugolix as prescribed, and never get this vaccine without first checking with your oncology team or pharmacist. Tell any vaccine provider that you are on cancer therapy.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Relugolix and Smallpox Monkeypox Vaccine together?
Do not receive the live smallpox/monkeypox vaccine while your immune system is weakened by cancer treatment; check with your oncology team or pharmacist first, as it may be safe only once you are in remission with restored immunity and off chemotherapy for at least 3 months. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Smallpox Monkeypox Vaccine interaction?
It is rated contraindicated. These should generally not be used together.
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 Smallpox Monkeypox Vaccine interaction managed?
What your care team typically does: Avoids giving the live smallpox/monkeypox vaccine to anyone with a severely weakened immune system. Reviews your immune status and cancer treatment history before any live vaccine. May wait until your disease is in remission, your immune function has recovered, and chemotherapy has been stopped for at least 3 months. May consider a non-live vaccine option where… 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 Smallpox Monkeypox Vaccine 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)
- Centers for Disease Control and Prevention (CDC): Vaccines & Immunizations: altered immunocompetence. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024.
- Product Information: ACAM2000 percutaneous injection, smallpox and mpox (vaccinia) vaccine, live percutaneous injection. Emergent Product Development Gaithersburg Inc (per FDA), Gaithersburg, MD, 2024. DailyMed
Keep reading about Relugolix
Keep reading about Smallpox Monkeypox Vaccine
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