Relugolix and Sultopride: 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
Sultopride
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.
Both of these medicines can affect your heart's rhythm. Relugolix (Orgovyx) lowers testosterone to treat prostate cancer, and lowering testosterone can slightly stretch out part of your heartbeat called the QT interval. Sultopride, an antipsychotic, is also well known for stretching out that same QT interval. When you take them together, those effects can add up, which in rare cases could lead to a dangerous irregular heartbeat.
The good news is this is manageable. Your care team can check your heart rhythm with an ECG, keep an eye on blood minerals like potassium and magnesium, and decide the safest plan for you. Please don't stop either medicine on your own. Talk with your doctor or pharmacist first.
Interaction: Additive QT interval prolongation (pharmacodynamic, not PK). Neither drug is a prodrug; this is not an enzyme-based interaction.
- Mechanism: Androgen deprivation from relugolix (GnRH antagonist) can prolong QT; sultopride is an intrinsically QT-prolonging antipsychotic. Effects are additive, raising torsades de pointes risk.
- Evidence: Theoretical; severity rated major.
- Management: Avoid concomitant use when possible. Weigh benefits of ADT in patients with congenital long QT, CHF, or recurrent electrolyte abnormalities. If combined, correct and maintain normal K+ and Mg2+, avoid other QT-prolonging or electrolyte-depleting agents, and perform 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 and antagonists can itself lengthen the QT interval. 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 outweigh the possible hazards 1. Where feasible, do not use relugolix concurrently with QT prolonging agents. Should coadministration be necessary, refrain from using drugs 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
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because both can lengthen the QT interval, your team will decide whether the benefit of relugolix outweighs the risk and whether the combination should be avoided.
- They may check periodic ECGs to watch your heart rhythm.
- They may monitor and correct potassium and magnesium levels, since low levels raise the risk.
- They will try to avoid other medicines that prolong QT or lower these minerals.
Tell your pharmacist or doctor if you feel fainting, palpitations, or dizziness, and share your full medication list.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In an analysis of male patients on androgen deprivation therapy (ADT) using individual case safety reports from the international pharmacovigilance database VigiBase, investigators identified 184 cases of acquired long-QT syndrome (aLQTS) and/or torsades de pointes (TdP; 11% of cases fatal), 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 exposure to other agents recognized to raise TdP risk; nevertheless, exposure to 1 drug and to 2 or more drugs carrying conditional, possible, or known TdP risk was documented 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. Patients had a median age of approximately 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 mainly for prostate cancer, with some receiving it 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 Sultopride together?
Relugolix and sultopride can each prolong the QT interval, so together the risk of a dangerous heart rhythm adds up; your care team will usually avoid this combination when possible or monitor your ECG and electrolytes closely if it is needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Sultopride 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 Sultopride interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because both can lengthen the QT interval, your team will decide whether the benefit of relugolix outweighs the risk and whether the combination should be avoided. They may check periodic ECGs to watch your heart rhythm. They may monitor and correct potassium and magnesium levels, since low levels raise the risk. T… 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 Sultopride 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 Sultopride
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