Sorafenib and Relugolix: 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
Sorafenib
Relugolix
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 sorafenib (Nexavar) and relugolix (Orgovyx) can affect the timing of your heartbeat. Doctors call this QT prolongation. Taking them together can add up and slightly raise the chance of an abnormal heart rhythm.
Right now this is a theoretical concern based on how each drug works, not on lots of real-world reports. The good news is that your care team can manage it easily. They may check an ECG (heart tracing) and your blood minerals like potassium and magnesium now and then. Please don't stop either medicine on your own. Just talk with your doctor or pharmacist, especially if you feel dizzy, faint, or notice a fluttering heartbeat.
Effect: Additive QT-interval prolongation with concurrent sorafenib and relugolix (a PD interaction, not PK). Neither agent is a prodrug here; both independently prolong QT, and androgen deprivation from relugolix can further prolong the QT interval.
- Severity/Evidence: Rated major, but substantiation is theoretical.
- Onset: Unspecified.
- Risk-enhancing factors: Congenital long QT syndrome, CHF, hypokalemia/hypomagnesemia, bradycardia, other QT-prolonging drugs.
- Management: Avoid the combination when possible. If required, correct and maintain electrolytes (K+, Mg2+), avoid agents causing electrolyte disturbance, and obtain periodic ECG and electrolyte monitoring. Weigh benefit of ADT against arrhythmia risk.
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 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 alongside 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 think about intermittent monitoring of ECGs and electrolytes 1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise. Because both can affect your heart's rhythm, your care team has straightforward ways to keep you safe.
- Your team may check periodic ECGs and blood levels of potassium and magnesium.
- They will aim to keep those minerals in a healthy range and correct any lows.
- They may weigh the benefits of this therapy against your personal heart risks, especially if you have a heart rhythm condition or heart failure.
Tell your pharmacist or prescriber about all your medicines, and report any fainting, dizziness, or palpitations right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a study assessing male patients on androgen deprivation therapy (ADT) using individual case safety reports from VigiBase, the international pharmacovigilance database, investigators 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 concomitant use of other agents known to raise TdP risk; nevertheless, use of 1 drug and 2 or more drugs carrying conditional, possible, or known TdP risk was documented in a portion of aLQTS/TdP events (23% or 43%) and sudden death events (18% and 22%). Agents classified as ADTs comprised 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 roughly 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 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 Sorafenib and Relugolix together?
Sorafenib and relugolix can each prolong the QT interval, so combining them may add up and slightly raise the risk of an abnormal heart rhythm. This is a theoretical concern your care team can manage with ECG and electrolyte checks, 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 Sorafenib and Relugolix 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 Sorafenib and Relugolix interaction managed?
Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise. Because both can affect your heart's rhythm, your care team has straightforward ways to keep you safe. Your team may check periodic ECGs and blood levels of potassium and magnesium. They will aim to keep those minerals in a healthy range and correct any lows. They may weigh the benefits of this therapy against… 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 Sorafenib or Relugolix 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 Sorafenib
Keep reading about Relugolix
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