Orilissa (elagolix)

Medically Reviewed By Alex Brewer, PharmD, MBA

About Orilissa

Orilissa is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) for use in adults to treat moderate or severe pain caused by endometriosis. (Endometriosis occurs when tissue similar to the lining of the uterus grows outside of the uterus, such as in the pelvis or abdomen.)

For details about endometriosis and how Orilissa treats this condition, see the “Orilissa: Uses” section below.

Key points

The following table provides key facts about Orilissa.

Active drugelagolix
Drug classgonadotropin-releasing hormone (GnRH) receptor antagonists
Formoral tablet
FDA approval2018

Finding a healthcare professional

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Orilissa: Generic

Orilissa contains the active drug elagolix. It only comes as a brand-name medication. And it isn’t currently available as a generic drug.

A generic is an identical copy of the active drug found in a brand-name medication. Generics typically cost less than brand-name drugs.

Orilissa: Side effects

As with most drugs, it’s possible to have side effects with Orilissa. These can include some mild side effects, but also some serious ones.

To learn more about Orilissa’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Orilissa, you can do so through MedWatch.

Mild and serious side effects

Mild and serious side effects of Orilissa are listed below. This article does not include all of Orilissa’s possible side effects.

Mild side effects

Mild side effects* of Orilissa may include:

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

* This is not a complete list of Orilissa’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† To learn more about allergic reaction, see below.

Serious side effects

Serious side effects of Orilissa may include:

Serious side effects from Orilissa aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

* To learn more about allergic reaction, see below.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The Suicide and Crisis Lifeline is available 24 hours per day when you call 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Orilissa. A more severe allergic reaction is rare but possible.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptomsSerious allergic reaction symptoms
flushing• swelling under your skin, possibly in your hands, feet, lips, or eyelids
rash• swelling in your throat or mouth
• itchingtrouble breathing

If you have an allergic reaction to Orilissa, call your doctor right away. This is important because the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Orilissa: Questions you may have

Here are some common questions about Orilissa and brief answers to them. If you’d like to know more about these topics, ask your doctor.

Are reviews available from people who’ve taken Orilissa?

Yes, reviews are available. Orilissa’s manufacturer, AbbVie, provides stories and reviews from people who have taken the drug on its website. Keep in mind, though, that each person’s experience with the medication may vary.

Talk with your gynecologist or another healthcare professional if you have questions about what to expect with Orilissa treatment.

Will stopping Orilissa cause withdrawal symptoms?

No, stopping Orilissa shouldn’t cause withdrawal symptoms.

Withdrawal symptoms can occur when you stop taking a medication your body is dependent on. With dependence, you need a certain drug to feel as you usually do. However, Orilissa hasn’t been shown to cause withdrawal or dependence.

However, some people’s endometriosis symptoms get worse after they stop Orilissa. Keep in mind that Orilissa is prescribed to treat moderate or severe pain caused by endometriosis.

If you have questions about stopping Orilissa, talk with your doctor. If they recommend stopping the drug, they may prescribe a different treatment option instead.

Does Orilissa cause weight loss?

Not typically. Weight loss isn’t known to be a side effect of Orilissa.

On the other hand, weight gain was reported as a side effect in Orilissa’s clinical studies. However, this side effect wasn’t common.

Tell your doctor if you’ve had unexplained weight loss. They can try to help identify the reason. Your doctor can also recommend ways to manage a weight that is healthy for you.

Are there dangers of taking Orilissa?

Most people do not have severe or dangerous side effects while taking Orilissa. The drug’s more common side effects are typically mild and temporary, such as hot flashes or nausea.

However, in rare cases, serious side effects may occur in people taking Orilissa. These include:

Talk with your doctor if you’re concerned about your risk of serious side effects with this medication.

Do doctors prescribe Orilissa for fibroids?

Possibly. However, Orilissa isn’t currently approved to treat fibroids. It’s only approved to treat moderate or severe pain caused by endometriosis.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside of the uterus, such as in the pelvis or abdomen. Fibroids are growths that form in or around the uterus.

Doctors may prescribe this drug off-label for fibroids, though. (Off-label use is when a drug is used to treat a condition other than what it was approved for.)

Talk with your doctor or pharmacist if you have questions about treatment options for fibroids.

Orilissa: Cost

As with other medications, prices for Orilissa may vary. The drug’s price will depend on factors such as:

Cost considerations for Orilissa

Here’s a list of things to consider when looking into the cost of Orilissa.

  • Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
  • Need for prior authorization. Before insurance coverage for Orilissa is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Orilissa. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Orilissa, contact your insurance company.
  • Possible cost assistance options. Financial assistance to help lower the cost of Orilissa is available. The Orilissa Complete Savings Card may help reduce the drug’s cost. To learn more and see if you’re eligible for support, call 800-ORILISSA (800-674-5477) or visit the manufacturer’s website. For more information on the drug’s cost, see this page. Also, check out this article to learn about ways to save on prescription drugs.
  • Use of a mail-order pharmacy. Orilissa may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
  • Availability of a generic form. Orilissa doesn’t come in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Typically, generics cost less than brand-name drugs.

Orilissa: Dosage

Below, you’ll find dosages that are commonly recommended for Orilissa. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

The dosage of Orilissa that your doctor prescribes will depend on factors such as:

  • any other health conditions you have, such as liver problems
  • the severity of the condition you’re using Orilissa to treat

Orilissa’s forms and strengths

Orilissa is available as follows.

  • Form: oral tablet
  • Strengths:
    • 150 milligrams (mg)
    • 200 mg

Orilissa’s recommended dosages

Recommended dosages for Orilissa in adults are described below.

  • Starting dosage: 150 mg once daily
  • Maximum dosage: 200 mg twice daily

If your symptoms include painful intercourse, your doctor may start you on the maximum dosage of 200 mg twice daily.

If you have liver problems, your doctor will likely not increase your dosage beyond the starting dosage of 150 mg once daily.

Dosage considerations

Below are some things to consider about Orilissa’s dosage.

  • Missing a dose. If you miss a dose of Orilissa, take it as soon as you remember that day. Then continue your regular dosing schedule. You should not take more than your prescribed number of tablets in one day. Consider trying these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
  • Length of treatment. If you take Orilissa once daily, you’ll likely take it for up to 24 months. If you take Orilissa twice daily, you’ll likely take it for up to 6 months. It isn’t known if it’s safe to take Orilissa for longer than this due to the risk of bone loss (a potential side effect of the drug).
  • Starting treatment. Before you start Orilissa, your doctor may have you take a pregnancy test to confirm you aren’t pregnant. Or, they may have you begin taking the drug within 7 days of starting your period.

Orilissa: How it works

Doctors prescribe Orilissa to treat moderate to severe endometriosis pain in adults. Endometriosis occurs when tissue similar to the lining of the uterus grows outside of the uterus. This tissue forms patches called endometrial lesions.

During the menstrual cycle, tissue lining the uterus responds to hormones, such as estrogen. Hormones signal the lining to thicken and then break down.

In people with endometriosis, hormones such as estrogen also cause endometrial lesions to build up and break down. This can cause symptoms such as heavy periods or bleeding internally from the lesions.

Orilissa’s mechanism of action (how it works) is to lower the amount of estrogen the body produces. By decreasing estrogen levels, endometrial lesions do not grow and thicken as much. This can help ease endometriosis pain.

How long does Orilissa take to start working?

Orilissa starts working from the first dose, but you may not notice a difference right away. In the drug’s clinical studies, it took up to 3 months for some people to feel a reduction in their endometriosis pain. However, you may feel pain relief sooner than this.

If you don’t feel as though the medication is helping and your pain is severe, talk with your doctor. They may recommend other ways to manage your condition.

Orilissa: Alternatives

Doctors may prescribe drugs other than Orilissa for your condition. Certain drugs may work better for you than others.

Orilissa is used to treat pain due to endometriosis. Here’s a summary of other treatments that doctors sometimes prescribe for this condition.

To learn how Orilissa compares with Lupron Depot, see this article.

For additional information about alternatives to Orilissa, ask your doctor. They can tell you about other medications that could be prescribed for your condition.

Orilissa: Uses

Prescription drugs, such as Orilissa, are approved by the Food and Drug Administration (FDA) to treat certain conditions. Doctors sometimes prescribe drugs off-label for other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

Using Orilissa for pain due to endometriosis

Orilissa is approved to treat moderate or severe pain caused by endometriosis in adults.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside of the uterus. This tissue forms patches called endometrial lesions.

Pain in the pelvic area and lower back is a common symptom of this condition. Other symptoms may include:

Using Orilissa in children

Orilissa is only approved for adult use. It isn’t known whether this medication is safe or effective for children under the age of 18 years.

Finding a healthcare professional for Orilissa

If you’re interested in taking Orilissa, you can find a doctor who may prescribe it by searching here. To prepare for your appointment, you may find it helpful to visit Healthgrades’ women’s health appointment guide.

Orilissa: Taking while pregnant

Doctors will likely not prescribe Orilissa if you’re pregnant or trying to become pregnant. It isn’t safe to take this medication during pregnancy. This is because it can cause pregnancy loss.

Taking Orilissa can cause changes to your menstrual cycle, such as not having periods. This makes it harder to know if you’re pregnant or not. If you think you may be pregnant, take a pregnancy test. If you are pregnant, call your doctor. They’ll advise that you stop taking Orilissa right away.

If you become pregnant while taking Orilissa, your doctor may encourage you to enroll in the drug’s pregnancy registry. Registries collect information about what happens when someone is exposed to a particular medication while pregnant. This helps doctors and patients make more informed decisions about medication use during pregnancy. Learn more about Orilissa’s pregnancy registry by calling 833-782­-7241.

To help prevent pregnancy, talk with your doctor about your birth control needs with Orilissa. See the “Orilissa: Birth control needs” section below for important information about Orilissa and birth control.

Orilissa: Birth control needs

Orilissa is not safe to take during pregnancy. Talk with your doctor about your birth control needs if you’re sexually active and can become pregnant.

It is important to note that hormonal birth control that contains estrogen may make Orilissa less effective for treating endometriosis pain. Examples include the pill, patch, or vaginal ring.

If you’d like to learn more about taking Orilissa during pregnancy, see the “Orilissa: Taking while pregnant” section above.

Note: Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

For females taking Orilissa

Your doctor will likely recommend a nonhormonal birth control method while you’re taking Orilissa. And you should continue using a nonhormonal birth control method for at least 28 days after your last dose of Orilissa. Check with your doctor about which type of birth control is best for you.

For males taking Orilissa

Orilissa isn’t typically prescribed to males. If you have questions about Orilissa use in males, talk with your doctor.

Orilissa: Taking while breastfeeding

It isn’t known whether Orilissa affects breast milk or whether it’s safe to breastfeed while taking this medication.

Talk with your doctor about the best way to feed your child while taking Orilissa.

Orilissa: Consuming alcohol during treatment

There is no known interaction between alcohol and Orilissa. However, drinking alcohol can worsen certain side effects of Orilissa, such as:

Additionally, drinking too much alcohol can damage the liver. And Orilissa may not be safe for people with severe liver damage.

If you drink alcohol, ask your doctor how much alcohol, if any, is safe for you to consume while taking Orilissa.

Orilissa: Interactions

Orilissa may interact with other medications and foods. It isn’t known to interact with any herbs or supplements.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

Before you start Orilissa, be sure to tell your doctor about any medications you take. They can check for any possible interactions between these medications and Orilissa.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

  • Orilissa and drugs that affect a certain protein. Some drugs affect a protein called organic anion transporting polypeptide 1B1. The manufacturer of Orilissa advises that these drugs should not be taken together. Be sure to discuss this with your doctor if these drugs have been prescribed together for you. Examples include:
  • Orilissa and drugs that affect certain enzymes. Some drugs affect a group of enzymes (a type of protein) called CYP3A. The manufacturer of Orilissa recommends avoiding these medications while taking Orilissa if possible, or shortening the amount of time you take them together. Your doctor can tell you more if these drugs are prescribed together for you. Examples include:
  • Orilissa and hormonal birth control. Because Orilissa may interact with hormonal birth control, your doctor may recommend a different contraceptive method. Examples of hormonal birth control include:
    • birth control pills that contain a form of estrogen, such as ethinyl estradiol or estradiol, which include numerous brands and generics
    • the norelgestromin and ethinyl estradiol transdermal patch (Xulane)
    • the ethinyl estradiol and etonogestrel vaginal ring (NuvaRing)
  • Orilissa and herbs and supplements. Orilissa isn’t known to interact with any specific herbs or supplements.
  • Orilissa and foods. Certain medications interact with foods. Your doctor may suggest avoiding or limiting grapefruit and grapefruit juice while you’re taking Orilissa. This is because grapefruit may affect a certain enzyme (type of protein) in your body.

For information about drug-condition interactions, see the “Orilissa: Precautions” section below.

Orilissa: How to take

Your doctor will recommend how you should take Orilissa. It’s important to take the drug exactly as your doctor instructs.

Orilissa comes as an oral tablet. You’ll take the tablets by swallowing them.

Questions about taking Orilissa

Here’s a list of common questions related to taking Orilissa.

  • When should I take Orilissa? If you take Orilissa twice daily, you should take it in the morning and in the evening. If you take Orilissa once daily, it can be taken at any time of day. However, it should be taken around the same time each day. Doing this helps keep a steady level of the drug in your body, which helps the medication work effectively. Try these medication reminder options to help avoid missing doses of Orilissa. You could also set an alarm, use a timer, or download a reminder app on your phone.
  • Do I need to take Orilissa with food? You may take Orilissa with or without food.
  • Can Orilissa be chewed, split, or crushed? There’s no guidance available from Orilissa’s manufacturer regarding whether this medication can be crushed, split, or chewed. If you have trouble swallowing Orilissa tablets, ask your pharmacist or doctor about the best way to take the medication.
  • When can I start treatment with Orilissa? Before you start Orilissa, your doctor may have you take a pregnancy test to confirm you aren’t pregnant. Or, they may have you begin taking the drug within 7 days of starting your period.

Orilissa: Precautions

Tell your doctor about your health history before starting treatment with Orilissa. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions. These situations are considered drug-condition interactions.

These factors and conditions include those listed below.

  • Osteoporosis. Orilissa can cause bone loss. If you already have bone loss due to osteoporosis, your doctor will likely not prescribe Orilissa. Doing so could make your condition worse. Your doctor can give you more information about other treatment options for endometriosis pain.
  • Mental health conditions. Orilissa may cause mood changes, depression, or anxiety. If you already have a mental health condition, taking Orilissa may worsen your symptoms. Also, while rare, you may be more likely to develop suicidal thoughts or behaviors while taking Orilissa. Talk with your doctor about how to monitor your mental health while you’re taking Orilissa.
  • Liver problems. If you have liver problems, such as alcohol-related liver disease, be sure to tell your doctor before you start taking Orilissa. They may prescribe a lower Orilissa dose depending on the severity of your liver condition. If you have severe liver problems, doctors typically won’t prescribe Orilissa. Instead, they can discuss other possible treatment options that may be safer for you.
  • Allergic reaction. Your doctor will likely not prescribe Orilissa if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
  • Pregnancy. If you’d like additional information about taking Orilissa while pregnant, view the “Orilissa: Taking while pregnant” section above.
  • Breastfeeding. If you’d like additional information about taking Orilissa while breastfeeding, view the “Orilissa: Taking while breastfeeding” section above.

To learn more about effects of Orilissa that could be harmful, see the “Orilissa: Side effects” section above.

Orilissa: Overdose

For some drugs, taking more than the recommended dosage may lead to unwanted side effects or overdose. Do not use more Orilissa than your doctor advises.

What to do if you take too much Orilissa

Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.

Orilissa: Expiration, storage, and disposal

Here’s some information about Orilissa’s expiration date, as well as how to store and dispose of the drug.

  • Expiration. Your pharmacist will add an expiration date to the label on Orilissa’s bottle. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises that you avoid taking expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
  • Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Orilissa should be stored between 36°F and 86°F (2°C and 30°C). Avoid storing it in areas where it could get damp or wet, such as bathrooms. The medication should be kept away from light in a tightly sealed container.
  • Disposal. It’s important to safely dispose of Orilissa if you no longer need to take it and have unused medication. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps avoid causing harm to the environment. Ask your pharmacist for information about disposing of Orilissa. Also, check out this page for several tips on safe medication disposal.

Orilissa: Questions for your doctor

If you have questions about Orilissa, talk with your doctor. They can help advise you on whether Orilissa could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

  • How long will I take Orilissa?
  • Since there is a limit on how long I can take Orilissa, how will my endometriosis pain be treated after I can no longer take it?
  • Should I continue taking my other medications with Orilissa?
  • How can I reduce my risk of side effects from Orilissa?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for endometriosis. And view our selection of videos on endometriosis.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Medical Reviewer: Alex Brewer, PharmD, MBA
Last Review Date: 2022 Jul 12
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.