Oriahnn (elagolix/estradiol/norethindrone acetate) is a prescription drug that’s used for heavy periods caused by fibroids in the uterus. Oriahnn comes as oral capsules.

Oriahnn is used to treat heavy periods caused by fibroids (noncancerous growths) in your uterus. This drug is prescribed for use in adult females* who haven’t yet gone through menopause.

It’s important to note that it’s not recommended to take Oriahnn for longer than 24 months. This is because the drug may cause bone loss that can’t be reversed. To learn more about Oriahnn’s uses, see the “What is Oriahnn used for?” section below.

* In this article, the term “female” refers to a person’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Oriahnn basics

Oriahnn contains the active ingredients elagolix, estradiol (a form of estrogen), and norethindrone acetate (a form of progestin). Active ingredients are what makes a drug work.

This medication is only available as the brand-name drug Oriahnn. It doesn’t come in a generic version.

Like most drugs, Oriahnn may cause mild or serious side effects. The lists below describe some of the more common side effects that Oriahnn may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Oriahnn. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Oriahnn can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Oriahnn’s prescribing information.

Mild side effects of Oriahnn that have been reported include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Oriahnn can occur, but they aren’t common. If you have serious side effects from Oriahnn, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Oriahnn that have been reported include:

* For more information, see the “What should be considered before taking Oriahnn?” section below.
† For more information about this side effect, see the “Allergic reaction” section just below.

Allergic reaction

Some people may have an allergic reaction to Oriahnn or one of its inactive ingredients. These include the artificial food coloring called yellow 5.

If you’re allergic to yellow 5 or any other ingredients in Oriahnn, tell your doctor before starting this drug. See the “What should be considered before taking Oriahnn?” section below for more information about this.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Oriahnn. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Whether you have health insurance or not, cost may be a factor when you’re considering Oriahnn. What you’ll pay for Oriahnn may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks* to get price estimates of what you’d pay for Oriahnn when using coupons from the site.
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. The Oriahnn Savings Card may also be available.

You can also check out this article to learn more about saving money on prescriptions.

* Optum Perks is a sister site of Healthline. Optum Perks coupons cannot be used with any insurance copays or benefits.

Oriahnn works to treat heavy periods caused by uterine fibroids (noncancerous growths in your uterus). How the drug works is known as its mechanism of action.

Oriahnn has three active ingredients, which are what makes the drug work. They have different functions:

To learn more about how Oriahnn is used, see the “What is Oriahnn used for?” section below. If you have questions about how Oriahnn works for your condition, ask your doctor for more information.

Your doctor will recommend the dosage of Oriahnn that’s right for you. Below is the commonly used dosage, but always take the dosage your doctor prescribes.

Forms and strengths

Oriahnn comes as two oral capsules. You’ll take one type of capsule in the morning and the other at night. The capsules are described in the table below.

FormColorsActive ingredients* and strengths
Oriahnn morning capsulewhite and yellow• 300 milligrams (mg) elagolix,
• 1 mg estradiol, and
• 0.5 mg norethindrone acetate
Oriahnn evening capsulewhite and blue• 300 mg elagolix

* Active ingredients are what makes a drug work.

Recommended dosage

Oriahnn is usually taken twice per day, once in the morning and once in the evening.

Questions about taking Oriahnn

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

  • What if I miss a dose of Oriahnn? If you miss a dose of Oriahnn, either in the morning or evening, take it as soon as you remember as long as it’s within 4 hours of your scheduled dose. If it’s been longer than 4 hours, skip the missed dose and just take your next scheduled dose. Do not take two doses of Oriahnn to catch up on a missed dose. Doing so can increase your risk for serious side effects.
  • Will I need to use Oriahnn long term? It’s not recommended to take Oriahnn for longer than 24 months. This is because the drug increases the risk of bone loss, which can increase your risk for bone fractures. Talk with your doctor about how long you should take this drug.
  • Can Oriahnn be chewed, crushed, or split? No, you should not crush, split, or chew Oriahnn capsules. It’s not known if this can change how the drug works. If you have trouble swallowing pills, ask your doctor for suggestions. You can also try these tips to help you swallow pills more easily.
  • Should I take Oriahnn with food? Food doesn’t change how Oriahnn works. So, you can take the drug either with or without food.
  • How long does Oriahnn take to work? It may take up to 1 to 2 months for Oriahnn to reduce your symptoms. Ask your doctor what you can anticipate with treatment and when you can expect to have lighter periods.

Overdose

Do not take more Oriahnn than your doctor prescribes. Taking more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an Oriahnn overdose can include:

Call your doctor if you think you’ve taken too much Oriahnn. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have heavy periods, your doctor may talk with you about Oriahnn.

It’s a prescription drug that’s used to treat heavy menstrual bleeding caused by fibroids in the uterus. (Fibroids are noncancerous growths.) This drug is prescribed for use in adult females* who haven’t yet gone through menopause.

Fibroids can cause you to have heavy bleeding with your periods. It’s not known for sure why this happens.

Oriahnn works to lower certain hormone levels in your body. This way, the lining inside your uterus doesn’t grow as thick as usual. This leads to a lighter flow during your periods.

It’s important to note that it’s not recommended to take Oriahnn for longer than 24 months. This is because the drug may cause bone loss that can’t be reversed. The risk of bone loss with Oriahnn is higher if you take the drug for more than 24 months and if you have other risk factors, such as:

Your doctor will monitor your bone density before you start Oriahnn treatment and during treatment. They may recommend taking vitamin D and calcium supplements while you’re taking Oriahnn.

Ask your doctor for more information about taking Oriahnn for heavy periods caused by fibroids.

* In this article, the term “female” refers to a person’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Below is important information you should consider before taking Oriahnn.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Oriahnn can interact with several other medications, as well as certain foods.

Before taking Oriahnn, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Drug interactions

Below is a list of medications that can interact with Oriahnn. This list does not contain all drugs that may interact with Oriahnn. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drug group or drug nameDrug examples
certain antibiotics• erythromycin (Eryc, Ery-tab)
• rifampin (Rimactane)
certain antifungal drugs• ketoconazole
• voriconazole (Vfend)
certain antiviral drugs• darunavir (Prezista)
• ritonavir (Norvir) and drugs that contain ritonavir as an ingredient, such as lopinavir/ritonavir (Kaletra)
certain seizure drugs• carbamazepine (Tegretol, others)
• phenytoin (Dilantin)
the benzodiazepine drug midazolam—
the heart failure drug digoxin—
the statin drug rosuvastatin (Crestor)—
the proton pump inhibitor drug omeprazole—

Other interactions

Oriahnn can also interact with other substances such as:

  • Foods: Do not drink grapefruit juice or eat grapefruit while you’re taking Oriahnn. Doing so can increase the level of Oriahnn in your body. This can increase your risk of side effects of the drug.
  • Alcohol: Alcohol is not known to interact with Oriahnn. However, drinking alcohol while you take Oriahnn may increase certain side effects of the drug. These could include hot flashes and the risk of blood clots, for example. If you drink alcohol, your doctor can tell you whether it’s safe for you to drink alcohol and how much is safe to drink with Oriahnn.

Pregnancy and breastfeeding

Oriahnn may cause pregnancy loss if it’s taken during pregnancy. Because of this, the drug is not safe to take while you’re pregnant, especially during the first few months of pregnancy.

Tell your doctor right away if you become pregnant while you’re taking Oriahnn. Keep in mind that Oriahnn can cause irregular or light periods. This can make it tough to tell if you’re pregnant. Watch for early pregnancy symptoms, such as nausea, weight gain, and breast tenderness. Tell your doctor right away if you think you may be pregnant.

If you do take Oriahnn during pregnancy, you can sign up for the drug’s pregnancy registry by calling 833-782-7241. You can also visit the registry website for details and ways to sign up. Your doctor can provide more information about this registry.

It’s not known whether Oriahnn passes into breast milk or is safe for a child who’s breastfed. Ask your doctor for more information about taking Oriahnn while breastfeeding.

Birth control

You’ll need to use a nonhormonal birth control method while you’re taking Oriahnn. And you should keep using birth control for at least 28 days after you stop taking the drug. Condoms and diaphragms are two examples of nonhormonal birth control.

It’s unclear whether it’s safe to use hormonal birth control while taking Oriahnn. Doing so may make Oriahnn less effective. Talk with your doctor about birth control options to help prevent pregnancy while you’re taking this drug.

Boxed warning

Oriahnn has a boxed warning about increasing the risk of blood clots and certain blood vessel problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Taking hormone therapy that contains estrogen and progestin, such as Oriahnn, may increase the risk of blood clots.

Examples of blood clots that may occur include pulmonary embolism (a blood clot in your lung) and deep vein thrombosis (a blood clot in certain veins in your body). Other blood vessel problems, such as stroke and heart attack, may also occur with Oriahnn.

Certain people may have an increased risk for these side effects. This includes females* older than 35 years of age who smoke. It also includes females with health conditions such as diabetes, high blood pressure that’s not managed, high cholesterol, or obesity. And it includes females who’ve had a blood clot or blood vessel problem in the past, and those who have certain heart valve or heart rhythm conditions (including atrial fibrillation).

Symptoms of a blood clot can vary based on the location of the clot. But they may include:

Be sure to discuss with your doctor your health history and any medical conditions you have. Also, tell your doctor if you smoke or if any family members have had a stroke, heart attack, or other blood vessel problems. The doctor can recommend whether it’s safe for you to take Oriahnn.

Call your doctor right away if you have any symptoms of blood clots while you’re taking Oriahnn. But call 911 or your local emergency number if your symptoms feel life threatening.

* In this article, the term “female” refers to a person’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Other warnings

Oriahnn can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Oriahnn is a good treatment option for you.

Talk with your doctor about your health history before you take Oriahnn. Be sure to tell them if any of the following factors apply to you:

* Doctors will not prescribe Oriahnn if you have a history of blood clots or blood vessel conditions, such as heart attack or stroke. It’s also not prescribed for use in people who are at high risk of blood clots or blood vessel disorders. See the boxed warnings section just above for more information.

Other drugs are available that can treat your condition. If you’d like to explore an alternative to Oriahnn, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are similar to Oriahnn:

If you’re having heavy periods caused by uterine fibroids, your doctor may discuss Oriahnn with you. (Fibroids are noncancerous growths.)

A few questions you might consider asking your doctor include:

  • Will Oriahnn cure my fibroids?
  • Can I take Oriahnn again if I stop taking it and have problems with fibroids later on?
  • What other treatments are available for my heavy periods?

You can read more about treatment options for fibroids and heavy menstrual bleeding. You can also check out these ways to help stop heavy periods.

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.