If you have endometriosis that causes you moderate or severe pain, your doctor may suggest treatment with Orilissa.

Endometriosis is a condition that causes tissue normally found lining the uterus to grow in your belly, outside the uterus. Orilissa is prescribed for adults to treat moderate or severe pain caused by endometriosis.

Because of the risk of bone loss, you shouldn’t take Orilissa for more than 24 months. But in some cases, your doctor may recommend that you only take it for 6 months. They will recommend which option is best for you. See “What are Orilissa’s side effects?” just below for more information.

To learn more about how Orilissa treats endometriosis, see “How does Orilissa work?” in the “What are some frequently asked questions about Orilissa?” section below.

Orilissa basics

Orilissa contains the drug elagolix. It comes as a tablet (pill) that you take by mouth.

It’s not currently available as a generic drug. Instead, elagolix only comes as the brand-name drug Orilissa.

Keep reading to learn more about Orilissa, including its side effects, cost, uses, and more.

Like most drugs, Orilissa may cause mild or serious side effects. The lists below describe some of the more common side effects that Orilissa 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’re taking

Your doctor or pharmacist can tell you more about the potential side effects of Orilissa. 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 Orilissa can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Orilissa’s medication guide.

Mild side effects of Orilissa 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.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

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

Serious side effects of Orilissa that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Side effect focus

Learn more about some of the side effects Orilissa may cause.

Stopped periods

Taking Orilissa could cause your periods to stop as a side effect. You may also bleed less or for a shorter length of time during your periods.

This side effect was more common than others reported by people who took the drug in studies. But, it’s important to note that most people who took Orilissa didn’t stop having periods. People taking a higher dosage of Orilissa were more likely to have this side effect.

What might help

Talk with your doctor if you have stopped periods, and this bothers you, while you’re taking Orilissa. They can discuss your treatment plan with you and suggest the best way to treat your condition.

Keep in mind that changes in periods caused by Orilissa may make it hard to tell if you’re pregnant. So, if your periods stop while taking Orilissa, watch for other signs of pregnancy, such as nausea and breast tenderness. This drug isn’t safe to take while pregnant. (For more information, see the “Pregnancy and breastfeeding” section under “What should be considered before taking Orilissa?” below).

Weight gain

Although it’s not common, you may experience weight gain while taking Orilissa. This was reported by people taking the drug in studies, but it was rare.

What might help

If you’re worried or have questions about your weight, talk with your doctor. They can recommend ways to maintain a weight that is healthy for you.

Bone loss

Orilissa is known to cause bone loss. In studies, people who took the drug lost bone mineral density (BMD). The degree of BMD loss varied, but it was severe in some people. (BMD indicates the strength of your bones.)

Taking a higher dosage of Orilissa increases your risk of bone loss. And the longer you take Orilissa, the more this risk increases.

It isn’t known whether bone loss caused by Orilissa is completely reversible, even if you stop taking the drug. And it isn’t known if this bone loss increases the risk of broken bones as you age.

What might help

Because of the risk of bone loss, you shouldn’t take Orilissa for more than 24 months. But, if you take Orilissa twice each day or have liver problems, you shouldn’t take the drug for more than 6 months.

While you’re taking Orilissa, your healthcare professional may recommend that you take a vitamin D and calcium supplement. They may also suggest other ways to support your bone health.

Before you begin taking Orilissa, tell your doctor if you’ve ever broken a bone. You should also tell them about all the medications you take, so they can see if any cause bone loss. If you’ve ever broken a bone or you’re taking another medication that causes bone loss, your doctor may order an X-ray to check your bone health.

You shouldn’t take Orilissa if you have osteoporosis. Instead, ask your doctor about other treatment options for your condition.

Allergic reaction

Some people may have an allergic reaction to Orilissa.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

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 Orilissa. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Find answers to some commonly asked questions about Orilissa.

Are there reviews of Orilissa?

Yes, the manufacturer of Orilissa has a video library of patient stories and reviews on its website.

You may also talk with your healthcare professional if you’re interested in learning more about Orilissa reviews.

Will Orilissa cause menopause, weight loss, acne, or hair loss?

Menopause, weight loss, acne, and hair loss weren’t reported as side effects by people taking Orilissa in studies.

Orilissa can cause amenorrhea (stopped periods), but this isn’t the same as menopause. Menopause begins when you haven’t had a period for 12 months in a row. You are also no longer able to become pregnant naturally.

Orilissa may cause some side effects similar to symptoms of menopause, such as night sweats and hot flashes. Talk with your doctor or pharmacist if these side effects are bothersome or become severe.

For more information about side effects that Orilissa may cause, see “What are Orilissa’s side effects?” above. If you have more questions, talk with your doctor or pharmacist.

Does stopping Orilissa cause withdrawal symptoms?

No, stopping Orilissa isn’t known to cause withdrawal symptoms. Some people’s endometriosis gets worse after they stop the treatment, though.

If you have questions about stopping Orilissa, talk with your healthcare professional. Don’t stop taking the drug unless they tell you to do so.

How does Orilissa work?

Orilissa’s mechanism of action (how it works) for treating endometriosis pain is to block the release of certain hormones made by your body. These hormones include follicle-stimulating hormone and luteinizing hormone.

Blocking these hormones decreases the levels of estrogen and progesterone in your body. This decreases tissue buildup outside your uterus.

For more information about how estrogen, progesterone, and endometriosis are related, see “Is Orilissa used for endometriosis?” below.

If you have more questions about how Orilissa works, talk with your pharmacist or doctor.

When was Orilissa approved by the FDA? Is it approved for fibroids or PCOS?

The Food and Drug Administration (FDA) approved Orilissa in 2018 to treat moderate or severe pain caused by endometriosis.

Orilissa isn’t currently approved to treat fibroids or polycystic ovary syndrome (PCOS). This drug may be prescribed off-label for these conditions, though. Off-label use is when a drug is used to treat a condition other than what it’s approved for.

If you have questions about off-label uses of Orilissa, talk with your doctor or pharmacist.

Can you take Orilissa with birth control, such as Mirena or Depo-Provera?

You should take Orilissa with birth control because the drug isn’t safe to take while pregnant. It also doesn’t prevent pregnancy. But some types of birth control should not be used with Orilissa.

Birth control that contains estrogen may cause Orilissa to not work as well. It’s not known if birth control injections (such as Depo-Provera) or an intrauterine device (IUD) (such as Mirena) affect how well Orilissa will work.

For a list of birth control types that can interact with Orilissa, see “What should be considered before taking Orilissa?” below.

Talk with your healthcare professional about the best form of birth control during treatment with Orilissa. You may need to change the birth control you use before you begin taking this drug.

Your doctor will explain how you should take Orilissa. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are common dosages, but always take the dosage that your doctor prescribes.

Taking Orilissa

Orilissa comes as a tablet (pill) that you swallow. It’s available in two strengths: 150 milligrams (mg) and 200 mg.

Dosage

To treat moderate or severe pain caused by endometriosis, you’ll likely take Orilissa once or twice each day.

You shouldn’t take Orilissa for more than 24 months. If you take Orilissa twice each day or have liver problems, you shouldn’t take the drug for more than 6 months.

Taking Orilissa with other drugs

When you take it to treat moderate or severe pain caused by endometriosis, you may take Orilissa on its own or with other drugs.

For example, your doctor may have you take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil, Motrin). You can use a NSAID as needed to treat any breakthrough endometriosis pain while you’re taking Orilissa. (Breakthrough pain is pain that happens even while you’re taking a medication to treat it.)

But, if Orilissa works well by itself to treat your pain, you can take the drug by itself.

Questions about taking Orilissa

Below are some commonly asked questions about taking Orilissa.

  • What if I miss a dose of Orilissa? If you miss a dose of Orilissa and it’s still the day the dose was due, take it as soon as you remember. Then, go back to your regular dosing schedule. But if you miss the dose and it’s the next day, skip the missed dose. Take your regular dose at your usual time.
  • Will I need to take Orilissa long term? Because of the risk of bone loss, you shouldn’t take Orilissa for more than 24 months. If you take Orilissa twice each day or have liver problems, you shouldn’t take the drug for more than 6 months. See the “Bone loss” section under “What are Orilissa’s side effects?” above for more information.
  • Can Orilissa be chewed, crushed, or split? The manufacturer of Orilissa hasn’t stated whether their drug may be chewed, crushed, or split. Talk with your doctor or pharmacist if you’re struggling to swallow Orilissa tablets. They may suggest other treatment options for you.
  • Should I take Orilissa with food? You may take Orilissa with or without food.
  • How long does Orilissa take to work? In studies of the drug, it took up to 3 months for some people to feel a decrease in their endometriosis pain. Some people had pain relief sooner, though.
Questions for your doctor

You may have questions about Orilissa and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions, such as:
    • How will Orilissa affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback about your treatment.

Costs of prescription drugs can vary, depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Orilissa tablets in your area, visit GoodRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Orilissa manufacturer’s website to see if they have support options.

If you have endometriosis, your doctor may suggest treatment with Orilissa. It’s used in adults to treat moderate or severe pain caused by endometriosis.

Endometriosis is a condition that causes tissue normally found lining the uterus to grow in the belly, outside the uterus. It’s most common in people between the ages of 25 and 29 years. The most common symptoms are pelvic pain and infertility.

It’s not fully understood why endometriosis develops in some people. But it’s known that the hormones estrogen and progesterone are involved.

Estrogen and progesterone are sex hormones that your body makes naturally. They play a major role in your menstrual cycle, including sending signals that make the lining of your uterus grow. Orilissa works by blocking these signals from being sent. This helps stop the growth of both the lining of your uterus and endometriosis tissue.

Note: You shouldn’t take Orilissa for more than 24 months. If you take Orilissa twice each day or have liver problems, you shouldn’t take the drug for more than 6 months. For more information, see “Bone loss” in the “What are Orilissa’s side effects?” section above.

Orilissa and Lupron are both prescription medications used to treat pain caused by endometriosis. They belong to different groups of drugs. But they both work to decrease levels of certain hormones in your body, such as estrogen and progesterone.

Orilissa and Lupron have some differences. The only form of Lupron available is Lupron Depot. It’s given as an injection into a muscle by a healthcare professional every 3 months. Orilissa, on the other hand, is a tablet that you swallow once or twice each day.

To learn more about these medications, talk with your doctor. You can also check out this side-by-side comparison.

When considering treatment with Orilissa, some important things to discuss with your doctor include your overall health and any medical conditions you have. You should also tell your doctor about all the medications you take.

Interactions

Taking medications or having vaccines, foods, or other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Orilissa, be sure to tell your doctor about all the medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions with Orilissa that these items may cause.

Interactions with drugs or supplements

Orilissa can interact with several types of drugs. These include:

  • certain birth control pills that contain estrogen, such as:
    • ethinyl estradiol and drospirenone (Gianvi, Loryna, Nikki, Yasmin, Yaz)
    • ethinyl estradiol and norethindrone (Leena, Nortrel, Ortho-Novum, Ovcon, and others)
    • ethinyl estradiol and levonorgestrel (Altavera, Amethia, Daysee, Lessina, Seasonique, and others)
  • the birth control vaginal ring, ethinyl estradiol and etonogestrel (NuvaRing)
  • the antibiotic clarithromycin
  • the antifungals itraconazole (Sporanox) and ketoconazole
  • the transplant drug cyclosporine (Gengraf, Neoral, Sandimmune)
  • the cholesterol drug gemfibrozil (Lopid)
  • the seizure drug carbamazepine (Tegretol)
  • the heart drugs digoxin (Lanoxin) and rivaroxaban
  • the blood pressure drug amlodipine (Norvasc)
  • the statin drug rosuvastatin (Crestor)
  • the sleep drug zolpidem (Ambien)

This list does not contain all the types of drugs that may interact with Orilissa. Your doctor or pharmacist can tell you more about these interactions and any others that may occur.

Other interactions

Orilissa can interact with the supplement St. John’s wort. Taking them together can decrease Orilissa levels in your body, causing it to not work as well.

Also, eating grapefruit or drinking grapefruit juice while taking Orilissa could lead to increased levels of the drug in your body. Talk with your doctor or pharmacist about how much, if any, grapefruit is safe for you to consume while you’re taking Orilissa.

Warnings

Orilissa may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Orilissa. Factors to consider include those in the list below.

  • Osteoporosis. You shouldn’t take Orilissa if you have low bone mineral density due to osteoporosis. Orilissa can cause bone loss and may make your condition worse. Your doctor can give you more information about other treatment options for your condition.
  • Depression. If you’ve ever had depression, you may be more likely to experience depression, mood changes, and suicidal thoughts while taking Orilissa. These symptoms may need to be treated while you’re taking Orilissa, which could include stopping Orilissa treatment.
  • Severe liver problems. You should not take Orilissa if you have a severe liver problem. People with severe liver problems have a higher risk of bone loss as a side effect of Orilissa. Your doctor can tell you whether your liver is safe enough for Orilissa. If it isn’t, talk with them about other medications that may be better options for you.
  • Allergic reaction. If you’ve had an allergic reaction to Orilissa or any of its ingredients, you shouldn’t take this drug. Ask your doctor what other medications are better options for you.

Orilissa and alcohol

Alcohol isn’t known to interact with Orilissa. But it’s possible that consuming alcohol may make certain side effects of Orilissa worse, such as:

Also, alcohol can sometimes worsen symptoms of endometriosis, which Orilissa is used to treat. Ask your doctor how much alcohol is safe for you to consume while taking Orilissa.

Pregnancy and breastfeeding

It is not safe to take Orilissa while pregnant. Doing so can lead to loss of the pregnancy.

It’s recommended that you use nonhormonal birth control to help prevent pregnancy while you’re taking Orilissa. And you should keep using birth control for at least 28 days after stopping the drug. Check with your doctor about which birth control method is right for you.

Taking Orilissa can cause changes to your menstrual cycle, making it harder to know if you’re pregnant or not. Consider taking a pregnancy test if you think you may be pregnant. If you’re pregnant, you’ll need to stop taking Orilissa right away.

It’s not known whether Orilissa is present in breast milk, or whether it’s safe to breastfeed while taking the drug. Talk with your doctor about the best way to feed your child while taking Orilissa.

Don’t take more Orilissa than your doctor prescribes. Taking more than this can lead to serious side effects.

What to do in case you take too much Orilissa

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

If you have questions about taking Orilissa, talk with your doctor. It’s a prescription medication used in adults who have moderate or severe pain caused by endometriosis.

Here are a few examples of questions you may want to ask your doctor about Orilissa:

  • I like to do activities that put me at risk of broken bones. Is it still safe for me to take Orilissa?
  • Is it safe to take Orilissa if I have an intrauterine device (IUD)?
  • How does taking Orilissa for endometriosis pain compare with surgical treatment options?

You may also want to ask your doctor about other treatments for endometriosis pain. Below are a few articles you may find helpful:

You can also learn more by subscribing to Healthline’s endometriosis newsletter.

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.