What to Know About Orilissa (Elagolix)

An FDA-Approved Pill to Treat Pain in Women With Endometriosis

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Orilissa (elagolix) is a prescription pill used to treat moderate to severe endometriosis pain. Orilissa is a gonadotropin-releasing hormone (GnRH) receptor antagonist that works by blocking GnRH receptors in the pituitary gland of the brain. This has the effect of reducing the signals to produce estrogen that your ovaries receive. It induces a form of menopausal state by preventing your body from making certain hormones, like luteinizing hormone and follicle-stimulating hormone, which are responsible for ovulation.

Young woman talking to her doctor

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Orilissa is FDA-approved for the management of moderate to severe endometriosis pain. More specifically, it helps women manage the three most common types of pain associated with endometriosis: 

  • Dysmenorrhea (painful periods)
  • Dyspareunia (pain during sex)
  • Non-menstrual pelvic pain (pelvic pain in the time between periods)

Before Taking

If you have been definitively diagnosed with endometriosis—usually after a laparoscopy, your doctor may consider you a good candidate for Orilissa. For your doctor to prescribe this medication would most likely have complained about moderate to severe pain after your diagnosis and other conservative treatments have been tried.

Orilissa will likely be prescribed only after other more well-established endometriosis prescription treatments, like birth control pills, have been tried unsuccessfully.

Precautions and Contraindications

Orilissa cannot be used if you:

  • Are pregnant. The same applies if there is a chance you may be pregnant. Your doctor will likely order a pregnancy test before putting you on Orilissa.
  • Have severe liver disease
  • Have osteoporosis
  • Are taking drugs known as strong OATP1B1 inhibitors. Examples of these drugs are cyclosporine or gemfibrozil. To be on the safe side, run your doctor through all the drugs you’re currently taking.

It is not known whether Orilissa is safe and effective for children below the age of 18.


According to the manufacturer, Orilissa is available in two dosages. The first is a 150 milligrams (mg) pill taken once daily (with or without food). The other is a 200 mg Orilissa pill taken twice daily, morning and night, (with or without food).

The appropriate dosage should be determined by your doctor based on your pain severity, liver function status, and other factors your doctor may consider.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.


Orilissa should be stored at temperatures between 36 and 85 F (2 and 30 C). It should be kept away from moisture.

Side Effects


Common side effects of taking Orilissa are:

  • Hot flashes
  • Night sweats
  • Sleeping difficulties
  • Amenorrhea (absence of periods)
  • Anxiety
  • Mood changes
  • Nausea


Although rare, there are a few side effects which can be serious, including:

  • Low estrogen levels, which can lead to loss of bone mineral density. Your doctor may recommend that you take calcium and vitamin D supplements while you’re taking Orilissa to counter this side effect and improve your bone health.
  • Suicidal thoughts and behavior
  • Abnormal liver tests

Call Your Doctor Immediately If You Have:

  • Jaundice (yellowing of your skin or the whites of your eyes)
  • Dark amber-colored urine
  • Fatigue
  • Nausea
  • Vomiting
  • Swelling all over the body
  • Pain in the right upper area of your stomach
  • Easily bruising skin
  • Depression or worsening of pre-existing depression

Warnings and Interactions

You should inform your doctor if you are taking any medication that may cause bone problems. Better yet, you should list all the drugs and supplements you’re currently taking to your doctor, as your physician will be in the best position to decide if it’s safe to take Orilissa with them.

Orilissa does not prevent pregnancy and should not be used as a form of birth control. You should use non-hormonal birth control options (like condoms) to prevent pregnancy while you’re using Orilissa, because hormonal birth control may make Orilissa less effective.

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