ORILISSA is different than many other treatment options for endometriosis pain

Features to consider1:

  • ORILISSA is the first FDA-approved pill specifically developed for moderate to severe endometriosis pain in over a decade
  • It is not a birth control pill, surgery, or an injection. It does not contain hormones
ORILISSA is a GnRH receptor antagonist available in 2 oral dosages

ORILISSA is a GnRH antagonist that competes with endogenous gonadotropin-releasing hormone (GnRH) for GnRH receptor occupancy and blocks receptors upon binding1,2

  • ORILISSA competitively binds to GnRH receptors
  • As a GnRH antagonist, ORILISSA binds without stimulating the receptors
ORILISSA is a GnRH-receptor antagonist

GnRH-receptor antagonism1,2

  • When ORILISSA enters the pituitary, it acts like a player in a game of musical chairs, competing with GnRH to sit in the receptor
  • Like a molecular game of musical chairs, GnRH is left with fewer receptors to activate
dose-dependent suppression of LH and FSH

Suppression of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in a dose-dependent manner1,3,4

  • GnRH receptor antagonism leads to a dose-dependent suppression of LH and FSH observed 4 to 6 hours after administration*

*Does not imply onset of efficacy or cessation of side effects during this time.

dose-dependent suppression of estradiol

Decreased levels of estradiol and progesterone1,3,4

  • After approximately 24 hours, subsequent suppression of estradiol levels occurs*
  • The degree of suppression is dependent on the dose of ORILISSA
  • Estrogen levels return to baseline 24 to 48 hours after discontinuation*

*Does not imply onset of efficacy or cessation of side effects during this time.

Watch the role of estrogen in endometriosis pain and the mechanism of action of ORILISSA.

Indication and Important Safety Information


ORILISSA® (elagolix) is indicated for the management of moderate to severe pain associated with endometriosis.



  • ORILISSA is contraindicated in women who are pregnant (exposure to ORILISSA early in pregnancy may increase the risk of early pregnancy loss), in women with known osteoporosis or severe hepatic impairment, or with concomitant use of strong organic anion transporting polypeptide (OATP) 1B1 inhibitors (e.g., cyclosporine and gemfibrozil).


Bone Loss

  • ORILISSA causes a dose-dependent decrease in bone mineral density (BMD), which is greater with increasing duration of use and may not be completely reversible after stopping treatment.
  • The impact of ORILISSA-associated decreases in BMD on long-term bone health and future fracture risk is unknown. Consider assessment of BMD in patients with a history of low-trauma fracture or other risk factors for osteoporosis or bone loss, and do not use in women with known osteoporosis.
  • Limit the duration of use to reduce the extent of bone loss.

Change in Menstrual Bleeding Pattern and Reduced Ability to Recognize Pregnancy

  • Women who take ORILISSA may experience a reduction in the amount, intensity, or duration of menstrual bleeding, which may reduce the ability to recognize the occurrence of pregnancy in a timely manner. Perform pregnancy testing if pregnancy is suspected, and discontinue ORILISSA if pregnancy is confirmed.

Suicidal Ideation, Suicidal Behavior, and Exacerbation of Mood Disorders

  • Suicidal ideation and behavior, including one completed suicide, occurred in subjects treated with ORILISSA in the endometriosis clinical trials.
  • ORILISSA users had a higher incidence of depression and mood changes compared to placebo and ORILISSA users with a history of suicidality or depression had an increased incidence of depression. Promptly evaluate patients with depressive symptoms to determine whether the risks of continued therapy outweigh the benefits. Patients with new or worsening depression, anxiety, or other mood changes should be referred to a mental health professional, as appropriate.
  • Advise patients to seek immediate medical attention for suicidal ideation and behavior. Reevaluate the benefits and risks of continuing ORILISSA if such events occur.

Hepatic Transaminase Elevations

  • In clinical trials, dose-dependent elevations of serum alanine aminotransferase (ALT) at least 3 times the upper limit of the reference range occurred with ORILISSA.
  • Use the lowest effective dose and instruct patients to promptly seek medical attention in case of symptoms or signs that may reflect liver injury, such as jaundice.
  • Promptly evaluate patients with elevations in liver tests to determine whether the benefits of continued therapy outweigh the risks.

Reduced Efficacy with Estrogen-Containing Contraceptives

  • Based on the mechanism of action of ORILISSA, estrogen-containing contraceptives are expected to reduce the efficacy of ORILISSA. The effect of progestin-only contraceptives on the efficacy of ORILISSA is unknown.
  • Advise women to use non-hormonal contraceptives during treatment and for one week after discontinuing ORILISSA.


  • The most common adverse reactions (>5%) in clinical trials included hot flushes and night sweats, headache, nausea, insomnia, amenorrhea, anxiety, arthralgia, depression-related adverse reactions, and mood changes.

These are not all the possible side effects of ORILISSA.

Safety and effectiveness of ORILISSA in patients less than 18 years of age have not been established.


For more information, please click here for full Prescribing Information.


1. ORILISSA [package insert]. North Chicago, IL: AbbVie Inc. 2. Huirne JA, Lambalk CB. Gonadotropin-releasing-hormone-receptor antagonists. The Lancet. 2001;358(9295):1793-1803. 3. Struthers RS, Nicholls AJ, Grundy J, et al. Suppression of gonadotropins and estradiol in premenopausal women by oral administration of the nonpeptide gonadotropin-releasing hormone antagonist elagolix. J Clin Endocrinol Metab. 2009;94(2):545-551. 4. Ng J, Chwalisz K, Carter DC, Klein CE. Dose-dependent suppression of gonadotropins and ovarian hormones by elagolix in healthy premenopausal women. J Clin Endocrinol Metab. 2017;102(5):1683-1691.