[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [GnRH analogues (agonists and antagonists)](https://durgical.com/en/pharmacology/classes/gnrh-analogues/) › Elagolix

# Elagolix

## GnRH analogues (agonists and antagonists)?

GnRH analogues (agonists and antagonists)

## Pregnancy: contraindicated?

Contraindicated: pregnancy is excluded before starting, and a reliable non-hormonal method is used because elagolix may weaken hormonal contraceptives.

Oral non-peptide GnRH antagonist for endometriosis pain. It lowers oestrogen, so it causes hot flushes, raised lipids and bone loss.

Updated Nov 1, 2026

## Quick facts

**Group**
[GnRH analogues (agonists and antagonists)](https://durgical.com/en/pharmacology/classes/gnrh-analogues/)

**Target**
Gonadotropin-releasing hormone receptor (GnRH-R) on pituitary gonadotroph cells

**Key effects**
Hot flushes and night sweats · Headache

**Monitor**
Pregnancy test before starting · Bone health

**ATC**
H01CC03

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Gonadotropin-releasing hormone receptor (GnRH-R) on pituitary gonadotroph cells**Elagolix

ⓘ The crystal shows elagolix bound to the human GnRH receptor; part of an intracellular loop was replaced by a helper protein to allow crystallisation.

**Target in 3D:** Gonadotropin-releasing hormone receptor (GnRH-R) on pituitary gonadotroph cells. PDB structure 7BR3 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7BR3) · Drag to rotate · pinch to zoom

Elagolix is an oral, non-peptide GnRH receptor antagonist. Blocking the pituitary receptor lowers LH and FSH, so the ovaries make less oestrogen; endometriosis lesions, which depend on oestrogen, cause less pain. The same low oestrogen explains its hot flushes, raised lipids and loss of bone density.

- Elagolix blocks pituitary GnRH receptors
- LH and FSH fall; the ovaries make less oestrogen
- Endometriosis pain eases; low oestrogen causes side effects

## Indications

- Moderate to severe pain from endometriosis. [Endometriosis →](https://durgical.com/en/conditions/endometriosis/)

## Adverse effects

### Common

- Hot flushes and night sweats
- Headache, nausea, insomnia
- Changes in menstrual bleeding (irregular, less or none)
- Raised blood lipids; joint pain; weight gain; mood changes

### Serious (rare, important)

- Loss of bone mineral density
- Depression, anxiety and suicidal thoughts
- Liver injury: yellow skin, dark urine, upper-right abdominal pain

## Contraindications

- Pregnancy
- Osteoporosis or liver disease (it may be ruled out)
- Use with cyclosporine or gemfibrozil

## Key interactions

**Cyclosporine and gemfibrozil**
Not combined with elagolix.

**Hormonal contraceptives**
Elagolix may make some of them less effective; a reliable non-hormonal method is used.

## What is monitored

- Pregnancy test before starting, or start within days of a period
- Bone health: fracture history, calcium and vitamin D
- Mood and suicidal thoughts
- Liver tests and blood lipids

## Administration and safety

- Oral tablet once or twice a day at about the same times; the course is time-limited.
- Calcium and vitamin D may be recommended during treatment.
- All other medicines are checked with the pharmacist before starting.

## Pregnancy and breastfeeding

Contraindicated: pregnancy is excluded before starting, and a reliable non-hormonal method is used because elagolix may weaken hormonal contraceptives.

## Nursing care

- Confirm that pregnancy is excluded and teach a non-hormonal contraceptive method.
- Ask about osteoporosis, fractures, liver disease, depression and suicidal thoughts before starting.
- Teach the patient and family to report new or worse mood changes at once.

## Pharmacokinetics

**Absorption**
Oral tablet, once or twice a day, with or without food; the length of treatment is limited.

## Memory aid

ELAgolix = ENDOmetriosis by mouth: lower the oestrogen, ease the pain — and pay in hot flushes, lipids and bone.

## Test yourself

Think of the answer, then tap the question to see it.

## Why does elagolix cause bone loss?

It lowers oestrogen, which normally protects bone density.

## Which contraceptive advice is given with elagolix?

Use a reliable non-hormonal method, because elagolix may make hormonal contraceptives less effective.

## Which two drugs must not be combined with elagolix?

Cyclosporine and gemfibrozil.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/elagolix/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**Pregnancy: contraindicated**
Contraindicated: pregnancy is excluded before starting, and a reliable non-hormonal method is used because elagolix may weaken hormonal contraceptives.

## Connections

## Related drugs 3

- [Relugolix](https://durgical.com/en/pharmacology/relugolix/)
- [Leuprorelin](https://durgical.com/en/pharmacology/leuprorelin/)
- [Goserelin](https://durgical.com/en/pharmacology/goserelin/)

## Related conditions 1

- [Endometriosis](https://durgical.com/en/conditions/endometriosis/)

[← Back to the class: GnRH analogues (agonists and antagonists)](https://durgical.com/en/pharmacology/classes/gnrh-analogues/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Elagolix: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a618044.html) (MedlinePlus (U.S. National Library of Medicine), 2018); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=H01CC03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [Crystal structure of the protein 1](https://www.rcsb.org/structure/7BR3) (RCSB Protein Data Bank, 2020).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/elagolix/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/elagolix/