Relugolix (Orgovyx) hormone therapy

Who can have Relugolix?

• You can have Relugolix if you have:
  • Hormone sensitive (dependent) prostate cancer that has not yet been treated with hormone therapy.
  • High risk or locally advanced prostate cancer alongside radiotherapy.
  • High risk or locally advanced prostate cancer before radiotherapy.

What is locally advanced prostate cancer?

Locally advanced prostate cancer is where the cancer has broken through the covering (capsule) of the prostate. This may mean it has:

• Spread into the seminal vesicles (T3 in the TNM staging system)
• Spread into tissues or organs that are close to the prostate (T4 in the TNM staging system). For example:
  • The bladder
  • The back passage (rectum)
  • The wall of your pelvis.
• Visit our grading and staging of prostate cancer page for more information on the TNM staging system (link will open in a new page).

• You will need to tell your healthcare team about any other medications or treatments that you are receiving. This is because they may affect how Relugolix works. This includes:
  • Over-the-counter medicines
  • Vitamins and minerals
  • Herbal supplements.
• Tell your healthcare team if you are taking medications for any of the following conditions:
  • Epilepsy e.g. carbamazepine, phenytoin or phenobarbital
  • Infections: Antibiotics such as erythromycin, clarithromycin, rifampicin tetracycline or rifabutin
  • High blood pressure e.g. carvedilol or verapamil
  • Problems with your heart rhythm e.g. amiodarone, dronedarone, propafenone or quinidine
  • Angina e.g. ranolazine
  • Fungal infections e.g. ketoconazole or itraconazole
  • Depression: St John’s Wort
  • HIV Hepatitis C: HIV or HCV protease inhibitors e.g. ritonavir or telaprevir or non-nucleoside reverse transcriptase inhibitors e.g. efavirenz. 

How do I take relugolix?

• Relugolix is a tablet taken by mouth (orally).
• It can be taken with or without food.
• It should be taken at around the same time every day.
• It should be taken whole. You should not crush or chew the tablet. 

How often do I take relugolix?

• First dose only: three 120mg tablets (360mg) taken together.
• Thereafter: one 120mg tablet daily.

• You should take your Relugolix as soon as you remember.
• If it is overdue by 12 hours or more: You should wait to take it until your next tablet is due.
• If it is seven days or more since you last took your Relugolix: You will need to take the starting dose of three tablets together (360 mg). Then continue with one tablet (120 mg) a day.

• Your first prescription will be given to you by your hospital team.
• Future prescriptions will be prescribed by your GP. 

• Anyone staying on hormone therapy should have a yearly check-up with their doctor. They will check your:
  • Blood pressure
  • Cholesterol
  • Blood sugars – to test for diabetes. This test is called the HbA1c test. 
  • PSA. Your hospital team will want you to have a PSA test from time to time. This is to make sure the regugolix is working. Your team will decide how often you need to have your PSA done.
• They should also talk to you about your bone health and keeping fit.

• You can carry on working normally if you feel able to do so.
• You may feel tired or lack energy when you are having hormone therapy. Ask your team what you can do to help this. You can also visit our page on managing fatigue and hot sweats with hormone therapy (this link will open in a new page).
• You may need to take time of work for regular check-ups with your doctor.

• You will have regular check-ups with your doctor or specialist nurse.
• This will include monitoring of your PSA level.
• This will probably fall while you are on hormone therapy. If it starts to rise again, your doctor will talk to you about other treatment options.
• Visit our page about PSA tests for more information (this will open in a new tab).

• Relugolix may affect your ability to father a child. It will affect your:
  • Desire for sex
  • Ability to have an erection
  • Sperm production.
• If you think you may want children, please talk to your doctor before starting treatment.
• You may be able to have some of your sperm saved and frozen. This is called sperm banking or sperm cryopreservation. You can learn more about sperm banking on the Human Fertilisation and Embryology Authority website (this link will open in an external tab).
• Cancer Research UK also have information about sperm collection and storage (this link will open in an external tab).

• It is not known whether Relugolix goes into your semen.
• You must use effective contraception when having sex with a female who has childbearing potential. You should do this while you are taking Relugolix and for up to two weeks after your last dose. Your female partner should also use an effective form of contraception.
• It is possible that exposure to relugolix could cause miscarriage. Therefore, you should use condoms if you have sex with a pregnant female.
• You must not donate sperm.
• You can talk to your healthcare team about using contraception.

Very common side effects

Affects MORE THAN

Physical

• Hot flushes or sweats
• Diarrhoea
• Constipation
• Musculoskeletal pain
• Fatigue.

Common side effects

Affects UP TO

Physical

• Anaemia
• Breast enlargement (Gynaecomastia)
• Insomnia (unable to sleep)
• Depression
• Dizziness
• Headache
• High blood pressure (hypertension)
• Nausea (feeling sick)
• Hyperhidrosis (excessive sweating)
• Rash
• Weight gain. 

Sexual

• Decreased libido. 

Changes in blood tests

• Increased blood glucose
• Increased blood cholesterol
• Increased blood triglycerides.