estradiol hemihydrate + norethisterone acetate + relugolix at a glance
Medicine class
GnRH receptor antagonist with oestrogen–progestogen add-back therapy
Licensed uses
Uterine fibroid symptoms and previously treated endometriosis in adults of reproductive age
Administration
Swallow with liquid, with or without food
Contraception
Hormonal contraception must not be used alongside it; follow the prescribed non-hormonal contraception advice
Bleeding pattern
Periods commonly become lighter or stop, although irregular bleeding can occur
What is estradiol hemihydrate + norethisterone acetate + relugolix used for?
Licensed uses in adults of reproductive age are:
Moderate to severe symptoms caused by uterine fibroids.
Symptomatic endometriosis after previous medical or surgical treatment for endometriosis.
How does estradiol hemihydrate + norethisterone acetate + relugolix work?
Relugolix blocks pituitary GnRH receptors, reducing LH and FSH release and suppressing ovarian hormones and ovulation. Estradiol helps limit low-oestrogen symptoms and bone loss, while norethisterone acetate protects the womb lining from unopposed oestrogen.
estradiol hemihydrate + norethisterone acetate + relugolix preparations and strengths
Tablet
Route: Oral
Strengths: 40 mg + 1 mg + 0.5 mg
How to take estradiol hemihydrate + norethisterone acetate + relugolix
Follow the prescriber's instructions. Swallow the film-coated tablet with liquid, with or without food. Hormonal contraceptives must be stopped before treatment; use non-hormonal contraception as instructed.
Starting outside the advised part of the menstrual cycle can initially cause irregular or heavier bleeding.
Tell clinicians and laboratory staff that you take this treatment because it can affect some test results.
The tablet contains lactose.
estradiol hemihydrate + norethisterone acetate + relugolix side effects
Common or expected effects
- Headache or hot flushes
- Irritability, dizziness or reduced interest in sex
- Nausea
- Hair loss, increased sweating or night sweats
- Joint pain
- Irregular, heavy or prolonged uterine bleeding
- Vulvovaginal dryness
Get urgent medical advice
- Face, lip, tongue or throat swelling, which may indicate angioedema
- Symptoms of a blood clot, heart attack or stroke
- Jaundice or other symptoms suggesting liver injury
- Severe recurrent bleeding or pain that may indicate fibroid prolapse or expulsion
- Serious or worsening depressive symptoms
estradiol hemihydrate + norethisterone acetate + relugolix in pregnancy
This combination is contraindicated in pregnancy. Pregnancy should be excluded before treatment. Stop taking it and contact the prescriber if pregnancy occurs or is suspected. Ovulation can return rapidly after stopping, so alternative contraception must be arranged promptly.
estradiol hemihydrate + norethisterone acetate + relugolix while breastfeeding
Breastfeeding is contraindicated during treatment and for 2 weeks after stopping because effects on a breastfed infant cannot be excluded.
estradiol hemihydrate + norethisterone acetate + relugolix interactions
Check all prescribed, over-the-counter and herbal products with a pharmacist or prescriber. Important interactions include:
Hormonal contraceptives
Concomitant use is contraindicated; use the recommended non-hormonal method instead.
Oral P-glycoprotein inhibitors, including erythromycin, clarithromycin, verapamil, amiodarone, itraconazole and ciclosporin
These can increase relugolix exposure; combined use is generally not recommended and closer monitoring may be needed.
Strong CYP3A4 or P-glycoprotein inducers, including rifampicin and several antiseizure medicines
These may lower relugolix concentrations and reduce effectiveness.
Common questions about estradiol hemihydrate + norethisterone acetate + relugolix
Answers are fully visible for fast scanning and source review.
What is Ryeqo used for?
It is licensed for moderate to severe uterine fibroid symptoms and for endometriosis symptoms following previous medical or surgical treatment.
Is Ryeqo a type of HRT?
No. It combines a GnRH receptor antagonist with oestrogen–progestogen add-back therapy and is licensed for fibroids and endometriosis, not menopausal hormone replacement.
Does Ryeqo stop periods?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.