Elagolix and Estradiol and Norethisterone side effects: what 600 FDA adverse event reports show
Drug class
Gonadotropin-releasing hormone (gnrh) receptor antagonist
Label matched
Elagolix (Orilissa)
Who reports
600 reports · 32% serious · 1 with death outcome · 100% female
Used for
ORILISSA is indicated for the management of moderate to severe pain associated with endometriosis. Limitation s of Use: Limit the duration of use based on the dose and coexisting condition (see Table 1 ) .
What it is
ORILISSA (elagolix) tablets for oral administration contain elagolix sodium, the sodium salt of the active moiety elagolix. Elagolix sodium is a nonpeptide small molecule, GnRH receptor antagonist.
Boxed warning
None in the current label
Causality screen of the 11 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 2 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Dysmenorrhoea | 17 | 45.5 28.5–72.7ROR 46.8 · χ² 695 / p 2e-153 | 43.4 EB05 28.7 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious n=6 | no trial data cached |
| Amenorrhoea (missed periods) | 19 | 39.8 25.6–62.0ROR 41.1 · χ² 681 / p 3e-150 | 38.4 EB05 26.0 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious PRR 8.6 | no trial data cached |
| Menstruation irregular | 21 | 27.7 18.2–42.1ROR 28.6 · χ² 514 / p 5e-114 | 27.1 EB05 18.7 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=4 · 90% consumer | no trial data cached |
| Vaginal discharge | 6 | 20.9 9.4–46.3ROR 21.1 · χ² 95 / p 1e-22 | 17.8 EB05 6.6 · IC025 +1.6 3/3 methods agree | Not in label — unassessed | serious n=1 | no trial data cached |
| Vaginal haemorrhage | 25 | 20.5 14.0–30.1ROR 21.4 · χ² 446 / p 3e-99 | 20.2 EB05 14.3 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious PRR 12.5 | no trial data cached |
| Surgery | 29 | 17.5 12.3–25.0ROR 18.3 · χ² 436 / p 5e-97 | 17.2 EB05 12.5 · IC025 +3.2 3/3 methods agree | Reporting / coding artifact | serious PRR 36.1 · 86% consumer | no trial data cached |
| Hot flush (hot flashes) | 32 | 14.8 10.6–20.8ROR 15.6 · χ² 401 / p 2e-89 | 14.5 EB05 10.6 · IC025 +3.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 8.5 · 84% consumer | no trial data cached |
| Menorrhagia (heavy periods) | 8 | 14.0 7.1–27.9ROR 14.2 · χ² 84 / p 2e-20 | 11.5 EB05 5.2 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 7.1 | no trial data cached |
| Alopecia (hair loss) | 71 | 12.6 10.1–15.7ROR 14.2 · χ² 754 / p 2e-166 | 12.4 EB05 10.1 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious PRR 3.4 · 87% consumer | no trial data cached |
| Mood altered | 9 | 11.6 6.1–22.1ROR 11.7 · χ² 77 / p 1e-18 | 9.2 EB05 4.6 · IC025 +1.8 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 16.4 | no trial data cached |
| Pelvic pain | 6 | 11.5 5.2–25.6ROR 11.6 · χ² 48 / p 3e-12 | 8.0 EB05 3.4 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Alopecia (hair loss) | 71 | 12.6 10.1–15.7ROR 14.2 · χ² 754 / p 2e-166 | 12.4 EB05 10.1 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious PRR 3.4 · 87% consumer | no trial data cached |
| Hot flush (hot flashes) | 32 | 14.8 10.6–20.8ROR 15.6 · χ² 401 / p 2e-89 | 14.5 EB05 10.6 · IC025 +3.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 8.5 · 84% consumer | no trial data cached |
| Surgery | 29 | 17.5 12.3–25.0ROR 18.3 · χ² 436 / p 5e-97 | 17.2 EB05 12.5 · IC025 +3.2 3/3 methods agree | Reporting / coding artifact | serious PRR 36.1 · 86% consumer | no trial data cached |
| Vaginal haemorrhage | 25 | 20.5 14.0–30.1ROR 21.4 · χ² 446 / p 3e-99 | 20.2 EB05 14.3 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious PRR 12.5 | no trial data cached |
| Menstruation irregular | 21 | 27.7 18.2–42.1ROR 28.6 · χ² 514 / p 5e-114 | 27.1 EB05 18.7 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=4 · 90% consumer | no trial data cached |
| Amenorrhoea (missed periods) | 19 | 39.8 25.6–62.0ROR 41.1 · χ² 681 / p 3e-150 | 38.4 EB05 26.0 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious PRR 8.6 | no trial data cached |
| Dysmenorrhoea | 17 | 45.5 28.5–72.7ROR 46.8 · χ² 695 / p 2e-153 | 43.4 EB05 28.7 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious n=6 | no trial data cached |
| Mood altered | 9 | 11.6 6.1–22.1ROR 11.7 · χ² 77 / p 1e-18 | 9.2 EB05 4.6 · IC025 +1.8 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 16.4 | no trial data cached |
| Menorrhagia (heavy periods) | 8 | 14.0 7.1–27.9ROR 14.2 · χ² 84 / p 2e-20 | 11.5 EB05 5.2 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 7.1 | no trial data cached |
| Pelvic pain | 6 | 11.5 5.2–25.6ROR 11.6 · χ² 48 / p 3e-12 | 8.0 EB05 3.4 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Vaginal discharge | 6 | 20.9 9.4–46.3ROR 21.1 · χ² 95 / p 1e-22 | 17.8 EB05 6.6 · IC025 +1.6 3/3 methods agree | Not in label — unassessed | serious n=1 | no trial data cached |
| Menstruation delayed | 4 | 13.5 5.1–35.8ROR 13.5 · χ² 35 / p 2e-9 | 8.1 EB05 2.7 · IC025 +0.7 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Metrorrhagia | 3 | 6.1 2.0–18.7ROR 6.1 · χ² 8 / p 0.002 | 3.6 EB05 1.4 · IC025 -0.3 PRR-only: not supported by EBGM or IC | Not in label — unassessed | – | no trial data cached |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Menstruation irregular — n=21, PRR 27.7
- Vaginal haemorrhage — n=25, PRR 20.5
- Alopecia — n=71, PRR 12.6
✓ A hand-written Bradford Hill causality assessment exists for this drug: Drospirenone/ethinyl estradiol ↔ Pulmonary embolism (venous thromboembolism).
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Elagolix and Estradiol and Norethisterone?
In FDA FAERS, the most frequently co-reported reaction terms for Elagolix and Estradiol and Norethisterone are alopecia, hot flush, vaginal haemorrhage, menstruation irregular, amenorrhoea, dysmenorrhoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Elagolix and Estradiol and Norethisterone have an FDA boxed warning?
No. The FDA label retrieved for Elagolix and Estradiol and Norethisterone has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Elagolix and Estradiol and Norethisterone causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID a86757b3-09c5-fd3b-1223-244e94f50a66, effective 20251219; matched on
openfda.generic_name.exact:"ELAGOLIX") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 13 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.