Endolix 200 mg

INDICATIONS

Elagolix is indicated for the management of moderate to severe pain associated with endometriosis.

PHARMACOLOGY

Elagolix is a GnRH receptor antagonist that inhibits endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. Administration of Elagolix results in dose-dependent suppression of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), leading to decreased blood concentrations of the ovarian sex hormones, estradiol and progesterone.

DOSAGE & ADMINISTRATION

Pregnancy should be excluded before starting treatment with Elagolix and start Elagolix within 7 days from the onset of menses.Initial treatment with Elagolix 150 mg: 150 mg once daily up to 24 months. But in case of moderate hepatic impairment up to 6 months.Initial treatment with Elagolix 200 mg: 200 mg twice daily up to 6 months (with coexisting dyspareunia). Treatment with Elagolix 200 mg should not exist more than 6 months as it may decrease bone mineral density (BMD). In moderate to severe hepatic impairment: Elagolix 200 mg is not recommended.Use in children and adolescents: <18 years not established.

INTERACTION

With medicine: May potentiate P-gp substrates (e.g. digoxin), CYP2C19 substrates (e.g. omeprazole; limit doses to <40 mg daily). May antagonize CYP3A substrates. Antagonizes oral midazolam, rosuvastatin; consider increasing their doses. May be antagonized by CYP3A inducers. Reduced efficacy with estrogen-containing contraceptives.With food and others: No known food interaction.

SIDE EFFECTS

Common: The most common side effects include hot flushes, night sweats, headache, nausea, amenorrhea, , arthralgia, mood changes & bone loss. Rare: Insomnia, anxiety & elevated hepatic transaminase.

PREGNANCY & LACTATION

The limited human data with the use of Elagolix in pregnant women are insufficient to determine whether there is a risk for major birth defects or miscarriage. Exposure to Elagolix early in pregnancy may increase the risk of early pregnancy loss. Use of it is contraindicated in pregnant women. Elagolix has to be discontinued if pregnancy occurs during treatment. There is no information on the presence of elagolix or its metabolites in human milk, the effects on the breastfed child or the effects on milk production.

PRECAUTIONS & WARNINGS

Bone Loss: Dose and duration-dependent decreases in bone mineral density (BMD) that may not be completely reversible. Assess BMD in women with additional risk factors for bone loss.Reduced Ability to Recognize Pregnancy: Elagolix may alter menstrual bleeding, which may reduce the ability to recognize pregnancy. Perform testing if pregnancy is suspected. Discontinue if pregnancy is confirmed.Suicidal Ideation and Mood Disorders: Advise patients to seek medical attention for suicidal ideation, suicidal behavior, new onset or worsening depression, anxiety, or other mood changes.Hepatic Transaminase Elevations: Dose-dependent elevations in serum alanine aminotransferase (ALT). Counsel patients on signs and symptoms of liver injury.Potential for Reduced Efficacy with Estrogen-Containing Contraceptives: Use non-hormonal contraception during treatment and for one week after discontinuing Elagolix.

USE IN SPECIAL POPULATIONS

No dose adjustment of Elagolix is required in women with any degree of renal impairment or end-stage renal disease (including women on dialysis)
No dosage adjustment of Elagolix is required in women with mild hepatic impairment.
Safety and effectiveness of Elagolix in patients less than 18 years of age have not been established.

THERAPEUTIC CLASS

Gonadotropin-releasing hormone (GnRH) antagonist

STORAGE CONDITIONS

Store in a cool & dry place, protect from light & moisture. Keep all medicines out of reach of children.