Side effects of Orgovyx (relugolix): Anyone have stomach or GI issues?

Have you considered trying a few days of a bland diet to see if it helps? Temporarily cut out spicy foods, fried foods, caffeine, alcohol, carbonated drinks, and dairy and see if the pain goes away in a few days, then gradually reintroduce foods one at a time to see what's irritating you.

Obviously, it's much better to consult your medical team and/or a registered dietician, but this is something safe you can start on by yourself, since it doesn't involve depriving yourself of any major nutritional groups (as many fad diets do).

Sorry to hear that the Orgovyx is causing some grief. I've been on it for two weeks thus far and haven't suffered any ill effects. I take it first thing in the morning on an empty stomach. It can be taken with or without food. You might consider tinkering with dose timing as regards when you take it during the day and, which meal. Also, stay upright for an hour or so, don't lie down right after taking the medication. I'd recommend consulting with your medical oncologist and their pharmacist in addition to mentioning it to the folks who supply the medication. All the best.

You might also be interested in these related discussions:
- What's your experience with Orgovyx (relugolix)?
https://connect.mayoclinic.org/discussion/the-orgovyx-thread/
See all: https://connect.mayoclinic.org/group/prostate-cancer/

@lfusilli, how are you doing? Have the gastro side effects subsided?

I had some mild GI issues initially when I took the meds before breakfast. I switched the time that I take them and my Zytiga to whenever I get up for the first time during the night. Problem solved !

Good luck on your journey

Bob

Hello, Ifusilli,
I have been on Orgovyx for 2 1/2 months. I am almost 73. I have had a damaged stomach mucosal layer for years. When I started taking Orgovyx (first thing in the morning with food), I had a distinctive stomach pain, kind of a sharp cramping sensation. It gradually diminished and by about a month or so in it seemed to disappear. Have no hot flashes, weight gain, or extreme fatigue. Biggest side effects are constipation, muscle pain, joint pain, significant weakness, loss of strength, occasional weepiness. Scheduled for another 1 1/2 months. Can't wait to get off it! Hang in there! Best Wishes!

Hello, my name is Keith and I started my cancer prostate cancer journey 3 years ago at the age of 86 in 2022 and I am now 88 in 2025. I had a 1 inch by .5 inch tumor in my prostate and the they did a wait and see and it got out into some lymph nodes close by and in my chest and tubes. Went on a diet of Lupron and Zytiga for a year (with all the side affects) and went to psa zero and after about 6 months started feeling like a man again. This new I could be in trouble again as my testosterone had come back (felt like a man again) and went a got checked and sure enough a new tumor had formed in my prostate and it was in a bad place in the very bottom up against my rectum. Because of the location they could not do radiation therapy with out damaging things and causing bowel and urinary problems.
Today I now start my second round of ADT using Orgovyx (Relugolix). I am very aprehensive because the last ADT (therapy) using Lupron and Zytiga ended up causing me to have Diabetes and Neuropathy and now because of my age I have Osteoporosis and Arthritis in my lower back and my Pancreas went on the blink and caused me to lose 30 lbs. I wish I where in better shape to start ADT again and hope it has not metastasized. I am a very active 88 year old and project oriented and this will really slow me down. I hope that Orgovyx has less side affects then Lupron and Zytiga has they really did a job on me. I like your article has my stomach has become very sensitive to morning food and have to be careful what I eat. They have put me on Prilosec 20 mg morning and 20 mg evening before meals to keep the acid down. I all ready have all the problems the cancer drugs to will cause before I even start. If the Lord wants me he will take me or see me through it again to stay a little longer. I have learned what an amazing chemical factory the body is. It is one of the amazing creations of God.

Hello! I’m 9 months into an 18 month course of treatment on Orgovyx. I seem to be a poster child for bad side effects, especially gastrointestinal. I’m 74 years old, and was previously in good health. My biggest issue is cramping, although there is bloating, weight gain, fatigue, joint pain, and swollen hands. So far I’ve tried different diets, different times of the day, and both an empty and full stomach. While my PSA is zero and my markers look good, I’ve gotten no answers from my doctors other than varying amounts of gas-x depending on the severity of the cramps. They go from a pain level of 2 to a pain level of 9. It’s brutal. This week I’m seeing my PCP to see if she can further guide me to a GI doc. I sleep 9-12 hours a night, work with an exercise physiologist, and have always watched my diet very carefully, with red meat treated as a condiment. Has anyone found a reliable method of relief? I will post if my test results give a good clue as to resolving this. Stay as well as possible.

@dogrocketp
One thing you could try is eating one shot glass of bran buds every day. This was brought up at the PCRI conference. Can’t remember who said it, but the doctor said it makes you regular. I bought a box of Kellogg’s bran buds And use a shot glass full every morning. It has made me regular, Something that was hit and miss before.

You do need to drink a fair amount of water every day to make your stool is not real hard. If that is a problem you have.

I’ve been on ADT for eight years and I’ve never had the problem you describe, Been on Orgovyx For almost 3 years.

@dogrocketp No one really knows the FULL extent of SE’s when you chemically castrate a male. Although GI symptoms are not usually high on the list, it doesn’t mean they can’t happen.
Look into the FODMAP diet and see if that might work for you. Usually recommended for those with irritable bowel, Crohn’s and other GI maladies.
Adding more fiber, could, in fact, make your symptoms worse. (You don’t mention constipation or diarrhea).
The type of fiber you eat is critical in combating bloating, cramps and gas. You may require non-fermentable types instead of the commonly used psyllium, bran and cereal based ones.
Amazon carries Healthy Fiber - a guar gum based powder which will keep you regular with NO gas or bloat.
I followed a FODMAP diet during my SRT to prevent gas but stay regular enough to maintain an empty rectum. It’s not difficult, but you MUST follow the diet and not cheat. Be sure to drink a LOT of water to keep your bowel hydrated.
After a few days of eliminating trigger foods (most of the gas producing foods we all love!) I think you’ll begin to see a difference…Best,
Phil

@dogrocketp I think you better suggest to your doctor that you should go on “vacation @ since you have 0 PSA. And then start taking Orgovyx again when your PSA goes up like.5 or 1 whatever you agreed with your doctor. I have read a few in this blog that they were told to go on vacation when their PSA is less than .1 so why not try it. You been suffering from continuing to take the medication, so take a break.