Has anyone else had tachycardia with Orgovyx?

The way Orgovyx works is it takes your testosterone down to Below 20. If you stop and start it it just leaves your testosterone low since it takes months to get your testosterone back to normal levels.

My oncologist has specifically said don’t do that (Take Orgovyx Intermittently). Orgovyx does have a 25 hour half life.

One solution would be getting a beta blocker. I take metoprolol it stopped all my tachycardia problems caused by Zytiga.

Instead of Orgovyx you could take Lupron or equivalent or maybe Firmagon would not cause tachycardia.

Apparently an elongated Q-T interval on the electrocardiogram is a known side effect to watch for. I have been on ORGOVYX (relugolix) for ten months and have noticed a drop in blood pressure. A confounding variable is alcohol abstinence. Consider avoiding 'Ms. Ethyl' if it is a potential co-factor. It will help the cariologist eliminate that issue.

How long does the tachycardia last? I had small bouts of tachycardia while on ADT but they only lasted 10-15 seconds. They were still terrifying but I went to see a cardiologist and they said the risk was small and put me on a low dose of metoprolol similar to Jeff. I would see a cardiologist to either get peace of mind or find out what's going on and how to treat it. I wouldn't just stop Orgovyx without consulting an oncologist and a cardiologist.

I would try to see a cardiologist as soon as possible. If you went to an emergency ward where I live, they'd take your vital signs and even if a cardiologist wasn't there at the time, they'd consult one on the phone before telling you what they thought was up.

I just saw a cardiologist, although he is a specialist in doing ablation procedures to treat heart arrhythmias and not a generalist. I was consulting him about a previous successful A-fib procedure. I mentioned I was on Orgovx.

I mentioned that I was spending a fair bit of my time (I think I used the words "all my time") researching how soon I could get off it. I said I had heard an interview with one expert on ADT who said her critique of study results showing that although cardiac issues are listed as a known side effect of ADT therapy severe cardiac problems are rare, most or all of the studies assigned a cardiologist to supervise ADT treatment with any of the study participants who had previous cardiac issues prior to signing up for the study to head problems off at the pass, which reduces the meaning of "cardiac problems are rare" as a lot of ROs administering ADT do not consult cardiologists prior to handing out the ADT like candy.

This cardiologist stopped paying attention to me and looked up Orgovyx and studied what he found for a while. He turned to me and said: "I see why you want to get off it".

He cheerfully went back to the original purpose of the appointment. I think he concluded the threat to me was small and way off in the distance, i.e. longer time period. But I have only presented with a few episodes of A-fib in the past prior to his procedure, and I have been in remission for years ever since. Prior more serious issues like previous heart attack or heart failure diagnosis would required more attention.

@jeffmarc
I do the same thing when my tachyardia comes around - but only when I have an elevated heart rate session. I have been on Orgovyx for about 8 weeks (started last weekend of October). I have had 2 episodes of elevated heart rate (both late at night) that lasted less than 20-30 minutes and metoprolol eased them away as normal. I had a cardiac ablation 2 years ago (prior to my prostate cancer getting to a recommended treatment level). I was advised that tachycardia could be a side effect and to treat as normal when/if that happens. My understanding is that this is 'normal' and to be prepared if you are susceptible to tachycardia.

@jonathanack
I lake metoprolol twice a day. Totally eliminates tachycardia problems.

@jeffmarc
Yes, I know that is an option for many folks. I was able to have the same for about 18 months. I had to have an ablation (electrophysicist) and it has worked well except for a few times since the ablation procedure. The occurrences became pretty long and very high rates. So, I had the ablation and now take only the fast acting metropolol when needed. During SBRT treatments the technicians are pretty careful about watching my heart rate because, I believe/understand, of the orgovyx.

@jonathanack
When I had surgery a few months ago, they talked about having me stop Nubeqa For a couple of days, And my oncologist told Them it was unnecessary.

They had no problem with my Continuing Orgovyx.

That’s after four a fib events in the Previous three years and no ablation,

I’m sure they did keep track of my heart rate but that metoprolol protects a lot.

@pfj0650, have you heard about a specialty called cardio-oncology?

Mayo Clinic offers expertise in addressing heart problems (called cardio-oncology), potential or current issues. The Cardio-Oncology Clinic (https://www.mayoclinic.org/departments-centers/cardio-oncology-clinic/overview/ovc-20442193) evaluates people prior to cancer treatment and patients who have experienced side effects due their treatment.

You might ask if they have cardio-oncology as a specialty where you receive care. Are you currently in the care of a cardiologist as well as you oncology team?

Just the opposite for me. Last visit to GU Oncology a few weeks back, heart rate clocked at 41 on digital BP cuff and same with manual. Doc was worried about a heart block (known side effect of Orgovyx), so he hooked me up to an EKG. Showed pulse @ 71 with a 20%+/- PVC burden (no block). Off to EP Cardiology this afternoon to see what's up. I made sure cardio-oncology was in the loop. (Same cardiology group but sometimes I have to poke them to get them to talk to each other) Guess I get to add another specialist to my doctor collection. 😁