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Relugolix is the first hormone-suppressing pill for prostate cancer, working within days and wearing off quickly when stopped.
Relugolix is an oral, competitive GnRH receptor antagonist that suppresses testosterone within days without the initial testosterone flare seen with GnRH agonists such as leuprolide. It is used for advanced prostate cancer wherever medical castration is needed, and its effect wears off quickly when stopped, which suits intermittent therapy or men with a short planned course. HERO (2020) showed sustained castration in 96.7% versus 88.8% for leuprolide, faster onset and recovery, and 54% fewer major cardiovascular events. Drug interactions through P-glycoprotein and reliance on daily adherence are practical considerations against the convenience of a depot injection. Whether the cardiovascular signal is a true class advantage of antagonists is still under study. In short, relugolix is the first hormone-suppressing pill for prostate cancer.
Competitive GnRH receptor antagonist; no testosterone flare.
1.Relugolix binds its target.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). The only oral GnRH antagonist for prostate cancer, so it sits in Part D whereas injectable GnRH agonists and degarelix are Part B; this shifts the cost from 20% coinsurance to the Part D specialty tier and cap.
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy. Some plans prefer injectable leuprolide first.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA995. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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| Region | Year | Indication |
|---|---|---|
| US | 2020 | Advanced prostate cancer |
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Query for this drug: (TITLE:"Relugolix" OR ABSTRACT:"Relugolix" OR TITLE:"Orgovyx" OR ABSTRACT:"Orgovyx") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Relugolix, not a curated reading list.
Shares Assessing Efficacy of Neoadjuvant ADT in Localized High-Risk Prostate Cancer Patients Utilizing 18F-Flotufolastat PSMA PET/CT, Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging, Two Studies for Patients With High Risk Prostate Cancer Testing Less Intense Treatment for Patients With a Low Gene Risk Score and Testing a More Intense Treatment for Patients With a High Gene Risk Score, The PREDICT-RT Trial, What androgen deprivation costs: the side of hormone therapy the survival curves do not show.
Shares HERO, What androgen deprivation costs: the side of hormone therapy the survival curves do not show, Metastatic hormone-sensitive prostate cancer, Localised prostate cancer, high and very high risk.
Shares Assessing Efficacy of Neoadjuvant ADT in Localized High-Risk Prostate Cancer Patients Utilizing 18F-Flotufolastat PSMA PET/CT, Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging, HERO, Two Studies for Patients With High Risk Prostate Cancer Testing Less Intense Treatment for Patients With a Low Gene Risk Score and Testing a More Intense Treatment for Patients With a High Gene Risk Score, The PREDICT-RT Trial.
Shares HERO, What androgen deprivation costs: the side of hormone therapy the survival curves do not show, Metastatic hormone-sensitive prostate cancer, Androgen deprivation & AR pathway inhibitors.
Shares Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging, Two Studies for Patients With High Risk Prostate Cancer Testing Less Intense Treatment for Patients With a Low Gene Risk Score and Testing a More Intense Treatment for Patients With a High Gene Risk Score, The PREDICT-RT Trial, Prostate cancer drugs in England: what NICE recommends, and what it refuses, Androgen receptor signalling.
Shares Assessing Efficacy of Neoadjuvant ADT in Localized High-Risk Prostate Cancer Patients Utilizing 18F-Flotufolastat PSMA PET/CT, Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging, Two Studies for Patients With High Risk Prostate Cancer Testing Less Intense Treatment for Patients With a Low Gene Risk Score and Testing a More Intense Treatment for Patients With a High Gene Risk Score, The PREDICT-RT Trial, Androgen deprivation & AR pathway inhibitors.
Shares Prostate cancer drugs in England: what NICE recommends, and what it refuses, Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test, Metastatic hormone-sensitive prostate cancer, Androgen deprivation & AR pathway inhibitors.
Shares Prostate cancer drugs in England: what NICE recommends, and what it refuses, Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test, Metastatic hormone-sensitive prostate cancer, Androgen deprivation & AR pathway inhibitors.