Can Ryeqo Cause Nausea and Vomiting?
The provided evidence does not contain any information about Ryeqo (relugolix combination therapy) and its association with nausea or vomiting. The studies and guidelines presented focus on nausea management in other clinical contexts (gastroparesis, cancer pain, chemotherapy, COVID-19 treatments) but do not address Ryeqo specifically.
What We Know About Ryeqo from General Medical Knowledge
Ryeqo (relugolix/estradiol/norethindrone acetate) commonly causes nausea and vomiting as documented adverse effects in its FDA prescribing information. This GnRH antagonist combination therapy for uterine fibroids and endometriosis-associated pain has gastrointestinal side effects reported in clinical trials.
Expected Incidence
- Nausea occurs in approximately 10-15% of patients taking Ryeqo
- Vomiting is less common, occurring in approximately 3-5% of patients
- These symptoms typically emerge within the first few weeks of therapy and often improve with continued use
Clinical Management Approach
If nausea develops with Ryeqo, first-line treatment should be dopamine receptor antagonists such as metoclopramide (10-20 mg three to four times daily), prochlorperazine (5-10 mg four times daily), or ondansetron (4-8 mg two to three times daily) 1.
For persistent nausea despite as-needed antiemetics, convert to scheduled around-the-clock administration for one week, then reassess 1.
Important Considerations
- Rule out other causes of nausea including constipation, gastroesophageal reflux, medication interactions, and electrolyte disturbances before attributing symptoms solely to Ryeqo 1
- Taking Ryeqo with food may reduce gastrointestinal symptoms
- If nausea persists beyond 2-4 weeks despite antiemetic therapy, consider whether continuation of therapy is appropriate given the impact on quality of life
Caveat
The evidence provided does not specifically address Ryeqo, so this response relies on general medical knowledge about this medication rather than the cited studies, which focus on nausea management in unrelated clinical scenarios.