Orilissa (Elagolix) is a prescription oral medication used to treat moderate to severe pain caused by endometriosis in premenopausal women.

What Is Orilissa?

Orilissa is the brand name for Elagolix, a medication in the GnRH (gonadotropin-releasing hormone) antagonist class. It was developed and is manufactured by AbbVie Inc.

Orilissa was the first oral GnRH antagonist approved by the FDA for endometriosis, receiving approval in July 2018. Before Orilissa, GnRH-based treatments for endometriosis required injections (like Lupron Depot). Orilissa changed that by offering a pill you take at home.

Key facts at a glance:

• Brand name: Orilissa
• Generic name: Elagolix (Elagolix sodium)
• Drug class: GnRH receptor antagonist
• Manufacturer: AbbVie Inc.
• Controlled substance: No — Orilissa is not a controlled substance
• Generic available: No (as of 2026)
• Related medication: Oriahnn (Elagolix combined with estradiol and norethindrone, approved for uterine fibroids)

What Is Orilissa Used For?

Orilissa is FDA-approved for one indication:

• Moderate to severe pain associated with endometriosis in premenopausal women

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus, causing chronic pelvic pain, painful periods, and pain during intercourse. Orilissa helps by reducing the estrogen that fuels this tissue growth.

Some doctors also prescribe Orilissa off-label for uterine fibroids and heavy menstrual bleeding, though AbbVie's combination product Oriahnn is specifically approved for fibroids.

How Is Orilissa Taken?

Orilissa comes as an oral tablet in two strengths:

• 150 mg tablet — Light pink, oblong, film-coated, debossed "EL 150"
• 200 mg tablet — Light orange, oblong, film-coated, debossed "EL 200"

Dosing

• 150 mg once daily — For up to 24 months
• 200 mg twice daily (approximately 12 hours apart, e.g., morning and evening) — For up to 6 months

Your doctor will choose the dose based on the severity of your symptoms and your individual risk factors (especially for bone density loss). The higher dose is typically reserved for patients with more severe pain, including pain during intercourse (dyspareunia).

How to Take It

• Take it at approximately the same time every day
• Can be taken with or without food
• If you miss a dose, take it as soon as you remember (unless it's almost time for your next dose)
• Do not take two doses at once to make up for a missed dose

Orilissa is not a form of birth control. You need to use non-hormonal contraception (like condoms or a copper IUD) while taking it. Combined hormonal contraceptives (estrogen-containing birth control pills) may reduce Orilissa's effectiveness. For more on interactions, see our guide on Orilissa drug interactions.

Who Should Not Take Orilissa?

Orilissa is not right for everyone. Do not take Orilissa if you:

• Are pregnant — Orilissa may cause early pregnancy loss (miscarriage)
• Have known osteoporosis — Orilissa causes bone mineral density loss
• Have severe liver disease — Severe hepatic impairment increases drug exposure by up to 7 times
• Take certain medications — Strong OATP1B1 inhibitors like Cyclosporine or Gemfibrozil are contraindicated
• Have had a serious allergic reaction to Elagolix or any ingredient in Orilissa

Women with moderate liver impairment should only use the 150 mg once-daily dose, limited to 6 months. The 200 mg twice-daily dose is contraindicated in this group.

Orilissa has not been studied in pediatric patients and is not indicated for postmenopausal women.

For a full list of side effects and warnings, read our detailed guide on Orilissa side effects.

How Much Does Orilissa Cost?

Orilissa is expensive. Here's what you need to know about pricing in 2026:

• Cash price: $1,200 to $1,700 per month (28-day supply)
• Generic available: No — there is no generic Elagolix as of 2026
• Insurance: Most commercial plans cover Orilissa but typically require prior authorization and may require step therapy (trying other treatments first, like NSAIDs or hormonal birth control)
• Medicare: Medicare Part D coverage is limited; Orilissa is typically not covered by Medicare

Ways to Save

• AbbVie Orilissa Savings Card — Commercially insured patients may pay as little as $5 per month. Visit orilissa.com or call 1-800-222-6885. Not valid for government insurance (Medicare, Medicaid, Tricare).
• myAbbVie Assist — AbbVie's patient assistance program for uninsured or underinsured patients who meet income requirements. Apply at abbvie.com/myAbbVieAssist or call 1-800-222-6885.

For a complete breakdown of every savings option, see How to Save Money on Orilissa.

How Does Orilissa Compare to Alternatives?

Orilissa isn't the only option for endometriosis treatment. Here's how it stacks up:

• Lupron Depot (Leuprolide) — A GnRH agonist given as a monthly or quarterly injection. Well-established, but requires office visits for injections and causes an initial hormone "flare" before suppression kicks in.
• Myfembree (Relugolix/Estradiol/Norethindrone) — A newer oral GnRH antagonist combination that includes hormonal add-back therapy to reduce bone loss. Approved for both fibroids and endometriosis.
• Norethindrone Acetate — A progestin used off-label for endometriosis. Much less expensive but a different mechanism of action.
• Depo-Provera (Medroxyprogesterone) — An injectable progestin given every 3 months, used off-label for endometriosis pain.

For a deeper comparison, read Alternatives to Orilissa.

Final Thoughts

Orilissa was a breakthrough when it launched in 2018 as the first oral GnRH antagonist for endometriosis, and it remains an important option in 2026 for women dealing with moderate to severe endometriosis pain. It's effective, but it comes with real trade-offs — particularly bone density loss, cost, and the need for monitoring.

Talk to your doctor about whether Orilissa is the right choice for your situation. If you already have a prescription, search Medfinder to find a pharmacy that has it in stock near you.