If You've Been Told "We Don't Have It," You're Not Alone

You finally got a prescription for Orilissa (Elagolix) to treat your endometriosis pain — only to hear your pharmacist say, "Sorry, we don't have that in stock." If this sounds familiar, you're not alone. Orilissa is one of those medications that can be surprisingly difficult to find, even though it's not technically in a national shortage.

In this article, we'll explain what Orilissa is, why it's so hard to find at many pharmacies, and what you can do to get your prescription filled as quickly as possible.

What Is Orilissa?

Orilissa is a brand-name prescription medication made by AbbVie. Its active ingredient is Elagolix, and it belongs to a class of drugs called GnRH (gonadotropin-releasing hormone) antagonists. It was approved by the FDA in July 2018 and was the first orally active GnRH antagonist available in the United States.

Orilissa is prescribed to treat moderate to severe pain associated with endometriosis in premenopausal women. It works by blocking the GnRH receptor, which lowers estrogen and progesterone levels. Since endometrial tissue growth is driven by estrogen, reducing those hormone levels helps relieve the pelvic pain, menstrual pain, and pain during intercourse that endometriosis causes.

It comes in two strengths: 150 mg tablets (taken once daily for up to 24 months) and 200 mg tablets (taken twice daily for up to 6 months).

Why Is Orilissa So Hard to Find?

There are several reasons why Orilissa can be difficult to locate at your local pharmacy. Here are the main ones:

1. It's a Specialty Medication With Low Demand

Orilissa is not a widely prescribed drug like blood pressure medications or antibiotics. It's used for a specific condition — endometriosis pain — and only in premenopausal women. Because of this, many retail pharmacies don't keep it on their shelves. Pharmacies typically stock medications based on how often they're dispensed, and a drug that only a handful of patients need simply may not make the cut for regular inventory.

2. There's Only One Manufacturer

Unlike many common medications that have multiple generic manufacturers, Orilissa is only made by AbbVie. There is no generic version of Elagolix available as of 2026. When a drug has a single source, any disruption in manufacturing or distribution can ripple through to pharmacy shelves. Even without an official shortage, supply chain bottlenecks can make it temporarily unavailable.

3. High Cost Limits Pharmacy Stocking

Orilissa is expensive — a 28-day supply can cost between $1,200 and $1,700 without insurance. Many pharmacies are reluctant to stock a high-cost medication that might sit on the shelf. If a pharmacy orders Orilissa and no one picks it up, they're left holding a very expensive product. This financial risk means fewer pharmacies carry it routinely.

4. Insurance and Prior Authorization Hurdles

Most insurance companies require prior authorization before covering Orilissa, and some impose step therapy requirements — meaning you must try other treatments first (like NSAIDs or hormonal birth control). These delays can create a confusing situation where your doctor has prescribed it, but your pharmacy can't or won't dispense it until insurance approval comes through.

What You Can Do to Find Orilissa

If you're struggling to find Orilissa in stock, here are some practical steps:

• Use Medfinder to search for pharmacies near you that have Orilissa in stock right now. It's free, fast, and updated regularly.
• Call specialty pharmacies. Specialty pharmacies are more likely to stock expensive, niche medications like Orilissa. Ask your doctor or insurance company which specialty pharmacy is in your network.
• Ask your pharmacy to order it. Even if your local pharmacy doesn't stock Orilissa, they can usually order it from their wholesaler. It may take 1–3 business days to arrive.
• Check with your prescriber's office. Some OB/GYN and reproductive endocrinology offices have relationships with specialty pharmacies or can direct you to ones that routinely carry Orilissa.

For more tips, read our guide on how to find Orilissa in stock near you.

Final Thoughts

Orilissa is an effective treatment for endometriosis pain, but finding it can be a challenge. The combination of low demand, a single manufacturer, high cost, and insurance barriers makes it one of those medications that requires a little extra effort to track down. The good news is that with the right tools and persistence, you can find it.

If you're also concerned about the cost, check out our article on how to save money on Orilissa in 2026. And if you and your doctor are considering other options, take a look at our overview of alternatives to Orilissa.