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Elagolix + estradiol + norethindrone acetate is a fixed-dose oral combination drug for the treatment of heavy menstrual bleeding associated with uterine leiomyomas (fibroids) in premenopausal women. Oriahnn contains elagolix (a gonadotropin-releasing hormone [GnRH] receptor antagonist), estradiol (an estrogen), and norethindrone acetate (a progestin). Elagolix inhibits endogenous GnRH signaling by competitively binding to GnRH receptors in the pituitary, suppressing luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion and lowering estradiol and progesterone levels. Estradiol supplementation reduces bone loss associated with elagolix, while norethindrone acetate protects against estrogen-induced endometrial hyperplasia. Oriahnn is administered orally—one combination capsule in the morning and an elagolix-only capsule in the evening. The medication is approved for up to 24 months of use due to the risk of irreversible bone loss. Major warnings include a significantly increased risk of thromboembolic and vascular events in women at risk and other class-associated adverse reactions[1][3][4][7].
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