Oriahnn (elagolix, estradiol, and norethindrone acetate) is a prescription drug that treats heavy periods from uterine fibroids. Oriahnn can cause side effects that range from mild to serious. Examples include hot flashes and headache.

Specifically, Oriahnn is used in females undergoing premenopause to treat heavy menstrual bleeding from uterine fibroids. (In this article, we use the term ”female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.)

The active ingredient in Oriahnn is elagolix, estradiol, and norethindrone acetate. The drug comes as an oral capsule.

Keep reading to learn about the common, mild, and serious side effects that Oriahnn can cause. For a general overview of the drug, including details about its uses, see this article.

Oriahnn has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Side effects explained” section below.

Some people may experience mild to serious side effects during their Oriahnn treatment. Examples of the drug’s commonly reported side effects include:

  • fatigue (low energy)
  • headache
  • atypical vaginal bleeding
  • hot flashes

The following sections include more side effects of Oriahnn. Each person’s experience with side effects may differ.

Mild side effects have been reported with Oriahnn. These include:

  • weight gain
  • nausea or vomiting
  • headache
  • fatigue (low energy)
  • hot flashes
  • joint stiffness
  • decreased sex drive
  • unusual vaginal bleeding
  • bloating

In most cases, these side effects should be temporary. And some may be managed easily. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Oriahnn unless your doctor recommends it.

Oriahnn may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Serious side effects have been reported with Oriahnn. These include:

You can learn more about the following side effects in the “Side effects explained” section below:

  • bone loss
  • suicidal thoughts or behaviors
  • boxed warning: risk of blood clots and blood circulation problems

If you develop serious side effects while taking Oriahnn, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911. Or call your local emergency number.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Oriahnn, visit MedWatch.

Allergic reaction

For some people, Oriahnn can cause an allergic reaction.

Oriahnn contains FD&C Yellow No. 5 (tartrazine). This ingredient can cause allergic reaction, such as asthma, in some people. Not many people are sensitive to tartrazine, but those who are also may react to aspirin.

In general, symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They also can determine whether you should keep taking Oriahnn.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 right away. Or call your local emergency number. These symptoms could be life threatening and require immediate medical care.

Your doctor can confirm whether you’ve had a serious allergic reaction to Oriahnn. If you have, they may switch you to a different treatment.

Get answers to some frequently asked questions about Oriahnn’s side effects.

What are the differences between side effects of Oriahnn and Myfembree?

Overall, the side effects and warnings are similar for Oriahnn and Myfembree. But weight gain was not observed in Myfembree studies. In addition, Myfembree studies noted rare occurrences of uterine fibroids detaching or protruding from the uterus. These instances resulted in bleeding.

Oriahnn and Myfembree are both approved to treat heavy menstrual bleeding from uterine fibroids.

Oriahnn’s active ingredients are elagolix, estradiol, and norethindrone acetate. Myfembree’s active ingredients are relugolix, estradiol, and norethindrone acetate.

Both drugs contain estrogen (estradiol) and progestin (norethindrone acetate). Estrogen is a natural hormone. Progestin is a synthetic form of progesterone, which is a hormone.

To learn more about Oriahnn vs Myfembree, check with your doctor or pharmacist.

Can Oriahnn cause weight loss?

Oriahnn studies didn’t report weight loss.

But the studies did report weight gain.

If you have unexpected weight gain while taking Oriahnn, it could be a sign of pregnancy. So consider taking a pregnancy test. And if you do become pregnant while taking Oriahnn, stop taking it right away and call your doctor.

Does Oriahnn shrink uterine fibroids?

Oriahnn decreases the amount of estrogen circulating in the body. Estrogen is a natural hormone. This may reduce the size of uterine fibroids slightly and stop bleeding. But if you were to stop Oriahnn, the fibroids would return.

The usual treatment to remove uterine fibroids is a hysterectomy, which is the removal of the uterus by surgery. Less invasive treatments for uterine fibroids may be available, including some without hormones.

Ask your doctor about your options.

Keeping track of side effects

During your Oriahnn treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Oriahnn affects you. They can then use this information to adjust your treatment plan if needed.

Learn more about some of the side effects Oriahnn may cause.

Boxed warning: Risk of blood clots and blood circulation problems

Oriahnn has a boxed warning about the risk of blood clots and blood circulation problems. A boxed warning is the most serious warning from the FDA.

Blood clots and blood circulation problems were uncommon side effects reported in studies of Oriahnn. Blood clots and blood circulation problems may cause:

  • blood clot in the lower leg or lung
  • stroke
  • heart attack
  • vision loss (from a clot in a blood vessel in the eye)

Factors that can increase the risk of blood clots and blood circulation problems when taking this drug include:

What might help

While taking Oriahnn, you can decrease your risk of blood clots by:

  • maintaining a moderate weight, blood pressure, and cholesterol level
  • scheduling routine eye exams
  • quitting smoking, if applicable
  • avoiding long periods of sitting

Also, watch for signs of a heart attack, stroke, or blood clot, such as:

  • sudden shortness of breath or coughing up blood
  • pain or squeezing pressure in the chest
  • face drooping on one side
  • difficulty speaking, seeing, or thinking
  • sudden numbness in arms, legs, or face
  • sudden vision loss
  • painful back of the lower leg with warm, swollen skin that’s red or deepened in color

If you experience any of these symptoms, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Bone loss

Bone loss and fracture were common side effects reported in studies of Oriahnn. This is because the drug decreases estrogen that circulates in the body, similar to what occurs in menopause.

People who have osteoporosis should not take Oriahnn. Your doctor will schedule a bone mineral density scan before and after your treatment.

Oriahnn can cause bone loss that may not be reversible. Due to this, your doctor will limit your treatment with Oriahnn to 24 months.

Some persons in Oriahnn studies partially or fully recovered bone density after stopping the medication. On the other hand, some participants lost bone density during the 12 months after stopping Oriahnn.

Factors that can increase the risk of bone loss when taking Oriahnn include:

  • use of other medications that cause bone loss (corticosteroids, acid-reducing drugs, antiseizure drugs)
  • a diet low in calcium and vitamin D
  • a history of fractures

What might help

While taking Oriahnn, you can decrease your risk of bone fractures and bone loss by:

  • taking a vitamin D and calcium supplement
  • doing weight-bearing exercises such as moderate weightlifting or brisk walking
  • adopting a safety-first mindset (examples: wearing a bike helmet, using safe step stools, removing household trip hazards)

Suicidal thoughts or behaviors

Suicidal thoughts or behaviors are possible side effects of Oriahnn. Suicidal thoughts or behaviors may cause symptoms such as:

Factors that can increase the risk of suicidal thoughts or behaviors when taking this drug include:

What might help

If you have suicidal thoughts or behaviors during Oriahnn treatment, call 911 right away. And seek help from a crisis line.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Below is important information you should consider before taking Oriahnn.

Boxed warning: Risk of blood clots and blood circulation problems

Oriahnn has a boxed warning about the risk of blood clots and blood circulation problems. A boxed warning is the most serious warning from the FDA. For details, see the “Side effects explained” section above.

Other warnings

Oriahnn can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors also may affect whether Oriahnn is a good treatment option for you.

Talk with your doctor about your health history before you take Oriahnn. Be sure to tell them if any of the following factors apply to you:

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.