The last day of operation for Hertfordshire and West Essex ICB was 31 March 2026. The information on this website has not been updated since 31 March 2026. The legacy policies, prescribing recommendations and pathways can be accessed on this website. Find out more

Indication
Endometriosis
RAG rating
Amber initiation
Document type
Decision document
Place
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing

Relugolix-estradiol-norethisterone acetate (Ryeqo)

HERTFORDSHIRE AND WEST ESSEX AREA PRESCRIBING COMMITTEE (HWE APC)

Relugolix-estradiol-norethisterone acetate for treating symptoms of endometriosis


AMBER INITIATION

Recommended for initiation by specialists, ongoing prescribing in primary care.

 

Name generic (trade): Relugolix-estradiol-norethisterone (Ryeqo®)

What it is: Non-peptide GnRH receptor antagonist 

Indication: Licensed for symptomatic treatment of endometriosis in women with a history of previous medical or surgical treatment for their endometriosis

Date decision last revised: June 2025

NICE: NICE TA 1057 recommended

 

HWE APC recommendation:

Relugolix–estradiol–norethisterone (relugolix combination therapy, Ryeqo®) is recommended in line with the recommendations of NICE TA1057 and can be used, within its marketing authorisation, as an option for treating symptoms of endometriosis in adults of reproductive age who have had medical (e.g. pain relief and hormonal treatment) or surgical treatment for endometriosis.


AMBER INITIATION

Specialists responsibilities include: 

At initiation

  • provide information to the patient relating to the safe and effective use such as, but not limited to, ongoing BMD monitoring requirements and advice on contraception.
  • advise patient on action to take if intolerance/significant side-effects develop prior to next follow up appointment and advise, if required, to contact initiating specialist for further treatment advice. 

This information should be included in the clinic letter to primary care clinicians

 

During follow up care

  • to arrange and review DEXA scan (recommended after one year of treatment) and ongoing BMD monitoring thereafter.
  • to undertake initial and follow up reviews for efficacy and tolerance and advise primary care of the ongoing treatment plan. 

During treatment, periodic check-ups must be carried out according to standard clinical practice.

Further information: for latest updates and more detailed information, including contra-indications, cautions and special warnings; please refer to summary of product characteristics SPC)


Relugolix combination therapy is a black Triangle drug ▼ report all suspected adverse reactions at Yellow Card | Making medicines and medical devices safer.


Version number
1.0
Developed by
Pharmacy and Medicines Optimisation Team, Hertfordshire and West Essex (HWE) ICB with relevant HWE ICS stakeholders.
Approved by
Hertfordshire & West Essex Area Prescribing Committee
Date approved / updated
June 2025
Review date
This HWE APC recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.
Superseded version
N/A
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