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Myfembree
Myfembree is a combination medication used to treat heavy menstrual bleeding associated with uterine fibroids in premenopausal women. It contains relugolix, an oral gonadotropin-releasing hormone (GnRH) antagonist, estradiol, an estrogen, and norethindrone acetate, a progestin. Myfembree helps reduce menstrual bleeding by regulating hormone levels and decreasing estrogen production, which shrinks fibroids and reduces related symptoms such as heavy bleeding and pain.
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Frequently Asked Questions
How long does it take for Myfembree to reduce bleeding?
Many women start to notice a reduction in menstrual bleeding within the first 1-2 months of treatment. Full benefits may take a few months to be observed.
Can I become pregnant while taking Myfembree?
Yes, pregnancy is possible while taking Myfembree. You should use a reliable non-hormonal contraceptive method (such as condoms) during treatment, as Myfembree may harm a developing fetus.
What should I do if I miss a dose of Myfembree?
If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Can I take Myfembree for longer than 24 months?
Myfembree is generally not recommended for use longer than 24 months due to the risk of bone density loss. Your doctor will assess the benefits and risks of extending treatment based on your individual health needs.
What should I do if I experience heavy bleeding after stopping Myfembree?
Some women may experience heavy or prolonged bleeding after discontinuing Myfembree. If this occurs, contact your healthcare provider for further evaluation and management.
Comprehensive Drug Guide
How Does Myfembree Work?
- Relugolix suppresses ovarian production of estrogen by blocking GnRH receptors in the pituitary gland, reducing hormone stimulation that causes fibroid growth.
- Estradiol is added to help reduce the risk of bone loss caused by decreased estrogen levels from relugolix.
- Norethindrone acetate is a progestin that helps protect the lining of the uterus and balance the effects of estradiol.
Together, these ingredients help reduce menstrual bleeding and shrink uterine fibroids while maintaining hormone balance to prevent side effects like bone loss.
Common Dosages
- One tablet once daily containing relugolix 40 mg, estradiol 1 mg, and norethindrone acetate 0.5 mg.
Typical Dosing
- The typical dose of Myfembree is one tablet once daily, taken at the same time each day with or without food.
- It is typically prescribed for up to 24 months, as long-term use may increase the risk of bone density loss.
Typical Dosing
FDA Approved Indications
- Treatment of heavy menstrual bleeding associated with uterine fibroids in premenopausal women.
Who Shouldn't Take Myfembree?
- Known hypersensitivity to any component of the medication.
- Undiagnosed abnormal uterine bleeding.
- Current or past history of blood clots (deep vein thrombosis, pulmonary embolism), heart attack, or stroke.
- Severe liver disease.
- Breast cancer or other hormone-sensitive cancers.
- Pregnancy or women who are trying to conceive.
Advice From The Pharmacist
- Take Myfembree at the same time every day, with or without food, to maintain consistent hormone levels.
- Use reliable non-hormonal contraception while taking Myfembree, as the medication may cause harm to an unborn baby if taken during pregnancy.
- Do not miss doses. Missing doses may reduce the effectiveness of the medication and could lead to an increased risk of symptoms returning or side effects.
- Bone density loss may occur with long-term use, so your healthcare provider may monitor bone health periodically.
- Avoid smoking while taking Myfembree, as it can increase the risk of cardiovascular side effects such as blood clots or stroke.
Side Effects of Myfembree
Common Side Effects
- Hot flashes
- Night sweats
- Headache
- Nausea
- Fatigue
- Decreased sex drive
- Heavy or prolonged bleeding when stopping the medication
Uncommon/Severe Side Effects
- Blood clots (deep vein thrombosis, pulmonary embolism)
- Cardiovascular events such as stroke or heart attack
- Liver problems, characterized by symptoms like yellowing of the skin or eyes (jaundice), dark urine, or severe fatigue.
- Bone loss (osteoporosis) with long-term use
Risks and Warnings of Myfembree
- Bone density loss: Long-term use of Myfembree can lead to decreased bone mineral density, increasing the risk of osteoporosis. It is recommended that treatment does not exceed 24 months unless otherwise directed by a healthcare provider.
- Blood clot risk: Myfembree can increase the risk of serious blood clots, especially in smokers or individuals with a history of clotting disorders. Patients should avoid smoking and discuss any personal or family history of blood clots with their doctor.
- Pregnancy risk: Myfembree is contraindicated in pregnancy. Women must use effective non-hormonal contraception while taking the medication, as it may harm a developing fetus.
Interactions with Myfembree
Common Drug Interactions
- Hormonal contraceptives: Myfembree should not be taken with hormonal contraceptives as it may alter hormone levels and reduce the effectiveness of either treatment.
- Anticoagulants: Myfembree may affect blood clotting, so it should be used cautiously in patients taking blood thinners like warfarin or heparin.
- Strong CYP3A4 inhibitors (e.g., ketoconazole): May increase the blood levels of relugolix, increasing the risk of side effects.
Alternatives to Myfembree
- Oriahnn: A combination of elagolix, estradiol, and norethindrone acetate, also used to treat heavy menstrual bleeding due to uterine fibroids.
- Gonadotropin-releasing hormone (GnRH) agonists: Like leuprolide (Lupron) for fibroid management, though they may cause more pronounced menopausal symptoms.
- Uterine fibroid embolization (UFE): A non-surgical procedure to shrink fibroids.
- Surgical options: Such as myomectomy (fibroid removal) or hysterectomy for those seeking more definitive treatments.
