What are the indications, dosage and side effects of Ryeqo?

(Myfembree) is suitable for women of childbearing age to treat moderate to severe symptoms related to uterine fibroids. One tablet is taken orally daily. Common side effects include: hot flashes, excessive uterine bleeding, irregular or continuous bleeding, hair loss, etc.

About Ryeqo

Drug therapy is currently a hot topic in the field of uterine fibroid treatment. Gonadotropin-releasing hormone agonists (GnRH-a), such as leuprolide acetate, are the most commonly used and effective drugs in the clinical treatment of uterine fibroids, but their use is limited to short-term effects. In recent years, Ryeqo, an orally active non-peptide GnRH receptor antagonist, is expected to provide new treatment options for patients with uterine fibroids.

Ryeqo indications

1. In 2019, Ryeqo was approved by the Pharmaceutical and Medical Devices Agency (PMDA) to improve symptoms such as menorrhagia, low back pain, lower abdominal pain and anemia caused by uterine fibroids, and was launched in Japan under the trade name Relumina (40mg tablets).

2. On May 26, 2021, a compound preparation containing this drug (Ryeqo 40 mg, estradiol 1.0 mg, norethindrone acetate 0.5 mg) was approved by the US FDA for the treatment of female uterine fibroids. The trade name is Myfembree. The drug is taken orally once a day, and the effective treatment duration can be up to 24 months.

Ryeqo usage and dosage

1. Take one tablet of MYFEMBREE once a day at about the same time, with or without food.

2. Start taking MYFEMBREE as soon as possible after the start of menstruation, but no later than 7 days after the start of menstruation.

3. The recommended total duration of MYFEMBREE treatment is 24 months.

Missed dose of Ryeqo

Take the missed dose of MYFEMBREE as soon as possible that day, then resume regular dosing at your normal time the next day.

Dosage adjustments for Ryeqo when used concomitantly with P-gp inhibitors

Avoid coadministration of MYFEMBREE with oral P-gp inhibitors. If concurrent use is unavoidable, take MYFEMBREE first and at least 6 hours between doses.

Ryeqo drug interactions

1. Combined administration of P-gp and moderate CYP3A inhibitors: Coadministration with erythromycin (P-gp and moderate CYP3A inhibitors) increased the AUC and Cmax of Ryeqo by 6.2 times.

2. Combined administration with strong inducers of P-gp and CYP3A: Coadministration with rifampicin (strong inducers of P-gp and CYP3A) reduced the AUC and Cmax of Ryeqo by 55% and 23% respectively.

3. Other drugs: No clinically significant differences in the pharmacokinetics of Ryeqo were observed when combined with voriconazole (a strong inhibitor of CYP3A), fluconazole (a moderate inhibitor of CYP3A), or atorvastatin (a weak inhibitor of CYP3A). No clinically significant differences in the pharmacokinetics of midazolam (a sensitive CYP3A substrate) or rosuvastatin (a BCRP substrate) were observed when coadministered with Ryeqo.

Ryeqo side effects

Common side effects of Ryeqo include: hot flashes, excessive uterine bleeding, irregular or persistent bleeding (uterine bleeding), hair loss, decreased interest in sex, irritability, increased sweating, lumps in the breast tissue (breast cysts), indigestion, night sweats, etc.

Treatment measures

1. Hot flashes: Hot flashes are one of the common side effects of Ryeqo. You can try adjusting your room temperature, wearing lighter clothing, and avoiding factors such as spicy foods and caffeine that may aggravate hot flashes. If hot flashes significantly affect your quality of life, it is recommended to consult your doctor, who may consider adjusting your dosage or providing other treatment recommendations.

2. Excessive, irregular or continuous uterine bleeding: If uterine bleeding occurs, it is recommended to consult a doctor in time. They may check the health of your uterus and recommend appropriate treatment depending on the situation.

3. Hair loss: Hair loss is a common side effect of medications. Although hair loss is usually temporary, it is recommended to talk to your doctor if you are feeling unwell or concerned. They may give advice on hair care or consider adjustments to your treatment plan.

4. Decreased interest in sex: If you feel that your interest in sex has decreased, it is recommended to communicate with your doctor. They can assess whether it is drug-related and provide advice or adjust treatment accordingly.

5. Irritability, increased sweating, indigestion, night sweats, etc.: These side effects may be related to drug treatment. If these symptoms are severe or continue to affect your quality of life, please contact your doctor promptly who can evaluate your situation and make adjustments as needed.

Summary

As the first oral GnRH receptor antagonist, Ryeqo has fast onset of action, short half-life and rapid recovery after drug withdrawal.

Gland axis function and other advantages. Current research results show that Ryeqo can treat and improve symptoms such as HMB, pain and pelvic discomfort caused by uterine fibroids in women, with significant clinical effects and can greatly improve the quality of life of patients.

However, using Ryeqo alone can cause adverse reactions such as hot flashes and BMD loss. When combined with low-dose estradiol and norethindrone acetate, the symptoms of hypoestrogenism caused by Ryeqo alone are significantly reduced, and the drug is safe and well tolerated by patients.

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