Available forms
Relugolix is available in the form of 40 and 120 mg oral tablets. Side effects
The main side effects of relugolix for uterine fibroids include abnormal uterine bleeding (24.6–48.6% vs. 6.3% for placebo), hot flashes (42.8–45.5% vs. 0% for placebo), heavy menstrual bleeding (12.1–49.3% vs. 9.4% for placebo), headache (12.3–15.2%), and excessive sweating (9.4–15.2% vs. 0% for placebo). In addition, decreased bone mineral density occurs with relugolix (21.7% decrease by week 12, 24.4% decrease by week 24). Pharmacology
Pharmacodynamics
Relugolix is a selective antagonist of the gonadotropin-releasing hormone receptor (GnRHR), with a half-maximal inhibitory concentration (IC50) of 0.12 nM.A dosage of relugolix of 40 mg once per day has been found to suppress estradiol levels to postmenopausal levels (<20 pg/mL) within 24 hours in premenopausal women. In the control group of women, estradiol levels fluctuated between 50 and 250 pg/mL. Estradiol levels have been found to return to normal concentrations within 4 weeks of discontinuation of relugolix in premenopausal women. The medication additionally suppresses levels of progesterone, luteinizing hormone, and follicle-stimulating hormone in premenopausal women. Relugolix at a dosage of 40 mg or more once per day has been found to reduce testosterone levels to sustained castrate levels (<20 ng/dL) in men. It additionally suppresses luteinizing hormone and follicle-stimulating hormone levels in men.Lower doses of relugolix (<40 mg/day) are under investigation for achieving partial sex hormone suppression in the treatment of endometriosis and uterine fibroids.
As of June 2016, Vaxchora was the only FDA-approved vaccine for the prevention of cholera. The Vaxchora vaccine can cost more than US$250. References
Further reading
World Health Organization (2010). The immunological basis for immunization series: module 14: cholera. World Health Organization (WHO). hdl:10665/44367. ISBN 9789241599740. Ramsay M, ed. (2013). "Chapter 14: Cholera". Immunisation against infectious disease. Public Health England. Centers for Disease Control and Prevention (2017). "Cholera". CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press. Cholera and enterotoxigenic escherichia coli (ETEC) travellers diarrhea vaccine: Canadian Immunization Guide. Health Canada (Report). External links
"Cholera Vaccine Information Statement". Centers for Disease Control and Prevention (CDC). 23 October 2019. Cholera Vaccines at the US National Library of Medicine Medical Subject Headings (MeSH)