CYP3A4 and hepatic porphyria: Elagolix is an oral GnRH-A that is FDA-approved for the treatment of moderate to severe pain associated with endometriosis (Lamb, 2018), however unlike leuprolide, it induces CYP3A and a fluorescence-based drug porphyrogenicity screening assay in Leghorn Male Hepatoma (LMH) cells demonstrated that it is porphyrogenic and associated with increased acute porphyria attacks in women (Ma and Bonkovsky, 2022).