The Sicilian-French tenor had been scheduled to sing the role of Manrico three times during Trovatore's June 7-29 run at the Real.
His official web site at Universal Music says, "Because of the various rumors that have been circulating on the Internet and in the newspapers about Roberto Alagna, he would like to reassure his fans. He is in very good health but he has to cancel his engagement in Madrid in order to have a general check-up and rest for a few days."
Alagna's most notorious recent cancellation, of course, was his walkout in the middle of a performance of Aida at La Scala last December.