Formulary
Osilodrostat: Indications, Dosing, Side Effects and Interactions
Osilodrostat is a potent inhibitor of 11-hydroxylase, the enzyme that catalyses the last step of cortisol synthesis in the adrenal gland, thereby lowering...
MedNext Academy | 3 min read
Osilodrostat: Indications, Dosing, Side Effects and Interactions
Osilodrostat is a potent inhibitor of 11-hydroxylase, the enzyme that catalyses the last step of cortisol synthesis in the adrenal gland, thereby lowering...
Drug action
Osilodrostat is a potent inhibitor of 11-hydroxylase, the enzyme that catalyses the last step of cortisol synthesis in the adrenal gland, thereby lowering cortisol levels.
Indications and dose
**Endogenous Cushing's syndrome (under expert supervision)**
- **Adult** (By Mouth): (patients of Asian origin) 1 mg twice daily, increased, if tolerated, in steps of 1-2 mg initially, no more frequently than once every 1-2 weeks, adjusted according to response; usual maintenance 2-7 mg twice daily (max. per dose 30 mg twice daily), for dose reduction or treatment interruption due to low cortisol levels or QT-interval prolongation-consult product literature.
Cautions
Patients of Asian origin (increased bioavailability); risk factors for QT-interval prolongation
Side effects
Common or very common Abdominal pain; adrenal hypofunction; appetite decreased; diarrhoea; dizziness; fatigue; headache; hirsutism; hypokalaemia; hypotension; malaise; nausea; oedema; QT interval prolongation; skin reactions; syncope; tachycardia; vomiting
Pregnancy
Avoid-toxicity in animal studies. M
Breast feeding
Discontinue breast-feeding during treatment and for at least 1 week after last treatment-no information available. M
Hepatic impairment
Caution (limited information available)-consider more frequent monitoring of adrenal function during dose titration. M Dose adjustments In moderate impairment, a starting dose of 1 mg twice daily is recommended. In severe impairment, a starting dose of 1 mg once daily in the evening, increased initially to 1 mg twice daily, is recommended. M
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Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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