11β-hydroxylase inhibitor
Osilodrostat
Brand names: Isturisa
Adult dose
Dose: Initial 2mg PO BD, titrate; max 30mg BD
Route: PO
Frequency: BD
Clinical pearls
- Endogenous Cushing's syndrome; specialist endocrine
- Monitor for cortisol-deficiency symptoms (block-and-replace approach if dosing high)
Contraindications
- Concurrent strong CYP3A4 inducers
- Pregnancy
- Hypersensitivity
Side effects
- Adrenal insufficiency
- Hypokalaemia
- Oedema
- QT prolongation
- Hirsutism
- Hypertension
Interactions
- Strong CYP3A4 modulators
- QT-prolonging drugs
Monitoring
- Cortisol
- ACTH
- K+
- ECG
- BP
Reference: BNF; NICE TA928 (Osilodrostat); SmPC; https://bnf.nice.org.uk/drugs/osilodrostat/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016