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Metyrapone (Metopirone) ๐
Related Subjects: |Adrenal Adenomas |Adrenal Cancer |Cushing Syndrome |Cushing Disease
โ ๏ธ Metyrapone is an adrenal steroid synthesis inhibitor. It is used rarely in treatment of Cushingโs syndrome and more commonly as a diagnostic test of pituitary ACTH function. Always check the BNF link here.
โ๏ธ Mode of Action
- Pyridine derivative that blocks cortisol synthesis.
- Mainly inhibits 11ฮฒ-hydroxylase โ โ cortisol.
- Reduced cortisol โ โ ACTH (if pituitary is intact) โ โ 11-deoxycortisol.
- Rapidly effective in ~50% of hypercortisolic states.
๐ Indications & Dose
- Cushingโs syndrome: Occasionally used when surgery or other medical therapy is unsuitable.
- Diagnostic test: โMetyrapone testโ to assess pituitary ACTH reserve (less used now, but exam favourite).
๐ Interactions
- See full list in BNF.
โ ๏ธ Cautions
- Monitor for adrenal insufficiency, particularly in patients with reduced adrenal secretory capacity.
- Use with caution in hepatic impairment.
๐ซ Contraindications
- Risk of precipitating acute adrenal insufficiency in patients with limited adrenal reserve.
โ Side Effects
- Dizziness, sedation.
- Hypokalaemia (low potassium).
- Hyperandrogenism (hirsutism, acne, menstrual irregularities in women).
๐ References
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