metyrapone (Metopirone)
Jump to navigation
Jump to search
Introduction
Tradename: Metopirone.
Indications
- diagnostic aid for hypothalamic-pituitary ACTH function
Dosage
- discontinue all corticosteroid therapy prior to & during administration
- day 1: control period: collect 24 hour urine to measure 17-hydroxycorticosteroids &/or 17-ketosteroids
- day 2: ACTH test: standard cosyntropin stimulation test
- days 3 & 4: rest period
- day 5: administer metyrapone, preferably with milk or snack children: 15 mg/kg every 4 hours for 6 doses; minimum of 250 mg/dose adults: 750 mg every 4 hours for 6 doses
- day 6: measure 24 hour urine steroids for effect
Tabs: 250 mg
Adverse effects
- not common (1-10%)
- fall in arterial blood pressure, increase in pulse rate, dizziness, vertigo, headache, sedation, allergic rash, nausea, abdominal discomfort, bone marrow suppression
Mechanism of action
- blocks cortisol synthesis by inhibiting cyt P450 11B (steroid 11-beta-hydroxylase)
- compensatory increase in plasma 11-deoxycortisol
More general terms
Additional terms
- adrenocorticotropic hormone; corticotropin; adrenocorticotropin (ACTH)
- cosyntropin (ACTH, Cortrosyn) stimulation test (delta cortisol test)
- metyrapone stimulation test
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Department of Veterans Affairs, VA National Formulary
- ↑ Wikipedia: Metyrapone http://en.wikipedia.org/wiki/Metyrapone