Korlym Disease Interactions

Mifepristone is contraindicated in patients with serious medical conditions, such as patients requiring treatment with systemic corticosteroids for immunosuppression after organ transplantation. Mifepristone antagonizes the effects of glucocorticoids.

Mifepristone is contraindicated in women with unexplained vaginal bleeding, and women with endometrial hyperplasia with atypia or endometrial carcinoma, as it promotes endometrial proliferation that may result in endometrium thickening, cystic dilatation of endometrial glands, and vaginal bleeding. It should also be used with caution in women with hemorrhagic disorders or those receiving anticoagulation therapy.

Mifepristone does not reduce serum cortisol levels, and elevated cortisol levels might activate mineralocorticoid receptors which are expressed in cardiac tissue. Caution should be used in patients with underlying heart conditions, including heart failure and coronary vascular disease.

There is limited information on the safety of mifepristone in patients with mild to moderate hepatic impairment, hence the manufacturers recommend that the maximum dose should not exceed 600 mg per day. The use of mifepristone is not recommended in patients with severe hepatic disease as the pharmacokinetics in these patients have not been studied.

Mifepristone prolongs the QTc interval in a dose-related manner. There is little or no experience with high exposure, concomitant dosing with other QT- prolonging drugs, or potassium channel variants resulting in long QT interval. Caution and monitoring is advised if used in patients with long QT. To minimize risk, the lowest effective dose should always be used.

No change in the initial dose of mifepristone is needed for renal impairment; but the manufacturers recommend that the maximum dose should not exceed 600 mg per day in these patients.