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Generic name: osilodrostat [ O-sil-OH-droe-stat ]
Brand name: Isturisa
Dosage form: oral tablet (1 mg; 10 mg; 5 mg)
Drug class: Adrenal corticosteroid inhibitors

Medically reviewed by on Apr 26, 2023. Written by Cerner Multum.

What is osilodrostat?

Osilodrostat is used in adults to treat Cushing's disease that cannot be treated with pituitary surgery.

Osilodrostat may also be used for purposes not listed in this medication guide.

Osilodrostat side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Osilodrostat may cause serious side effects. Call your doctor at once if you have:

Common side effects of osilodrostat may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Osilodrostat can cause serious side effects, such as heartbeat problems or decreased adrenal gland hormones. Call your doctor at once if you have irregular heartbeats, stomach pain, vomiting, loss of appetite, tiredness, or feeling light-headed.

Before taking this medicine

Tell your doctor if you have ever had:

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether osilodrostat will harm an unborn baby. However, having Cushing's disease during pregnancy may cause complications such as diabetes or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating Cushing's disease may outweigh any risks to the baby.

Do not breastfeed while using osilodrostat, and for at least 1 week after your last dose.

Osilodrostat is not approved for use by anyone younger than 18 years old.

How should I take osilodrostat?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take osilodrostat with or without food.

Your doctor will check your heart function using an electrocardiograph or ECG (sometimes called an EKG). Your next dose may be delayed based on the results of your ECG or other medical tests.

Do not change your dose or dosing schedule without your doctor's advice.

Store at room temperature away from moisture and heat.

Osilodrostat dosing information

Usual Adult Dose for Cushing's Syndrome:

Initial dose: 2 mg orally twice a day
Titration: Initially by 1 to 2 mg twice a day, no more frequently than every 2 weeks
-Further titration (after reaching 10 mg orally twice a day): By 5 mg twice a day every 2 weeks
Maximum dose: 30 mg orally twice a day

-The dose should be titrated based on rate of cortisol changes, individual tolerability, and individual improvement in signs/symptoms of Cushing's disease.
-If a patient tolerates 10 mg twice a day and continues to have elevated 24-hour urine free cortisol (UFC) level above the upper limit of normal (ULN), the dosage can be titrated further by 5 mg twice a day every 2 weeks.
-Cortisol levels should be monitored from at least two 24-hour UFC collections every 1 to 2 weeks until adequate clinical response is maintained.
-The maintenance dosage is individualized and determined by titration based on cortisol levels and patient's signs/symptoms; the maintenance dosage varied between 2 and 7 mg twice a day in clinical trials.
-Once maintenance dosage achieved, cortisol levels should be monitored at least every 1 to 2 months or as indicated.

Use: For the treatment of patients with Cushing's disease for whom pituitary surgery is not an option or has not been curative

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, stomach pain, extreme tiredness, feeling light-headed, or fainting.

What should I avoid while taking osilodrostat?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What other drugs will affect osilodrostat?

Osilodrostat can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Other drugs may affect osilodrostat, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.