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Recorlev

Pronunciation: re-kor-lev
Generic name: levoketoconazole
Dosage form: oral tablets (150 mg)
Drug class: Adrenal corticosteroid inhibitors

Medically reviewed by Carmen Pope, BPharm. Last updated on Jul 9, 2025.

What is Recorlev?

Recorlev is used to treat high cortisol (endogenous hypercortisolemia) levels in adults with Cushing’s syndrome (CS) who cannot have surgery or who have had surgery that did not cure their Cushing's syndrome. It is an oral tablet that is taken 2 times a day.

Recorlev is a prescription medicine but is not available through every pharmacy. PANTHERx Rare Pharmacy is the only pharmacy that carries it, and they will deliver it right to you. Your support team will make sure you receive your treatment.

Recorlev works by blocking three key enzymes that make cortisol and testosterone in the body: CYP11B1, which produces cortisol; CYP11A1, which starts converting cholesterol to hormones; and CYP17A1, which helps make both cortisol and testosterone. This blocking action reduces cortisol production and helps return cortisol levels to normal. Recorlev belongs to the drug class called cortisol synthesis inhibitors.

Recorlev (levoketoconazole) gained FDA approval on December 30, 2021. There is no generic. It is not approved for the treatment of fungal infections.

Side effects

The most common side effects of Recorlev are:

Recorlev may cause fertility problems in females and males, which may affect your ability to have children. Talk to your healthcare provider if you have concerns about fertility.

Serious side effects and warnings

Recorlev carries a Boxed Warning for liver damage and QT prolongation.

Liver damage (hepatotoxicity). Hepatotoxicity can happen in people who take Recorlev. Some people who are treated with ketoconazole, a medicine like the active ingredient in Recorlev, had serious liver problems that required a liver transplant or led to death. Call your healthcare provider right away if you have any of the following signs or symptoms:

Recorlev should not be used if you have any of the following conditions:

Your healthcare provider will do liver tests before and during treatment with Recorlev.

Heart rhythm problems (QT prolongation). Recorlev can cause a heart problem called QT interval prolongation, or QT prolongation. QT prolongation can cause irregular heartbeats that can be life-threatening. Call your healthcare provider right away if you feel severe lightheadedness or if you faint during treatment with Recorlev.

Recorlev can cause other serious side effects, including:

Your healthcare provider will collect blood or urine samples to measure your cortisol.

These are not all the possible side effects of Recorlev. Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA1088.

Before taking

Do not take Recorlev if you:

Before taking Recorlev, tell your healthcare provider about all of your medical conditions, including if you:

Your healthcare provider will obtain baseline liver and electrocardiogram tests and correct low potassium levels (hypokalemia) or low magnesium levels ( hypomagnesemia) before starting Recorlev.

Pregnancy

Recorlev may harm your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with Recorlev or think you might be pregnant.

Breastfeeding

Recorlev can pass into your breast milk. You and your healthcare provider should decide if you should take Recorlev or breastfeed. You should not breastfeed during treatment with Recorlev and for 1 day after the final dose.

How should I take Recorlev?

Take Recorlev exactly as your healthcare provider tells you. Your healthcare provider will tell you how much Recorlev to take and when to take it.

Your healthcare provider may decrease, temporarily hold, or permanently stop your treatment with Recorlev if needed.

Dosing information

Dose of Recorlev for Cushing's syndrome in Adults

See the Recorlev Full Prescribing Information for additional recommendations on titration, monitoring, and dosage modifications for hepatotoxicity, QT prolongation, and hypocortisolism.

What happens if I miss a dose?

If you miss a dose of Recorlev, take the next dose at your regular scheduled time.

What happens if I take too much?

If you take too much Recorlev, call your healthcare provider or go to the nearest hospital emergency room right away

What should I avoid while taking Recorlev?

Avoid drinking alcohol to excess while taking Recorlev because it may increase your chances of having serious side effects.

What other drugs will affect Recorlev?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Recorlev and other medicines may affect each other causing side effects. Recorlev may affect the way other medicines work, and other medicines may affect how Recorlev works.

Does Recorlev interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.

Storage

Store Recorlev at room temperature between 68°F to 77°F (20°C to 25°C).

Keep out of the reach of children.

Ingredients

What are the ingredients in Recorlev?

Active ingredient: levoketoconazole.

Inactive ingredients: colloidal silicon dioxide, lactose monohydrate, magnesium stearate, modified corn starch, and silicified microcrystalline cellulose.

Available as 150 mg tablets.

Company

Recorlev is distributed by Xeris Pharmaceuticals, Inc., Chicago, IL 60607.

Further information

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