. 2016 Sep 6;19(6):643–653. doi: 10.1007/s11102-016-0742-1

Table 1.

Mechanisms of action of steroidogenesis inhibitors [21]

	Mechanism of action	Efficacy (%)	Common side effects
Ketoconazole	Inhibitor of CYP17A1, CYP11A1, and CYP11B1	53–88	Liver enzyme increase
			Gastrointestinal AEs
			Interactions with multiple drugs
			Not approved for use during pregnancy
Metyrapone	Inhibitor of CYP11B1, CYP11B2, and CYP17A1	75	Hypokalemia
			Hypertension
			Gastrointestinal AEs
			Hirsutism
			Not approved for use during pregnancy
Etomidate	Inhibitor of CYP11B1, CYP17A1, and CYP11A1	NR	Hypnosis
Etomidate	Inhibitor of CYP11B1, CYP17A1, and CYP11A1	NR	Not approved for use during pregnancy
Mitotane	Inhibitor of CYP11A1, CYP11B1, and CYP11B2	~70	Gastrointestinal AEs
			Neurological side effects
			Teratogen (not approved for use during pregnancy)
Osilodrostat (LCI699)	Inhibitor of CYP11B2 and CYP11B1 at higher doses	78–92	Nausea
			Hirsutism
			Fatigue
			Headache
			Hypokalemia
			Not approved for use during pregnancy
Levoketoconazole (COR-003)	Inhibitor of CYP17A1, CYP11A1, CYP11B1, and CYP21A2	NR	Headache^a
			Nausea^a
			Mild liver enzyme increase^a
			Not approved for use during pregnancy

CYP, cytochrome P450; AE, adverse event; NR, not reported. All of these drugs can induce adrenal insufficiency

^aIn patients with diabetes mellitus