Table 2.
Drug–drug interactions with adrenal steroidogenesis inhibitors
| Medical intervention | Interacts with | Potential for adverse event |
|---|---|---|
| Ketoconazole [24, 54, 69] | CYP3A4 | Drug–drug interactions with oral anticoagulants, statins, cyclosporine, and tacrolimus |
| hERG | Possible QT prolongation | |
| Use acid-lowering and hepatotoxic drugs with caution | ||
| Metyrapone [68] | UGT1 | Drug–drug interactions occur frequently |
| Acetaminophen toxicity | ||
| Etomidate [70–73] | CYP11B1 | Etomidate should be given carefully with calcium channel blockers, opioids, and benzodiazepines |
| Mitotane [35] | CYP3A4 | Drug–drug interactions with oral anticoagulants, statins, cyclosporine, and tacrolimus |
| Hydrocortisone dose increased | ||
| Osilodrostat (LCI699) [21, 60, 74] | CYP1A2 and CYP2C19 (moderate inhibition) CYP2D6 and CYP3A4 (weakly inhibited) |
Drug–drug interactions Possible QT prolongation |
| Levoketoconazole (COR-003) [21] | CYP3A4, CYP3A5 hERG |
Drug–drug interactions with oral anticoagulants, statins, cyclosporine, and tacrolimus |
| QT prolongation |
CYP, cytochrome P450; hERG, human ether-a-go–go–related gene; UGT1, UDP-glucuronosyltransferase 1 family; NR, not reported