. Author manuscript; available in PMC: 2019 Jun 1.

Published in final edited form as: Endocrinol Metab Clin North Am. 2018 Jun;47(2):451–462. doi: 10.1016/j.ecl.2018.02.008

Table 2.

Medical treatment of Cushing syndrome

	Mechanism of action	Side effects	FDA/EMA approval
Ketoconazole	Antifungal azole inhibits steroidogenesis	Gastrointestinal side effects, hepatotoxicity, breakthrough requiring dose escalation, adrenal insufficiency	European Medicines Agency for adults
Mitotane	Adrenolytic	Gastrointestinal side effects, fatigue, dermatologic changes	FDA approval for treatment of adrenal cancer
Pasireotide	Somatostatin analog	Adrenal insufficiency, hyperglycemia, bradycardia, gastrointestinal side effects, hepatotoxicity, fatigue, headache	FDA approval for adults with CS who are not surgical candidates
Mifepristone	Glucocorticoid receptor blocker	Hypokalemia, adrenal insufficiency, endometrial thickening	FDA approval for adults with CS with diabetes or glucose intolerance who are not surgical candidates