From the Research
The recommended treatment regimen for Cushing's syndrome using Korlym (mifepristone) typically begins with a starting dose of 300 mg once daily, taken with a meal, as supported by the study published in Pharmacotherapy in 2013 1. The dose can be increased in 300 mg increments to a maximum of 1,200 mg daily based on clinical response and tolerability. Key points to consider when treating Cushing's syndrome with Korlym include:
- Dose adjustments should occur no more frequently than every 2-4 weeks.
- Treatment is continued until the desired clinical response is achieved, with regular monitoring of cortisol levels and symptoms.
- Korlym works by blocking glucocorticoid receptors, thereby reducing the effects of excess cortisol rather than lowering cortisol levels themselves.
- This medication is specifically indicated for hyperglycemia secondary to hypercortisolism in adults with endogenous Cushing's syndrome who have type 2 diabetes or glucose intolerance and are not candidates for surgery or have had unsuccessful surgery.
- Patients should be monitored for adrenal insufficiency, hypokalemia, vaginal bleeding, and potential drug interactions, as noted in the study published in the European journal of endocrinology in 2009 2.
- Korlym should not be used in pregnant women due to pregnancy termination risk, and reliable contraception is required for women of reproductive potential during treatment, as highlighted in the study published in Endocrine practice in 2013 3. It is essential to follow the guidance provided in the most recent and highest quality study, which in this case is the 2013 study published in Pharmacotherapy 1, to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life for patients with Cushing's syndrome.