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About Metopirone®

What is Metopirone®?

Each soft capsule of Metopirone® contains 250 mg of metyrapone.1

Indication:1

Metopirone® is indicated, in combination with other diagnostic tests, for the diagnosis of adrenal insufficiency in adult and pediatric patients.

Single-Dose Short Test

Where


Usually given on an outpatient basis*

Adult and pediatric dosages


The recommended single dose is 30 mg/kg (maximum 3 grams of

Metopirone) administered at midnight with milk/yogurt or snack

Labs


1 blood sample**


When to measure


Early in the following morning
(7:30 - 8:00 am)

Interpretation


Approximately 8 hours after administration of Metopirone, evaluate the values of ACTH and 11- desoxycortisol. Normal values will depend on the method used to determine ACTH and 11‑desoxycortisol levels. An intact HPA axis function is generally indicated by an increase in 11‑desoxycortisol to over 70 mcg/L. 

Figure prepared by HRA Pharma based on Metopirone US Prescribing Information.

*Patients with suspected adrenocortical insufficiency based on the test results previously performed should be hospitalized overnight as a precautionary measure

**After the blood sample is collected, a prophylactic dose of glucocorticoid may be considered for patients with high risk for acute adrenal insufficiency.

Method of administration:1

The capsules should be administered at midnight with milk/yogurt or snack.

Mechanism of action:1,2

Metopirone® (metyrapone capsules) is an adrenal steroid synthesis inhibitor.

The pharmacological effect of Metopirone is to reduce cortisol and corticosterone production by inhibiting the 11-beta-hydroxylation reaction in the adrenal cortex.

Metopirone is used as a diagnostic test, with urinary 17-OHCS measured as an index of pituitary ACTH responsiveness.

As a consequence: compensatory rise in ACTH and increase in:

  • 11-deoxycortisol (S compound) and ACTH levels in plasma
  • 17-OHCS and 17-KGS levels in urine

Figure prepared by HRA Pharma based on Metopirone US Prescribing Information.

REFERENCES

1. Metopirone® US Prescribing Information
2. Avgerinos PC, Yanovski JA, Oldfield EH, Nieman LK, Cutler GB Jr. The metyrapone and dexamethasone suppression tests for the differential diagnosis of the adrenocorticotropin-dependent Cushing syndrome: a comparison. Ann Intern Med. 1994;121(5):318-327. doi:10.7326/0003-4819-121-5-199409010-00002

Abbreviations:
ACTH: Adrenocorticotropic hormone; 11-DOC: 11-deoxycortisol; 17–OHCS: 17-hydroxycorticosteroids; 17–KGS: 17 ketogenic steroids.

INDICATION AND IMPORTANT SAFETY INFORMATION

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Metopirone® is indicated, in combination with other diagnostic tests, for the diagnosis of adrenal insufficiency in adult and pediatric patients.

Metopirone® is contraindicated in patients with adrenal cortical insufficiency, or hypersensitivity to Metopirone® or to any of its excipients.

Metopirone® may induce acute adrenal insufficiency. Ability of adrenals to respond to exogenous ACTH should be demonstrated before Metopirone® is employed as a test. In the presence of hypo- or hyperthyroidism, response to the Metopirone® test may be subnormal.

Since Metopirone® may cause dizziness and sedation, patients should not drive or operate machinery until these effects have passed.

The following adverse reactions have been observed after use of Metopirone®: hypotension, nausea, vomiting, abdominal discomfort or pain, headache, dizziness, sedation, allergic rash, leukopenia, anemia, and/or thrombocytopenia.

Avoid concomitant use with acetaminophen. Anticonvulsants, psychotropic, hormone preparations, corticosteroids, antithyroid agents, and cyproheptadine may affect the results of the Metopirone® test.

Please see Full Prescribing Information for METOPIRONE® (metyrapone) capsules. To report SUSPECTED ADVERSE REACTIONS, contact Direct Success Pharmacy, Inc. at 1-844-597-6373 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

HRA Pharma Rare Diseases, 200 avenue de Paris, 92320, Chatillon, FRANCE
Tel: +33 (0) 1 40 33 93 14 / Fax: +33 (0) 1 40 33 30 87
© 2020 HRA Pharma Rare Diseases | Metopirone is a registered trademark of HRA Pharma Rare Diseases
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Last updated: June 2023; MTP – US – 0028

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