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About Metopirone®

What is Metopirone®?

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


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


1 blood sample**

When to measure

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


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.


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

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

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