磷酸奥唑司他(osilodrostat)的用法用量

Osilodrostat is a new cortisol synthesis inhibitor that reduces cortisol synthesis in the body by inhibiting the activity of 11β-hydroxylase (CYP11B1), thereby effectively controlling cortisol levels in patients with Cushing's disease.

Usage and dosage of osilodrostat phosphate

Correct use requires strict compliance with the dosage regimen and administration specifications, and patients should strictly take the medication under the guidance of a doctor.

Standard dosage regimen

The recommended starting dose is 2 mg orally twice a day, which can be taken with food or on an empty stomach. Depending on the urinary free cortisol level and clinical symptoms, the dose can be increased by 1-2 mg/time every 2 weeks, with the maximum dose not exceeding 30 mg/time, twice a day. Cortisol levels need to be monitored weekly during the initial stages of treatment and then monthly after stabilization.

Principles of dose adjustment

When cortisol levels fall below the normal range, the dose should be reduced by 50% immediately or administration should be suspended. When the QTc interval is >480ms, medication should be suspended and the dose should be reduced and restarted after returning to normal. Severe adverse reactions require treatment to be interrupted and restarted at a lower dose after symptoms subside.

Adjustment for hepatic insufficiency

For patients with Child-Pugh class B, the starting dose is halved to 1 mg twice a day. For patients in Child-Pugh Class C, a single dose of 1 mg in the evening is recommended. Patients with hepatic impairment require more frequent monitoring of cortisol levels and adverse drug reactions.

Individualized dosage regimen is the basis for ensuring the therapeutic effect of ozolostat phosphate, which needs to be dynamically adjusted according to the patient's response.

Side effects of osilodrostat phosphate

Understanding adverse drug reactions can help early identification and intervention. For specific side effects, please consult a professional physician.

Endocrine system reaction

Adrenal insufficiency manifests as fatigue, hypotension, etc. Long-term medication requires monitoring of morning cortisol and electrolyte levels.

Effects on the cardiovascular system

The QTc interval is prolonged by an average of 8ms, and in severe cases, arrhythmia may occur. Electrolyte imbalances need to be corrected before use, and concomitant use of other QT prolonging drugs should be avoided. Regular EKG monitoring is essential.

Other common reactions

Gastrointestinal symptoms such as nausea and vomiting are mostly temporary. Nervous system symptoms such as headache and dizziness are common, and long-term use requires attention to changes in bone density.

Most of the side effects of ozolostat phosphate are controllable, and timely intervention can ensure the continuity of treatment.

Osilodrostat phosphate (osilodrostat) medication for special groups

Different groups of people require individualized medication plans, which are explained below from three types of special groups.

Patients with hepatic insufficiency

Child-Pugh grade B starting dose is halved, grade C is changed to a single dose in the evening. Cortisol levels and adverse drug reactions need to be monitored more frequently, and the risk of drug accumulation needs to be alerted.

Elderly patients

The starting dose does not need to be adjusted for patients over 65 years old, but electrocardiogram monitoring needs to be strengthened. Special attention should be paid to drug interactions when coadministering drugs, especially drugs that affect the QT interval.

Pregnant women

Use only when clearly needed, closely monitor maternal cortisol levels and fetal development during treatment. The dosage needs to be adjusted before and after delivery, and the need for continued treatment is assessed postpartum.

Special groups need to weigh the pros and cons of medication and implement individualized treatment strategies under close monitoring.