Drug interactions
Mifepristone + Osilodrostat
Severity: Major
Mifepristone and Osilodrostat: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Mifepristone inhibits CYP3A4 and may increase osilodrostat exposure, and both drugs can prolong the QT interval. Together this raises the risk of QT prolongation and arrhythmia, particularly with hypokalemia.
What this interaction means in plain words
Mifepristone and Osilodrostat can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Mifepristone belongs to Endocrine; Osilodrostat belongs to Endocrine.
Why it happens
CYP3A4 inhibition by mifepristone raises osilodrostat levels, with additive QT prolongation.
What to do
Obtain a baseline ECG and monitor ECG and potassium and magnesium. Consider reducing the osilodrostat dose and avoid the combination if QT risk is high.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Other interactions of Osilodrostat
Frequently asked questions
Can I take Mifepristone with Osilodrostat?
MediHelp rates the interaction as major. Mifepristone and Osilodrostat can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Mifepristone inhibits CYP3A4 and may increase osilodrostat exposure, and both drugs can prolong the QT interval. Together this raises the risk of QT prolongation and arrhythmia, particularly with hypokalemia.
How serious is the interaction between Mifepristone and Osilodrostat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor ECG and potassium and magnesium. Consider reducing the osilodrostat dose and avoid the combination if QT risk is high.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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