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METYRAPONE (METOPIRONE® )

Available as capsules containing Metapyrone 250 mg supplied under the trade name MetopironeÒ .

Metapyrone blocks the formation of Hydrocortisone, the hormone produced by the adrenal gland which is present in excessive amounts in Cushing's syndrome. It does this by interfering with an important chemical reaction involved in Hydrocortisone production. The aim of therapy is to reduce this to near normal levels. Metyrapone therefore reduces the symptoms of Cushing's syndrome ("moon face and buffalo hump appearance", skin thinning, excessive bruising, etc) in patients awaiting surgery or where surgery cannot be performed for whatever reason.

Metyrapone should be taken with milk or immediately after a meal in order to reduce the troublesome stomach upsets which it commonly causes (see Side Effects, below). The individual dosage is very variable (from as little as one capsule to as many as twenty-four capsules per day) depending upon the degree of control of Hydrocortisone overproduction that must be achieved. This is determined by gradually increasing from a low dose initially until the desired response is obtained.

What side effects can be expected?

• Nausea and vomiting is relatively common and may be accompanied by cramping abdominal pain. This is likely to become less troublesome if any dosage increase is done gradually and people develop some tolerance to the side effect. It is essential that each dose is taken on a full stomach (or at least a light snack) preferably swallowed with a glass of milk treatment.
  
• Headaches, dizziness and sedation are also frequently reported and may affect your ability to drive or operate machinery.
  
• Less common side effects include allergic skin reactions, a fall in blood pressure (which may cause dizziness), and rarely excessive facial hair growth (hirutism) associated with male-type baldness.

Other medicines or substances which might interfere with your treatment

• Since Metyrapone can cause a fall in blood pressure (BP) and, indeed, because long-term treatment has been associated with hypertension, your doctor will require to check your BP on a regular basis to ensure no interference with any medicines which you take to control BP.

Phenytoin (EpanutinÒ ), a medicine used in the treatment of epilepsy, may increase the metabolism of Metyrapone in the body. If you take Phenytoin, therefore, the dose of Metyrapone will be higher than would otherwise be required.

Metyrapone capsules are stored at normal room temperature but do not store in a very warm place ( near a radiator, fire, etc) or in a moist environment (e.g. bathroom cabinet).

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Ó NHS Tayside; 2006; version 1.0

Disclaimer; no liability whatsoever is accepted for information given and all such information, especially with regard to drug usage (UK version provided), must be checked with a person’s health provider.