Metyrapone capsules can be used for the treatment of adrenal tumors, adrenal insufficiency, Cushing's syndrome, and can also improve the efficacy of antidepressants. However, patients may experience adverse reactions such as hypotension, nausea, vomiting, allergic rash, anemia, and thrombocytopenia during treatment.
Efficacy of Metyrapone capsules
Metyrapone capsule has the effect of reducing the rate of 11-B light baseization of the adrenal cortex and reducing the production of cortisol and corticosterone. In the brain, inhibition of cortisol synthesis can lead to more ACTH secretion in the brain. Clinically, it can be used for the treatment of adrenal cortical tumors and adrenal insufficiency, which can inhibit the synthesis of cortisol and relieve uncomfortable symptoms such as hypertension, fatigue, paralysis, and abnormal secretion of sex hormones.
When Metyrapone was used in the long-term treatment of 13 patients with pituitary-dependent bilateral adrenal hyperplasia (Cushing's disease), the total duration of treatment ranged from 2 to 66 months, with an average of 21 months. With the use of Metyrapone, the clinical features of the disease improved rapidly, and this improvement was maintained.
In addition, a clinical study showed that Metyrapone, a diuretic that inhibits steroid production, can improve the efficacy of serotonergic antidepressants. Depression is associated with an imbalance in the HPA axis feedback mechanism, which maintains the body's hormonal balance. Major depressive disorder is often associated with overactivity of the hypothalamic-pituitary-adrenal cortical axis, and glucocorticoid synthesis inhibitors have been shown to have antidepressant effects. In treatment-resistant depression and animal models, Metyrapone (an inhibitor of 11-β-hydroxylase) has been found to be effective as adjunctive therapy in combination with other antidepressants (ADs).
Metyrapone capsules side effects
1. Cardiovascular system: hypotension.
2. Gastrointestinal system: nausea, vomiting, abdominal discomfort or pain.
3. Central nervous system: headache, dizziness, sedation.
4. Skin system: allergic rash.
5. Blood system: leukopenia, anemia or thrombocytopenia.
6. Adrenal insufficiency: In patients with reduced adrenal secretion and panpituitary insufficiency, Metyrapone may lead to acute adrenal insufficiency. In cases where adrenal insufficiency is suspected, testing should be done in a hospital and closely monitored.
Measures to deal with side effects
Dizziness
After dizziness occurs in patients using Metyrapone, they should immediately rest in place, find something to rely on, and avoid falling. At the same time, you should stabilize your mind and avoid causing nervousness, panic and other bad emotions. Don't shake your head during a dizziness attack, and use a cold towel to ice your forehead. Do not go out alone during an episode of dizziness to prevent accidents.
If dizziness is severe, medication can be used to relieve it under the guidance of a doctor. Once dizziness is under control, activities should be started as soon as possible, gradually, from simple bedside activities to indoor walking, and then gradually transition to normal activities.
If dizziness persists or worsens, the dose of the drug can be adjusted or discontinued and replaced with other drugs.
Adrenal insufficiency
The ability of the adrenal glands to respond to exogenous ACTH should be demonstrated before the test is carried out with Metyrapone. In the setting of hypothyroidism or hyperthyroidism, the response to the Metyrapone test may be lower than normal, and if the adrenal cortex or anterior pituitary function is more severely impaired than the test results suggest, Metyrapone may trigger adrenal insufficiency. This can be corrected by giving appropriate doses of corticosteroids.
Hypotension
Patients should avoid eating stimulant drinks such as coffee and alcohol during the treatment of Metyrapone, control their emotions, and avoid being too emotional. If hypertensive patients feel uncomfortable after taking Metyrapone due to a rapid drop in blood pressure, the administration method and dose should be adjusted under the guidance of a doctor.
Nausea and vomiting
If the patient has gastrointestinal discomfort after using Metyrapone, he should pay attention to a light diet and avoid eating spicy, irritating, greasy, raw and cold foods such as chili, spicy hot, fried skewers, fried dough sticks, ice cream, etc., so as not to increase the burden on the gastrointestinal tract.
Storage of Metyrapone capsules
Metyrapone capsules are supplied as 250 mg soft gelatin, white to yellowish-white, rectangular, opaque capsules, store at room temperature 20°C to 25°C, with a permissible deviation between 15°C and 30°C. Keep the container tightly closed and protected from heat and moisture.
