What are the side effects of these medications: Ketoconazole and Metyrapone?
Ketoconazole (Nizoral): The most common side effect is nausea and abnormalities in liver function. Before this medication is taken, a blood test should be measured to make sure there are no liver abnormalities. If the patient develops fatigue or jaundice, liver tests should be measured again and the medication stopped. Other side effects include vomiting, abdominal pain and itching. Metyrapone (Metopirone): nausea, vomiting, and diarrhea. If these block adrenal gland cortisol production completely, adrenal insufficiency occurs. Dexamethasone (a synthetic cortisol drug) is often given (in a small dose) to protect against developing adrenal insufficiency or the dose can be reduced. A morning blood cortisol level is helpful to determine if the dose is too high. A 24 hour urine cortisol measurement is the best test to determine the effectiveness of medical treatment. If the urine cortisol level remains elevated, the dose of medication may need to be increased.
