Ketoconazole in Cushing’s syndrome: a profile of its use

Ketoconazole (Ketoconazole HRA™), an imidazole derivative, is a useful treatment option in the management of endogenous Cushing’s syndrome adults and adolescents > 12 years age, based on evidence from more than three decades use drug clinical practice. Originally developed as antifungal agent, ketoconazole potent steroidogenesis inhibitor. Approximately 60% (range, 45–88% across key studies) patients with who are treated achieve control hypercortisolism, efficacy demonstrated all aetiologies disease. Furthermore, reductions cortisol levels associated improvements biochemical features common comorbidities. Hepatotoxicity, main safety concern ketoconazole, can be managed effectively careful monitoring hepatic enzymes, enzyme abnormalities generally being mild to moderate, asymptomatic reversible upon dose reduction or withdrawal.