Metyrapone (0.5ΓÇô4g daily in two to four divided doses) is commonly used for short- and long-term control of excessive secretion of cortisol of any aetiology. It reversibly blocks the 11b-hydroxylase enzyme involved in the final step in cortisol synthesis. Metyapone should be taken with food and used to control the condition prior to adrenal or pituitary surgery or pending a final decision on definitive therapy. Hirsutism is a problem in some women.
