Korlym drug: Uses, indications and precautions when using

Cushing's disease is a disease when the body produces too much of the hormone cortisol and affects the body's physiology. One of the most common complications is high blood sugar. Accordingly, to treat patients, it is necessary to use Korlym with the active ingredient Mifepristone. So what does Korlym do?

How does Korlym work? Korlym is used to control hyperglycemia in patients who have Cushing's disease and have either failed surgery or are unable to undergo surgery to treat it.
Cushing is a condition that occurs when the body produces too much of the hormone cortisol, which can lead to glucose intolerance or type 2 diabetes. Mifepristone is the active ingredient in Korlym, which inhibits the effects of cortisol on the body.

Carefully read the medication instructions provided by the pharmacist before the patient starts taking Korlym. Korlym is a drug used by mouth, usually taken after meals as prescribed by the doctor, once a day. When using Korlym, the patient should swallow the capsule whole, do not crush, chew or split the tablet.
Dosage of Korlym is prescribed based on the patient's medical condition, response to treatment and other combination therapies. Therefore, be sure to tell your doctor and pharmacist about all the products you are using. To reduce the risk of side effects, your doctor may direct you to start Korlym at a low dose and increase it gradually as your response progresses, when you must carefully follow your doctor's instructions.
Using Korlym regularly and continuously every day will bring the highest treatment effect. Therefore, patients should take Korlym at the same time every day to avoid forgetting the medicine.
Do not stop taking Korlym unless directed to do so by your doctor. If the drug is stopped suddenly, the patient may have to start Korlym again at a lower dose and gradually increase the dose again. Consult your doctor or pharmacist for instructions on restarting Korlym if you have not taken it for several days.
Patients should avoid eating grapefruit or drinking grapefruit juice while using Korlym unless their doctor or pharmacist says it is safe to do so. Grapefruit may increase the risk of side effects with Korlym. Notify your doctor if Cushing's condition persists or worsens. Korlym can be absorbed through the skin and harm an unborn baby, so women who are pregnant or may become pregnant should not use this medicine.

Possible side effects of Korlym include:
Nausea, vomiting; Decreased appetite; Dry mouth ; Tired; Dizzy ; Headache; Joint pain. If any of the side effects of Korlym persist or get worse, tell your doctor or pharmacist right away. Tell your doctor quickly if you have any of the following serious side effects of Korlym:
Swelling of the hands and feet; Abnormal vaginal bleeding; Symptoms of hypokalemia (such as cramps, muscle weakness); Signs of infection (eg, fever, persistent sore throat, difficulty breathing). Korlym may cause hypoglycemia. Symptoms of this condition include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness or tingling in the hands/feet. Patients should get in the habit of carrying snacks that can immediately add sugar or drinking sugar water, juice or milk while taking Korlym.
Inform the treating doctor immediately about the reaction when using the drug Korlym . At the same time, to help prevent sudden hypoglycemia, people should eat on a regular schedule and do not skip meals.
Symptoms of hyperglycemia include increased thirst, increased urination, confusion, drowsiness, flushing, rapid breathing and fruity breath....if these symptoms occur, the person or body Tell your doctor right away as the dose of Korlym may need to be increased.
Some rare but very serious side effects of Korlym include:
Fast/irregular heartbeat; Severe dizziness; Faint.

Before being treated with Korlym, the patient must inform the treating doctor if he or she has been allergic to mifepristone in the past or if he has any other allergic conditions. Before using Korlym, a doctor or pharmacist must take a patient's medical history, especially of: kidney disease, liver disease, unexplained vaginal bleeding, problems with the uterine lining. (endometrial hyperplasia, endometrial cancer), electrolyte disturbances (hypokalemia), cardiovascular disease (such as coronary artery disease), hypertension.
Mifepristone can affect heart rate (QT prolongation). QT prolongation can cause severe (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that require immediate medical attention.
The risk of QT prolongation may be increased if the patient has certain medical conditions or is taking other drugs that can prolong QT. Before using Korlym, tell your doctor or pharmacist of all medications you are taking and any of the following conditions: heart failure, bradycardia, QT prolongation on ECG, family history of these conditions. certain heart problems (QT prolongation in electrocardiogram, sudden cardiac death).
Hypokalemia or hypomagnesemia may increase the risk of QT prolongation. This risk is higher if the patient is taking certain medications (such as diuretics) or the patient is sweating profusely, has diarrhea, or is vomiting. Talk to your doctor about using Korlym safely.
Older adults may be more sensitive to the side effects of Korlym, especially QT prolongation. Mifepristone must not be used during pregnancy because it can cause miscarriage. If a person with Cushing's disease becomes pregnant or thinks she may be pregnant, she should tell her doctor right away. At the same time, the drug Korlym can be absorbed through the skin and harm an unborn baby, women who are pregnant or may become pregnant are absolutely contraindicated to this product. Korlym passes into breast milk, so patients should consult their doctor before breast-feeding.

Some products that may interact with Korlym include: corticosteroids (such as prednisone). Mifepristone may slow the removal of other medicines from the body and affect how they work. Products affected by Korlym include:
Cyclosporin; Ergot alkaloids (such as dihydroergotamine, ergotamine); Fentanyl; Pimozide; Quinidine; statin drugs (such as fluvastatin, lovastatin, simvastatin); Sirolimus; Tacrolimus; Warfarin. Other drugs may affect the removal of mifepristone from the body and affect how Korlym works. Examples include;
azole antifungals (such as itraconazole, ketoconazole, posaconazole); Boceprevir; Macrolide antibiotics (such as clarithromycin); Nefazodone; HIV protease inhibitors (ritonavir, nelfinavir); Telithromycin. Korlym may reduce the effectiveness of hormonal contraceptives such as the Pill, the patch or the IUD... resulting in an unwanted pregnancy. Patients should discuss with their doctor or pharmacist about non-hormonal birth control methods while using Korlym.
Beta-blockers (such as metoprolol, propranolol, timolol) can prevent tachycardia symptoms, masking signs of hypoglycemia, so patients should be aware of other symptoms of low blood sugar. such as: dizziness, hunger, or sweating (symptoms are not affected by these drugs).
Many drugs can affect a patient's blood sugar levels causing blood sugar to go out of control. Before a patient starts, stops, or changes any medication, the patient should talk to their doctor or pharmacist about whether the medication may affect the patient's blood sugar. Check your blood sugar as often as directed and share the results with your doctor immediately if symptoms of excessive elevation or hypoglycemia develop. Your doctor may then need to adjust your diabetes medications, redesign your exercise program, or advise you on your diet.
Tests such as blood potassium levels, thyroid function tests, blood pressure checks... should be performed periodically to monitor disease progression or check for Korlym side effects.
If the patient misses a dose of Korlym, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose of Korlym and do not take a double dose.
Store Korlym at room temperature, away from light and moisture, do not put Korlym in the bathroom, to keep it away from children and pets.
Do not flush Korlym down the toilet or empty it into the drain except, dispose of it appropriately when Korlym has expired or is no longer needed.

Reference source: webmd.com