What is Metopirone®?
Each soft capsule of Metopirone® contains 250 mg of metyrapone.1
Indication:1
Metopirone® is a diagnostic drug for testing hypothalamic-pituitary ACTH function. The metyrapone diagnostic test should be restricted to referral hospital centers.
Overnight single‑dose | Multiple‑dose | |
Where |
| Hospitalization required |
Adult dosage | 30 mg/kg at midnight (maximum 3 g) with yogurt or milk |
|
Pediatric dosage | 30 mg/kg at midnight (maximum 3 g) with yogurt or milk |
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Labs |
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When to measure |
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Figure prepared by HRA Pharma based on Metopirone US Prescribing Information.
* Patients with suspected adrenocortical insufficiency should be hospitalized overnight as a precautionary measure.
Abbreviations:
ACTH: Adrenocorticotropic hormone; 11-DOC: 11-deoxycortisol; 17–OHCS: 17-hydroxycorticosteroids; 17–KGS: 17 ketogenic steroids.
Method of administration:1
The capsules should be taken with a snack, yogurt or milk.
Mode of action:1,2
Metopirone® is an inhibitor of endogenous adrenal corticosteroid synthesis.
It reduces cortisol and corticosterone production by inhibiting the 11 β – hydroxylation reaction in the adrenal cortex.
As a consequence: compensatory rise in ACTH and increase in:
- 11-deoxycortisol (S compound) and ACTH levels in plasma (OMT)
- 17-OHCS and 17-KGS levels in urine (STD)

Figure prepared by HRA Pharma based on Metopirone US Prescribing Information.
REFERENCES
1. Metopirone®US Prescribing Information, February 2020
2. Avgerinos PC, Yanovski JA, Oldfield EH, Nieman LK, Cutler GB Jr. The metyrapone and dexamethasone suppression tests for the differential diagnosis of the adrenocorticotropin-dependent Cushing syndrome: a comparison. Ann Intern Med. 1994;121(5):318-327. doi:10.7326/0003-4819-121-5-199409010-00002