Trilostane, more commonly known by the brand names Modrenal and Vetoryl among others, is a medication that has been used in the treatment of Cushing’s syndrome, Conn’s syndrome, and postmenopausal breast cancer in humans.
Trilostane is an inhibitor of 3 beta-hydroxysteroid dehydrogenase and works by blocking an enzyme involved in the production of several steroids including cortisol. Inhibiting this enzyme inhibits the production of cortisol. In Cushing’s syndrome, the adrenal gland overproduces steroids.
Why was trilostane taken off the market?
Trilostane was withdrawn from the U.S. market in April 1994 because it reduces the amount of steroids produced by the adrenal gland. Studies have also shown that the use of trilostane even for very brief therapy may lead to persistent Addison’s disease probably caused by irreversible lesions in the adrenal glands.
The adrenal glands produce hormones that help regulate your metabolism, immune system, blood pressure, response to stress, and other essential functions. Adrenal glands are composed of two parts — the cortex and the medulla — which are each responsible for producing different hormones.
For example cortisol, a glucocorticoid hormone produced by the zona fasciculata plays several important roles in the body. It helps control the body’s use of fats, proteins, and carbohydrates; suppresses inflammation; regulates blood pressure; increases blood sugar, and can also decrease bone formation
Trilostane can also cause skin irritation of the mucous membranes and upper respiratory tract
Following its withdrawal from human use, the drug was subsequently approved for use in veterinary medicine in the 2000s to treat Cushing’s syndrome in dogs.
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