Rankings / Hormones & Endocrine
Osilodrostat
Hormones & Endocrine · Cortisol synthesis inhibitor
Tier D-
High-risk evidence profile
Bottom line
Read Off Label grades Osilodrostat as D- (2.5/10) based on weak evidence, low benefit magnitude, and a high-risk safety profile.
Its high-risk evidence profile reflects a Safety score of 2/10; reported benefits and harms can differ by indication, dose, route, duration, and population.
Added from WADA S1.
Studied, labeled, or reported-use context: Clinical Cushing dosing is titrated by cortisol response; no performance dose — Rx for Cushing disease in some jurisdictions; WADA S1 prohibited; not individualized guidance.
What the evidence says
Added from WADA S1.2. This is not a normal hormone-optimization tool; risk is driven by intentionally disrupting adrenal steroidogenesis.
Mechanism
Osilodrostat inhibits 11-beta-hydroxylase to lower cortisol; WADA lists it among anabolic agents, likely because cortisol suppression can shift catabolic/anabolic balance.
Studied, labeled, or reported dose & route
Clinical Cushing dosing is titrated by cortisol response; no performance dose
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Osilodrostat's effects?
- Read Off Label rates the evidence for Osilodrostat as Weak and the benefit magnitude as low, producing an overall grade of D- (2.5/10). Added from WADA S1.
- What safety findings are reported for Osilodrostat?
- Osilodrostat has a high risk profile in the database. High (adrenal insufficiency, QT prolongation, androgen excess, hypocortisolism symptoms) Legal status: Rx for Cushing disease in some jurisdictions; WADA S1 prohibited.
- What does the low Safety score for Osilodrostat represent?
- The Safety score is 2/10. It records the substantial harms described for one or more use contexts; the Benefit score, indication, dose, route, duration, population, and legal status remain separate parts of the evidence profile.
- What doses or routes are reported for Osilodrostat?
- Clinical Cushing dosing is titrated by cortisol response; no performance dose This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- How does Osilodrostat work?
- Osilodrostat inhibits 11-beta-hydroxylase to lower cortisol; WADA lists it among anabolic agents, likely because cortisol suppression can shift catabolic/anabolic balance.
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.