Rankings / Hormones & Endocrine

Osilodrostat

Hormones & Endocrine · Cortisol synthesis inhibitor

Tier D-

High-risk evidence profile

wadacortisoladrenal-axisbanned-sport
High-risk evidence profile
2.5 / 10
Tier D-
Ev 3 Bn 2 Sf 2

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.