Starting Isturisa (osilodrostat)Your first 90 days with cushing syndrome, including Cushing disease: the steps, the dates and who to call

Trial Friendtrialfriend.com

Fill in with your doctor's office

First dose date

Doctor who prescribed it

Doctor's office phone

Specialty pharmacy name

Specialty pharmacy phone

Tell your doctor right away about:

Nausea, vomiting, tiredness, low blood pressure, stomach pain, loss of appetite, dizziness or low blood sugar, which may be signs of very low cortisol; irregular heartbeats.

Also tell your doctor's office about:

Low potassium, high blood pressure, or swelling in your legs or ankles
Extra facial or body hair growth, or acne in women
Any new medicine before you start it, especially one for heart problems or an antifungal or antibiotic such as itraconazole or clarithromycin
An infection, illness or other physical stress, which the label says can bring on low cortisol
A pregnancy, plans for one, or plans to breastfeed

R.A.R.E. Patient Support Program (Recordati Rare Diseases, with Anovo)1-888-855-7273

Monday to Friday, 8 AM to 8 PM Eastern, per the Isturisa site and prescriber guide (Recordati's company page says 8 AM to 5 PM Central)

The drugmaker's support program, for questions about getting the medicine and paying for it. Answer calls from the specialty pharmacy; a missed call can delay your delivery.

Scan for your full plan, with every date added to your phone calendartrialfriend.com/p/isturisa

How you take it

Tablets 2 times a day, with or without food. You start at 2mg each time, and your doctor may raise the dose no sooner than every 2 weeks.

Before your first dose

A heart tracing (ECG), because Isturisa can change your heart rhythm. You get another one about 1 week after you start.
A blood test for potassium and magnesium. Low levels are fixed before your first dose.
A full medicine check, especially heart medicines and some antifungal or antibiotic pills, which can change your Isturisa dose.
Your doctor's office sends the prescription to Anovo, the only pharmacy that fills Isturisa. You sign a form to join R.A.R.E., the drugmaker's support program.
Your insurance approves the medicine. With commercial insurance you may pay $20. A pharmacist calls you to set up overnight delivery, so answer calls from numbers you do not know.

The first 90 days

Before day 1Heart tracing and blood test before your first dose
About 2 weeks beforePrescription form to Anovo
Days beforeThe pharmacist calls
Day 1First dose, 2mg twice a day
Within week 1Second heart tracing, week 1
Every 1 to 2 weeks, then every 14 days24-hour urine tests, every 1 to 2 weeks
Day 15Earliest day your dose may go up
About day 30, then every 30 daysRefill, if the first fill was a month
Day 90Three months in

Trial Friend, trialfriend.com. From the Isturisa FDA label dated November 18, 2025 and the drugmaker's program, checked November 10, 2026. Not medical advice: Trial Friend is not a medical provider, and your doctor decides your dose and tests.