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

How you take it

One 300mg tablet once a day with a meal to start, swallowed whole. Your doctor may raise the dose no sooner than every 2 to 4 weeks. The Medication Guide says not to drink grapefruit juice while you take Korlym.

Before your first dose

• If you can become pregnant, a pregnancy test that is negative. Korlym causes the loss of a pregnancy. A new negative test is needed before restarting after any break longer than 14 days.
• Birth control that does not use hormones, for the whole time you take Korlym and for 1 month after.
• A blood test for potassium. Low potassium is fixed before your first dose.
• A full medicine check. Some medicines cannot be taken with Korlym, including simvastatin, lovastatin and fentanyl.
• Your doctor's office faxes a form to SPARK, the drugmaker's pharmacy program, and your insurance approves the medicine. Korlym is not sold at local pharmacies.
• A coordinator calls you every month to set up delivery. Korlym cannot ship until you confirm, so answer that call.

The first 90 days

1. Before day 1Pregnancy test if it applies, potassium blood test and medicine check
2. About 2 weeks beforeYour doctor's office faxes the form to SPARK
3. Days beforeA coordinator calls to set up your first delivery, then a pharmacist checks your medicines
4. Day 1First dose, 300mg once a day
5. Weeks 1 to 2Potassium blood test, 1 to 2 weeks after you start
6. Weeks 2 to 4Earliest time your dose may go up
7. About monthly, then every 28 daysRefill call and delivery
8. Within 6 weeksBlood sugar may start to show how well it is working
9. Day 90Three months in