Starting Recorlev (levoketoconazole)Your first 90 days with Cushing's syndrome (high cortisol): 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

Call your doctor right away about:

Pain on the upper right side of your belly with nausea; unusual tiredness; yellow skin or yellowing of the whites of your eyes; unusual bruising or bleeding; severe lightheadedness or fainting; vomiting, dizziness, low blood pressure, unexplained belly pain, loss of appetite, low blood sugar or body aches, which can mean low cortisol; a rash, itching, hives, fever, swelling of the lips or tongue, chest pain or trouble breathing (or go to an emergency center).

Also tell your doctor's office about:

Any new medicine, supplement, antacid or heartburn medicine before you start it
Breast enlargement or erection problems in men, or lower sex drive or mood changes in women
Flu-like feelings in the first few weeks, such as tiredness, nausea, headache or muscle aches
A pregnancy, or plans for one

Xeris CareConnection (Xeris Pharmaceuticals) with PANTHERx Rare Pharmacy1-844-444-7258

Monday to Friday, 8 AM to 7 PM Eastern, per Xeris's January 2022 launch release; the current Recorlev pages do not list hours, and the prescriber site says PANTHERx offers 24/7 support

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/recorlev

How you take it

One 150mg tablet twice a day to start, with or without food. Your doctor may raise the dose slowly, no sooner than every 2 to 3 weeks.

Before your first dose

Blood tests of your liver, because Recorlev can harm the liver.
A heart tracing (ECG), and a blood test for potassium and magnesium. Low levels are fixed before you start.
A full medicine check. Many medicines cannot be taken with Recorlev, and some must stop 2 weeks before.
Your doctor's office sends a Start Form to Xeris CareConnection, the drugmaker's support program, and your insurance approves the medicine. Some plans want ketoconazole tried first.
PANTHERx Rare Pharmacy, the only pharmacy that carries Recorlev, calls to set up home delivery. Answer calls from PANTHERx that week.

The first 90 days

Two weeks beforeMedicine check, 2 weeks before your first dose
Before day 1Liver blood tests, ECG, potassium and magnesium
Week beforeInsurance approval, then PANTHERx calls
Day 1First dose, 150mg twice a day
Day 8, then weekly, then every 7 daysLiver blood test every week for at least 6 weeks
Weeks 2 to 3Urine cortisol tests, and the earliest dose change
Around day 30, then every 30 daysRefill shipment, about monthly
Weeks 7 to 12, then every 14 daysLiver blood test every 2 weeks
Day 90Three months in

Trial Friend, trialfriend.com. From the Recorlev FDA label dated March 10, 2026 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.