Crenessity
Crenessity (crinecerfont) is a medication used to treat people 4 years of age and older with classic congenital adrenal hyperplasia (CAH). It’s a corticotropin-releasing factor type 1 receptor antagonist (CRF1 antagonist). Crenessity (crinecerfont) is taken together with steroids to help control androgen levels in people with CAH. It might help lower the steroid dose they need to take. Crenessity (crinecerfont) comes as a capsule or orange-flavored liquid that’s taken by mouth twice a day. Common side effects are tiredness and headaches.
What is Crenessity (crinecerfont)?
What is Crenessity (crinecerfont) used for?
How Crenessity (crinecerfont) works
Crenessity (crinecerfont) is a corticotropin-releasing factor type 1 receptor antagonist (CRF1 antagonist). This means that it blocks CRF1, a protein that tells your body to make a hormone called ACTH.
When you have CAH, your body can’t make enough cortisol. This causes the body to make ACTH, which then tells your body to make the hormone androgen. As a result, the body makes too much androgen, which can lead to problems like early puberty and fertility issues later in life.
By blocking CRF1, Crenessity (crinecerfont) stops your body from making as much ACTH. This helps your body make less androgen.
Drug facts
Side effects of Crenessity (crinecerfont)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults:
- Tiredness (25%)
- Headache (16%)
- Low white blood cell count (14%)
- Dizziness (8%)
- Joint pain (7%)
- Back pain (6%)
Children:
- Low white blood cell count (37%)
- Headache (25%)
- Stomach pain (13%)
- Tiredness (7%)
- Nasal congestion (7%)
Less Common Side Effects
Adults:
- Low appetite
- Muscle pain
Children:
- Nosebleed
Crenessity (crinecerfont) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: throat tightness, difficulty breathing, swelling of your face, skin rash
- Low hormone levels due to not taking enough steroids: severe tiredness, low blood pressure, low blood sugar, nausea, vomiting
The following Crenessity (crinecerfont) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dizziness
- Fatigue
- Headache
- Joint pain
- Loss of appetite
- Stomach pain
- Stuffy nose
Pros and cons of Crenessity (crinecerfont)
Pros
- Can lower the amount of steroids you need to take every day
- Comes as a pill and liquid
- Approved for children 4 years old and up who weigh at least 22 pounds
Cons
- Have to take it with food
- Can cause tiredness or headaches
- Need to do blood tests regularly to check androgen levels
Pharmacist tips for Crenessity (crinecerfont)
- Take Crenessity (crinecerfont) with a meal, once in the morning and once in the evening. Food helps your body absorb more of the medication so it can work better.
- If you miss a dose of Crenessity (crinecerfont), take it as soon as possible, even if it’s close to your next dose. Then, take your next dose at the regular time. If you miss more than one dose, talk to your prescriber about what you should do.
- Headaches are a common side effect of Crenessity (crinecerfont). To help with headaches, try drinking more water or taking over-the-counter painkillers like acetaminophen (Tylenol) or ibuprofen (Advil). If your headaches still bother you, talk to your prescriber.
- You can also feel tired while taking Crenessity (crinecerfont). Make sure to get enough sleep and practice good sleep hygiene. Let your prescriber know if it’s a side effect that’s getting in the way of your life.
- Keep taking your steroid medications while taking Crenessity (crinecerfont). Follow your prescriber’s instructions to adjust your steroid dose when needed. And make sure you know when to take extra steroid doses, like when you’re sick, injured, or recovering from surgery. These extra doses can help your body handle physical stress well.
Tips for the Crenessity (crinecerfont) capsules:
- You should swallow the capsule whole with liquid. Don’t chew or open them up. If you have problems with swallowing, ask your prescriber about switching to the liquid version of Crenessity (crinecerfont) instead.
Tips for the Crenessity (crinecerfont) liquid:
- Follow the directions to prepare, measure, and give the liquid. Get a press-in bottle adapter and oral syringe from the pharmacy; they don’t come in the box with the liquid. Leave the bottle adapter there the entire time once you put it in the bottle.
- Draw the liquid up into the syringe to measure out the correct dose. Don’t use a household spoon because they aren’t as accurate as a syringe.
- Keep unopened liquid bottles of Crenessity (crinecerfont) in the fridge. After opening the bottle, you can store it in the fridge or at room temperature. Throw it out 30 days after opening it.
Common questions about Crenessity (crinecerfont)
Studies show that for both adults and children, androgen levels can start to go down within 4 weeks of taking Crenessity (crinecerfont) with their regular steroid dose. After 4 weeks, they could start taking lower steroid doses each day. Many adults got to their lowest steroid dose 2 months later. And for children, many got to their lowest steroid dose 3 months after dose adjustments began. Even with a lower steroid dose, people could still keep their androgen levels controlled. Keep in mind that everyone responds to medications differently. This means Crenessity (crinecerfont) and steroid dose adjustments might not work as well for some people as it does for others. Talk to your prescriber about your progress with Crenessity (crinecerfont) and your steroids.
People with CAH usually need to take a high dose of steroids every day to help lower their androgen levels. But taking high doses of steroids over a long period of time can cause problems. This can include weight gain, a higher risk for bone fractures and infections, diabetes, and more. In children with CAH, long-term steroid use can also stunt their growth, which can be problematic since they need to take steroids their whole life. With Crenessity (crinecerfont), people can take a lower steroid dose because Crenessity (crinecerfont) also helps your body make less androgen. Talk to your prescriber to learn more about how Crenessity (crinecerfont) can help you manage CAH.
After about 6 months of treatment, people taking Crenessity (crinecerfont) didn’t have to take as much of their steroids every day. On average, daily steroid doses went down by 27% in adults and 18% in children while taking Crenessity (crinecerfont). Your prescriber will check the androgen levels in your blood regularly during treatment. This helps them figure out how much they can lower your steroid dose. Remember, you’ll still need to take extra steroids when your body is under stress, like when you’re sick. Ask your prescriber if you’re not sure how much steroid medication to take with Crenessity (crinecerfont).
Crenessity (crinecerfont) can interact with certain medications and supplements, like carbamazepine (Tegretol) and St. John’s wort. These medications can lower the amount of Crenessity (crinecerfont) in your body, which can make Crenessity (crinecerfont) not work as well. In these cases, you’ll need to take a higher dose of Crenessity (crinecerfont) so it keeps working properly. Tell your prescriber about other medications and supplements you're taking, or if you stop taking any. They can adjust your Crenessity (crinecerfont) dose as needed.
Before you open the bottle of the Crenessity (crinecerfont) liquid, store it in the fridge. After opening, you can keep it in the fridge or at room temperature. Store it upright, and don’t let the medication freeze.
Before you open the Crenessity (crinecerfont) liquid, it’s good until the expiration date on the packaging when you keep it in the fridge. Once you open the Crenessity (crinecerfont) liquid, the medication is good for 30 days, whether you store it in the fridge or at room temperature. After those 30 days, you should throw away any liquid that’s left over and start using a new bottle.
No, Crenessity (crinecerfont) doesn’t completely cure CAH. It helps you manage it. So you’ll still need to keep taking steroids, the main treatment for CAH, over the long term.
If you become pregnant or want to breastfeed, talk to your healthcare team about whether you should take Crenessity (crinecerfont). Right now, there aren’t enough studies to know how the medication affects pregnancy or breastfeeding. But there might be some risk of harm to the baby during pregnancy or while breastfeeding. Your care team can discuss with you about the risks and benefits of taking Crenessity (crinecerfont).
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Risks and warnings for Crenessity (crinecerfont)
Crenessity (crinecerfont) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reaction
There’s a small chance that you can have an allergic reaction to Crenessity (crinecerfont), but it can be really serious. One person in a study had a severe allergic reaction three days after starting the medication, so it might not happen right away.
Signs of a severe allergic reaction can include sudden throat tightness, difficulty breathing, swelling of your face, or rash. If this happens, you should stop taking Crenessity (crinecerfont) and get medical help as soon as possible.
Low hormone levels due to not taking enough steroids
- Risk factors: Being sick | Having a serious injury | Getting surgery
It’s important you keep taking your steroid treatment while you’re taking Crenessity (crinecerfont). Otherwise, you might have dangerously low hormone levels. This is known as acute adrenal insufficiency or adrenal crisis. Symptoms might be weakness, nausea, vomiting, or low blood sugar.
To lower your risk, follow your prescriber’s instructions on how much steroid medication to take with Crenessity (crinecerfont). Don’t change your steroid dose on your own. Also ask how much to take when you’re sick, injured, or having surgery. Your body naturally needs more steroids when under stress.
Crenessity (crinecerfont) dosage
Typical dosage for Crenessity (crinecerfont)
-
Adults: The typical dose is 100 mg by mouth twice a day with food.
-
Children 4 years of age and older: The dose depends on your child’s weight.
- Weigh 22 lbs to less than 44 lbs: The typical dose is 25 mg by mouth twice a day with food.
- Weigh 44 lbs to less than 121 lbs: The typical dose is 50 mg by mouth twice a day with food.
- Weigh 121 lbs or more: The typical dose is 100 mg by mouth twice a day with food.
Your overall dose might be higher if you take certain medications that interact with Crenessity (crinecerfont).
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