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©2013 UpToDate ® Print Email Inhibitors of adrenal steroid biosynthesis or action Chemical structure of eight inhibitors of adrenal steroid biosynthesis or action. Mitotane is an adrenocorticolytic agent; aminoglutethimide, metyrapone, ketoconazole, trilostane, etomidate, and cyanoketone inhibit one or more of the enzymes in the steroid biosynthetic pathways; and mifepristone is a competitive antagonist of glucocorticoid binding to its cytosol receptor.