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What the FDA labels say about taking them together

Osilodrostat and theophylline

Osilodrostat's FDA label of November 18, 2025 names theophylline in its drug interactions section; the theophylline label PlainMeds reads does not name osilodrostat. The osilodrostat label: “Concomitant use of ISTURISA with strong CYP3A4 and/or CYP2B6 inducers may cause a decrease in osilodrostat concentration and may reduce the efficacy of ISTURISA. …”

Check it at the source: the osilodrostat FDA label on DailyMed (effective November 18, 2025, Recordati Rare Diseases, Inc.); the theophylline FDA label on DailyMed (effective March 10, 2026, Strides Pharma Science Limited).

What does the osilodrostat label say about theophylline?

Osilodrostat label, drug interactions

Clinical Impact: Concomitant use of ISTURISA with strong CYP3A4 and/or CYP2B6 inducers (…) may cause a decrease in osilodrostat concentration and may reduce the efficacy of ISTURISA. Discontinuation of strong CYP3A4 and/or CYP2B6 inducers while using ISTURISA may cause an increase in osilodrostat concentration and may increase the risk of … caution when coadministered with CYP1A2 and CYP2C19 substrates with a narrow therapeutic index, such as theophylline, tizanidine, and S-mephenytoin [see Clinical Pharmacology (12.3) ].

Source: FDA drug label (Isturisa), Recordati Rare Diseases, Inc., effective November 18, 2025 (SPL set f3a5ec24-63c3-4d83-b1c0-6c550fbe7ae2), via openFDA; the full label on DailyMed

What does the theophylline label say about osilodrostat?

Theophylline's label (effective March 10, 2026) does not name osilodrostat in these sections. A label lists what its studies and reports found; it is not a complete list.

Source: FDA drug label (Theophylline), Strides Pharma Science Limited, effective March 10, 2026 (SPL set b7a90ccf-9c32-40cc-9008-7e55b3da4dfd), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

0Osilodrostat generic labelers
26Theophylline generic labelers
OsilodrostatTheophylline
Labeled forn/aAsthma
Boxed warningNoNo
Pharmacy cost (NADAC)n/a$0.330 per tablet 300 mg tablet
Shortage nowNo current entryNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?