Mitotane

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Mitotane Brand Name– Lysodren

What is Mitotane

Mitotane is an adrenocortical cytotoxic antineoplastic agent that is structurally related to the insecticide chlorophenothane (DDT).

It is used almost exclusively for adrenocortical carcinoma but also could be useful in Cushing’s disease.

It appears to act by impairing steroid synthesis, which in turn causes adrenal atrophy.

Mitotane was approved by the FDA in 1970.

Indications

  • adrenocortical cancer
  • Cushing’s syndrome

For the treatment of inoperable adrenocortical cancer, both functional and non-functional types

Side Effects

  1. adrenocortical insufficiency
  2. anorexia
  3. arthralgia
  4. ataxia
  5. blurred vision
  6. confusion
  7. depression
  8. diarrhea
  9. diplopia
  10. dizziness
  11. drowsiness
  12. dysarthria
  13. elevated hepatic enzymes
  14. fever
  15. flushing
  16. growth inhibition
  17. gynecomastia
  18. headache
  19. hematuria
  20. hemorrhagic cystitis
  21. hepatitis
  22. hypercholesterolemia
  23. hypertension
  24. hypertriglyceridemia
  25. hypothyroidism
  26. lethargy
  27. myalgia
  28. nausea
  29. neutropenia
  30. orthostatic hypotension
  31. pelvic pain
  32. proteinuria
  33. rash
  34. retinopathy
  35. vaginal bleeding
  36. vertigo
  37. vomiting
  38. weakness

Monitoring Parameters

  • neurologic function
  • serum cortisol

Contraindications

  • adrenal insufficiency
  • breast-feeding
  • contraception requirements
  • driving or operating machinery
  • infection
  • neurotoxicity
  • ovarian cyst
  • pregnancy
  • reproductive risk
  • shock
  • surgery
  • trauma
  • vaginal bleeding

Mitotane therapy should not be given to individuals who have demonstrated a previous hypersensitivity to mitotane

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abemaciclib
  • Abiraterone
  • Acalabrutinib
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Alfentanil
  • Alfuzosin
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Almotriptan
  • Alosetron
  • Alpelisib
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Apremilast
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Artemether; Lumefantrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
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  • Brompheniramine; Guaifenesin; Hydrocodone
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  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
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  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
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  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
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  • Elagolix
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  • Elbasvir; Grazoprevir
  • Eletriptan
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Elvitegravir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
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  • Enalapril; Felodipine
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  • Ethinyl Estradiol; Levonorgestrel
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  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethosuximide
  • Etravirine
  • Everolimus
  • Exemestane
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  • Fedratinib
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  • Fentanyl
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  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydrocortisone
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  • Hydroxyzine
  • Ibrutinib
  • Ibuprofen; Oxycodone
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  • Lansoprazole; Naproxen
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  • Lemborexant
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  • Lidocaine; Prilocaine
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Losartan
  • Lovastatin
  • Lovastatin; Niacin
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  • Lumateperone
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