Drug Interaction:
Antineuoplastic agents include- Interferon ALFA 2a, Interferon ALFA -2b, Interferon ALFA -n3, Levamisole, Altretamine, Cladribine, Hydroxyurea, Aldesleukin, Paclitaxel, Docetaxel,Tretinion, Procarbazine,Dacarbazine, Gemcitabine, Mitotane, Asparaginase, Pegaspargase,Porfimer Sodium
Interacting drugs- summary
Mitotane +
Corticosteroids- corticosteroids metabolism altered by mitotane, higher doses may be required.
Warfarin- metabolism of warfarin accelrated by the mechanism of hepatic mircosomal enzyme induction, leading to an increase in dosage requirement of warfarin
Indication:
Adrenal cortical carcinoma
Antineuoplastic agents include- Interferon ALFA 2a, Interferon ALFA -2b, Interferon ALFA -n3, Levamisole, Altretamine, Cladribine, Hydroxyurea, Aldesleukin, Paclitaxel, Docetaxel,Tretinion, Procarbazine,Dacarbazine, Gemcitabine, Mitotane, Asparaginase, Pegaspargase,Porfimer Sodium
Adverse Reaction:
Anorexia, nausea,or vomiting, and diarrhea. Depression as manifested by lethargy, Somnolence, Dizziness and vertigo. Transceint skin rashes.
Contra-Indications:
Hypersens to the drug
Special precautions:
Adrenal insufficiency may develop- consider adrenal steroid replacement
Dosages/ Overdosage Etc:
Indication:
Adrenal cortical carcinoma
Dosage:
Start at 2 to 6 g/day in divided doses, 3 or 4 times daily. Increase dose incrementally to 9 to 10g/day.
Patient Information:
MITOTANE -
Ref - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Mitotane. Also tell your healthcare care professional if you are allergic to
any other substances such as foods. preservatives or dyes.
2.Pregnancy-
Mitotane has not been shown to cause problems in humans.
3. Breast-feeding-
Although it is not known whether mitotane passes into breast milk. it has been
reported to cause problems in nursing babies
4.Children-
Although there is no specific information comparing use of mitotane in children
with use in other age groups, this medicine is not expected to cause different
side effects or problems than it does in adults.
5.Older adults-
There is no specific information about the use of mitotane in the elderly.
6. Other medicines-
Tell your doctor if you are using any of the following -
CNS stystem depressants- CNS depressant effects may be increased
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Infection -
Liver disease - effects may be increased because of slower removal of
mitotane from the body.
Pharmacology/ Pharmacokinetics:
Pharmacology:
Mitotane is an adrenal cytotoxic agent, although it can cause adenal inhibition without cellular destruction. The primary action is on adrenal cortex.
Pharmacokinetics:
Forty percent of mitotane is absorbed. it can be found in most of the body tissues but is primarily stored in fat.Approximately 10% of the drug is excreted in the urine as unidentified water soluble metabolite. Upto 60% is excreted unchanged in the stool.
Pregnancy and lactation:
Pregnancy:
Use only if needed
Lactation:
Use with caution and decide whether to,discontinue the drug or discontinue nursing depending on the importance of the drug to the patient