Mitotane Disease Interactions

Mitotane inhibits production of corticosteroids and alters extra-adrenal metabolism of endogenous and exogenous steroids. All patients treated with mitotane should be instructed to immediately report signs and symptoms of infection or other illnesses. Therapy with mitotane should be withheld immediately following shock or severe trauma or infection. Exogenous steroids should be administered since the suppressed adrenal may not immediately begin to secrete steroids.

Symptoms of depression consisting of lethargy and somnolence have been reported during mitotane therapy. Therapy with mitotane should be administered cautiously to patients with or predisposed to depression. Clinical monitoring of psychological behavior is recommended.

Mitotane is primarily metabolized by the liver. Metabolism and therapeutic activity may be altered in patients with hepatic impairment. Therapy with mitotane should be administered cautiously in patients with hepatic impairment. Clinical monitoring of hepatic function is recommended.

Unspecified brain damage and impairment of function have been reported during prolonged mitotane therapy. Therapy with mitotane should be administered cautiously to patients with neurologic impairment. Clinical monitoring of behavior and neurological function is recommended when continuous mitotane therapy exceeds two years.

Ovarian macrocysts, often bilateral and multiple, have been reported in premenopausal patients receiving mitotane which might lead to adnexal torsion and hemorrhagic cyst rupture. It is recommended to use care when using this agent in premenopausal patients and to seek medical care if they experience gynecological symptoms such as vaginal bleeding and/or pelvic pain.