Pronunciation:

MYE-toe-tane

Brand Names:

• Lysodren

Dosage Forms:

• Tablet

Warnings:

In patients taking mitotane, adrenal crisis occurs in the setting of shock or severe trauma and response to shock is impaired. Administer hydrocortisone, monitor for escalating signs of shock and discontinue mitotane until recovery .

Classifications:

Therapeutic—

Adrenocortical Suppressant

Uses of This Medicine:

Mitotane is used to treat some types of cancer in the adrenal glands. This medicine acts on a part of the body called the adrenal cortex. Mitotane reduces the amount of steroids (cortisone-like hormones) that are produced by the adrenal cortex. These hormones are important for various functions of the body, including growth. However, too much of these hormones can cause problems.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of mitotane in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mitotane in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving mitotane.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Atazanavir
• Daclatasvir
• Dasabuvir
• Delamanid
• Doravirine
• Elbasvir
• Fostemsavir
• Grazoprevir
• Isavuconazonium
• Lenacapavir
• Lorlatinib
• Mavacamten
• Nirmatrelvir
• Pacritinib
• Ritonavir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abemaciclib
• Abiraterone Acetate
• Acalabrutinib
• Adagrasib
• Alfentanil
• Alpelisib
• Amiodarone
• Apremilast
• Aprepitant
• Aripiprazole
• Atogepant
• Avacopan
• Avapritinib
• Axitinib
• Belumosudil
• Benzhydrocodone
• Bictegravir
• Bortezomib
• Bosutinib
• Brigatinib
• Buprenorphine
• Cabozantinib
• Cannabidiol
• Capmatinib
• Ceritinib
• Clozapine
• Cobimetinib
• Codeine
• Copanlisib
• Crizotinib
• Cyclosporine
• Daridorexant
• Dasatinib
• Deflazacort
• Desogestrel
• Dexamethasone
• Dienogest
• Dihydrocodeine
• Dihydroergotamine
• Dofetilide
• Dronedarone
• Drospirenone
• Duvelisib
• Elacestrant
• Elexacaftor
• Eliglustat
• Encorafenib
• Entrectinib
• Eravacycline
• Erdafitinib
• Ergotamine
• Erlotinib
• Estetrol
• Estradiol
• Ethinyl Estradiol
• Ethynodiol
• Etonogestrel
• Everolimus
• Exemestane
• Fedratinib
• Fenfluramine
• Fentanyl
• Fexinidazole
• Finerenone
• Flibanserin
• Fosaprepitant
• Fosnetupitant
• Fostamatinib
• Gepirone
• Gestodene
• Glasdegib
• Hemin
• Hydrocodone
• Ibrexafungerp
• Ibrutinib
• Idelalisib
• Imatinib
• Infigratinib
• Istradefylline
• Ivabradine
• Ivacaftor
• Ivosidenib
• Ixabepilone
• Ixazomib
• Ketoconazole
• Larotrectinib
• Lefamulin
• Lemborexant
• Leniolisib
• Levoketoconazole
• Levonorgestrel
• Linagliptin
• Lumateperone
• Lurbinectedin
• Macimorelin
• Macitentan
• Manidipine
• Maribavir
• Medroxyprogesterone
• Meperidine
• Mestranol
• Methadone
• Midostaurin
• Mirtazapine
• Mitapivat
• Mobocertinib
• Naloxegol
• Neratinib
• Netupitant
• Nilotinib
• Nomegestrol
• Norelgestromin
• Norethindrone
• Norgestimate
• Norgestrel
• Olanzapine
• Olaparib
• Olutasidenib
• Omaveloxolone
• Osimertinib
• Oxcarbazepine
• Oxycodone
• Palbociclib
• Paliperidone
• Palovarotene
• Panobinostat
• Pemigatinib
• Pentazocine
• Perampanel
• Pexidartinib
• Pimavanserin
• Pimozide
• Pirtobrutinib
• Pitolisant
• Ponatinib
• Pralsetinib
• Pretomanid
• Quetiapine
• Quinidine
• Quizartinib
• Regorafenib
• Ribociclib
• Rimegepant
• Ripretinib
• Risperidone
• Ritlecitinib
• Romidepsin
• Ruxolitinib
• Samidorphan
• Segesterone
• Selpercatinib
• Selumetinib
• Sildenafil
• Sirolimus
• Sirolimus Protein-Bound
• Sotorasib
• Sparsentan
• Stiripentol
• Sufentanil
• Sunitinib
• Tacrolimus
• Tamoxifen
• Tasimelteon
• Tazemetostat
• Temsirolimus
• Tezacaftor
• Thiotepa
• Ticagrelor
• Tivozanib
• Tofacitinib
• Tolvaptan
• Tramadol
• Tucatinib
• Ubrogepant
• Ulipristal
• Upadacitinib
• Valbenazine
• Vandetanib
• Velpatasvir
• Vemurafenib
• Venetoclax
• Vilazodone
• Vincristine
• Vincristine Sulfate Liposome
• Vinflunine
• Voclosporin
• Vonoprazan
• Vorapaxar
• Vortioxetine
• Voxelotor
• Voxilaprevir
• Zanubrutinib
• Zolpidem
• Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aripiprazole Lauroxil
• Midazolam
• Warfarin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Injury, serious or
• Shock or
• Trauma, severe—Should not be used in patients with these conditions.

• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

Take this medicine only as directed by your doctor. Do not take more or less of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Do not stop taking this medicine without first checking with your doctor. To do so may increase the chance of unwanted effects.

Swallow the tablet whole. Do not crush, break, or chew it. If contact with broken or crushed tablets occurs, wash your hands immediately.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For cancer of the adrenal glands:
    • Adults—At first, 2 to 6 grams (g) per day, given in 3 or 4 divided doses per day. Your doctor may adjust your dose as needed and tolerated.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by this medicine.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and for as long as this medicine is detected in your blood. If you think you have become pregnant while using the medicine, tell your doctor right away.

Check with your doctor right away if you get a serious injury, infection, or illness of any kind. This medicine may weaken your body's defenses against infection or inflammation.

Adrenal insufficiency may develop in patients using this medicine. Check with your doctor right away if you have more than one of the following symptoms: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

This medicine may cause cysts in the ovaries in premenopausal women (have menstrual cycles). Tell your doctor if you have bloating, sudden or severe pelvic pain, or vaginal bleeding.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Darkening of the skin

diarrhea

dizziness or lightheadedness

drowsiness

loss of appetite

mental depression

nausea or vomiting

skin rash

unusual tiredness or weakness

Less common

Blood in the urine

blurred vision

double vision

Incidence not known

Bloating

chills

cloudy urine

cold sweats

confusion

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position

feeling of warmth

fever

frequent urination

headache

pelvic cramping, discomfort, pain, or heaviness

nervousness

painful urination

pounding in the ears

redness of the face, neck, arms, and occasionally, upper chest

slow or fast heartbeat

vaginal bleeding

vision changes

white area over the eye

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Feeling of constant movement of self or surroundings

indigestion

passing of gas

sensation of spinning

sleepiness

Less common

Aching muscles

flushing or redness of the skin

muscle twitching

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.