Drug interactions of Mitotane

1.Effects of Other Drugs on Mitotane

Spironolactone 

Spironolactone may block the action of mitotane. Avoid concomitant use of mitotane with spironolactone.

2.Effects of Mitotane on Other Drugs

Certain CYP3A substrates

Mitotane is a strong CYP3A inducer. Concomitant use of Mitotane may decrease the levels of CYP3A substrates, which may reduce the activity of these substrates.

Avoid concomitant use of Mitotane with other CYP3A substrates, where minimal level changes may lead to serious therapeutic failures. If concomitant use cannot be avoided, modify the dosage of the CYP3A substrate in accordance with the approved product labeling. 

Hormonal Contraceptives

Avoid concomitant use of Mitotane with hormonal contraceptives. 

Warfarin

Mitotane may induce the metabolism of warfarin, which may reduce its level and its efficacy.

Avoid concomitant use of Mitotane with warfarin. If concomitant use cannot be avoided, monitor INR more frequently and adjust warfarin dose as recommended in accordance with the recommendations in the warfarin Prescribing Information.

from FDA,2024.01