Medical Information

Mitotane, as a specific drug for adrenal cortical cancer, has strict contraindications for its use in certain populations. The following is an explanation of 7 taboo groups, including pregnancy and liver dysfunction, and provides alternative suggestions.

1. Pregnant women

Mitotan can cause fetal malformations through the placental barrier. Animal experiments have shown that therapeutic doses can induce developmental abnormalities such as cleft palate and skeletal deformities. Women of childbearing age need to confirm that they are not pregnant before taking medication, and effective contraceptive measures should be taken during treatment and 3 months after discontinuing medication.

2. Breastfeeding women

Medications can be secreted into breast milk, and lactating infants may experience adrenal dysfunction. It is recommended to suspend breastfeeding during the treatment period and for 3 months after discontinuing medication, and switch to formula milk powder as a substitute.

3. Severe liver function impairment

Child Pugh Class C patients are contraindicated. Due to the hepatic metabolism of mitoxan, the drug clearance rate decreases by 60% in patients with severe liver dysfunction, and the risk of poisoning significantly increases. Mild damage (Child Pugh A) also requires a 25% reduction in usage.

4. Active infection patients

Mitotan can inhibit the secretion of adrenal cortex hormones and reduce the body's ability to resist infections. Patients with combined active tuberculosis and deep fungal infections need to control their infections before considering medication.

5. Patients with mental illness

Drugs can cause neurotoxicity through the blood-brain barrier. The incidence of central adverse reactions increases threefold in patients with a history of depression or epilepsy after medication, and the risk benefit ratio should be carefully evaluated.

6. Child patients

Lack of safety data for children under 12 years old. Clinical observations have shown that children are more prone to adverse reactions such as severe vomiting and ataxia, and should only be used under the guidance of a specialist doctor.

7. Individuals with allergies

It is contraindicated for individuals allergic to mitoxan or its excipients (such as lactose). The first medication should be administered under hospital supervision, and anti allergic emergency measures should be prepared.

Alternative treatment recommendations

For contraindicated patients, the combination therapy of streptozotocin and doxorubicin may be considered, or they may participate in clinical trials of novel targeted drugs such as Linsitinib.