The side effects and mitigation methods of Mitotane, the Lao bear version
Mitotane, as a therapeutic drug for adrenal cortical cancer, has multiple systemic side effects that require targeted management. The following is a detailed explanation of the main side effects and mitigation measures:
1. Common side effects and treatment
(1) Gastrointestinal reactions: The incidence rate is about 80%, manifested as nausea, vomiting, and diarrhea. It is recommended to take medication after meals and use antiemetic drugs such as ondansetron if necessary.
(2) Nervous system: Dizziness (45%), drowsiness (60%). Avoid driving and operating machinery, and adjust the medication administration time to bedtime when symptoms are severe.
(3) Skin reactions: rash (30%), photosensitivity. Use SPF50+sunscreen to avoid direct sunlight.
Serious side effects that require immediate medical attention
(1) Adrenal insufficiency: manifested as extreme fatigue and low blood pressure. Urgent supplementation of glucocorticoids is required.
(2) Hepatotoxicity: Medication should be suspended when ALT levels increase by more than three times.
(3) Neurotoxicity: Ataxia or confusion require immediate discontinuation of medication.
3 Precautions for Special Groups
(1) Patients with liver dysfunction: need to reduce dosage by 50% and monitor liver function weekly.
(2) Elderly patients are more prone to central nervous system side effects, and it is recommended to reduce the initial dose by 25%.
4 Laboratory Monitoring Requirements
(1) Initial treatment: Monitor plasma drug concentration weekly (target 14-20mg/L).
(2) Long term treatment: Monthly check of thyroid function and blood lipid levels.
5 Drug Interaction Management
(1) Warfarin: Mitotan can reduce its anticoagulant effect, and the dose of warfarin needs to be increased by 30-50%.
(2) CYP3A4 inducer: It can reduce the blood concentration of mitoxan and should be avoided in combination.
Disclaimer：《The side effects and mitigation methods of Mitotane, the Lao bear version》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！