Medical Information

Mitotane is a cytotoxic drug used to treat adrenal cortex cancer, with clear indications and strict adherence to medication precautions.

Medication precautions

1. Contraindications for pregnancy

Mitotan has clear embryotoxicity and is absolutely contraindicated for pregnant women. Women of childbearing age need to confirm that they are not pregnant before treatment, and effective contraceptive measures should be taken during the treatment period and within 3 months after discontinuation of medication.

2 Liver function monitoring

Individuals with mild to moderate liver function impairment should reduce their dosage by 25% -50%, while those with severe liver function impairment should not use it. During the treatment period, ALT/AST should be monitored monthly, and medication should be suspended when the ULN increases by more than 3 times.

3 drug interactions

Mitotan is a strong inducer of CYP3A4, which may reduce the blood drug concentration of drugs metabolized by this enzyme. Combined use with anticoagulants may increase the risk of bleeding and requires close monitoring of INR values.

4. Monitoring of blood drug concentration

Regular monitoring of blood drug concentration is required during treatment, with a target range of 14-20mg/L. Adjust the dosage based on the concentration results to maintain the therapeutic effect and reduce toxicity.

5. Monitoring of the nervous system

There may be neurological adverse reactions such as drowsiness and ataxia, and elderly patients are at a higher risk. Suggest reducing the initial dose by 25% and strengthening symptom monitoring.

Dietary precautions

1 Grapefruit and its products

Grapefruits and grapefruit juice contain potent CYP3A4 inhibitors, which may significantly increase the blood concentration and toxicity risk of mitoxan. During treatment, intake, including beverages or foods containing grapefruit ingredients, should be completely avoided.

2. High fat diet

Mitotan is a fat soluble drug, and a high-fat diet can promote its absorption. It is recommended to maintain a stable fat content in the diet during medication and avoid excessive consumption of high-fat foods that can cause fluctuations in blood drug concentration.

3 Alcoholic beverages

Alcohol may exacerbate the liver toxicity and central nervous system inhibitory effects of mitoxan. During the treatment period, alcohol should be quit, especially for patients with abnormal liver function, which should be strictly prohibited.

4 caffeinated foods

Coffee, strong tea, etc. may exacerbate the neurological adverse reactions (such as tremors and insomnia) caused by mitoxan. It is recommended to limit intake and completely avoid related symptoms.