Brands, Medical Use, Clinical Data
Drug Category
Dosage Forms
Brands / Synonyms
Chloditan; Chlodithan; Chlodithane; Khlodithan; Lysodren; Mitotan; Mitotanum [INN-Latin]
Indications
For treatment of inoperable adrenocortical tumours; Cushing's syndrome
Pharmacology
Mitotane is an oral chemotherapeutic agent indicated in the treatment of inoperable adrenal cortical carcinoma of both functional and nonfunctional types. Mitotane can best be described as an adrenal cytotoxic agent, although it can cause adrenal inhibition, apparently without cellular destruction. The administration of Mitotane alters the extra-adrenal metabolism of cortisol in man; leading to a reduction in measurable 17-hydroxy corticosteroids, even though plasma levels of corticosteroids do not fall. The drug apparently causes increased formation of 6-B-hydroxyl cortisol.
Mechanism of Action
Its biochemical mechanism of action is unknown, although data are available to suggest that the drug modifies the peripheral metabolism of steroids as well as directly suppressing the adrenal cortex.
Absorption
About 40% oral Lysodren is absorbed
Toxicity
Not Available
Biotrnasformation / Drug Metabolism
Hepatic and renal
Contraindications
Mitotane should not be given to individuals who have demonstrated a previous hypersensitivity to it.
Drug Interactions
Mitotane has been reported to accelerate the metabolism of warfarin by the mechanism of hepatic microsomal enzyme induction, leading to an increase in dosage requirements for warfarin. Therefore, physicians should closely monitor patients for a change in anticoagulant dosage requirements when administering Mitotane to patients on coumarin-type anticoagulants. In addition, Mitotane should be given with caution to patients receiving other drugs susceptible to the influence of hepatic enzyme induction.
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