Mitotane is a cancer drug belonging to the antineoplastic agents group of drugs that is used in treating cancer of the adrenal gland (adrenal cortical carcinoma) that is impossible to treat with the use of surgery. Mitotane hinders the growth and multiplication of cancer cells in the patient"s body. By hindering the growth and multiplication of cancer cells, Mitotane slows down the growth and reduces the size of the tumor.
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Mitotane is used in the treatment of cancer of the adrenal glands. The adrenal glands are responsible for the production of hormones required by the body in fighting infections, dealing with stress and maintaining normal functions like blood pressure. Some types of cancers cause the production of too much cortisol and other hormones by the adrenal glands leading to a severe condition (Cushings syndrome). When these hormones are in excess, a patient can experience conditions like weight change, diabetes, thinning skin, muscle/bone weakness and blood pressure changes. Mitotane works by destroying or slowing down the growth of the cells of the adrenal gland and reduces the side effects resulting from excessive hormone production.
- Adrenal gland cancer
- Cushings syndrome
Dosage of Mitotane depends on the individual and the condition being treated. Mitotane should be taken by mouth with/without food, normally 3-4 times every day as instructed by a medical professional. Mitotane is often started in a hospital or clinic, where a medical expert can easily monitor the patient"s dose adjustment to achieve the best dose.
- The initial dose for adrenal cortical carcinoma should be 2-6g every day, taken orally in 3 or 4 doses divided equally. The maintenance dose should be 9-10 g, and the dose may be increased up to 16 g a day if tolerated. The highest dose should be between 18-19 g a day
- Patients need to take replacement corticosteroids like hydrocortisone daily while taking Mitotane and for some time after stopping.
Mitotane Side Effects
Mitotane can cause some side effects and should be used with great caution. Common Mitotane side effects
- Mild skin rash
- Unusual Drowsiness
- Loss of appetite, vomiting, nausea
- Spinning sensation, dizziness
- Depressed mood
- Rash or changes in skin color
- Lack of energy, weakness
Serious Mitotane side effects
- Unstoppable bleeding
- Double or blurred vision
- Easy bruising or bleeding (bleeding gums, nosebleeds)
- Confusion, problems with balance, walking or speech
- Light-headed Feeling like one may pass out
- Severe dizziness
- Fast/pounding heartbeat
- Change in skin thickness/color
- Unusual /rapid weight loss
- Mental /mood changes
- Breast tenderness/enlargement in males
- Unwanted facial/body hair
- Numbness/tingling of feet/hand,
- Pink urine
- Shakiness (tremors)
Mitotane can interact with other drugs, and patients need to notify their doctors when using other medications together with Mitotane. Some medications that can cause interaction with Mitotane include:
- Spironolactone (Aldactone)
- Anticoagulants such as warfarin
- Sleeping pills, sedatives, or tranquilizers
- Medications for anxiety, seizures or mental illness
- Corticosteroids (for example prednisone, dexamethasone)
- Water pills (spironolactone, furosemide)
- Medications removed from the body by some liver enzymes like phenytoin and barbiturates
- Medications that lead to drowsiness such as: anti-seizure drugs (carbamazepine), muscle relaxants, psychiatric medications (like risperidone, trazodone, amitriptyline, chlorpromazine) , some antihistamines, narcotic pain relievers ( like codeine), medications for sleep anxiety (such as diazepam, alprazolam, and zolpidem).