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Mitotane

Chemotherapy

Brand names:

Lysodren®

Other names:

Chloditan; Chlodithane; Khloditan; Mytotan

Often used for:

Adrenocortical carcinoma, Cushing syndrome

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About Mitotane

Mitotane is a type of chemotherapy used to treat cancer of the adrenal gland. It works by slowing or stopping the growth of adrenocortical cells. It also lowers production of steroid hormones made in the adrenal gland. These hormones help to regulate important body functions. Patients will need steroid replacement therapy with fludrocortisone and hydrocortisone.

Patients will begin therapy with a low dose, which will be gradually increased. Patients will have regular blood draws to check the amount of mitotane in the blood. The dose of mitotane may change based on results of lab tests. Blood levels that are too high increase the risk of unwanted side effects.

Mitotane is stored in the body primarily in fat tissue. Because of this, it can take several weeks to reach high enough levels in the blood. It may also remain in the blood for months after the medication has been stopped as the drug is slowly eliminated from the body.

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May be taken as a tablet by mouth

 
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May be taken as a liquid by mouth

 
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Possible Side Effects

  • Nausea and vomiting
  • Changes in mood or behavior
  • Adrenal gland problems: flushing, hypertension, hypotension, changes in electrolytes
  • Thyroid problems
  • Diarrhea
  • Loss of appetite
  • Rash
  • Fatigue or weakness
  • Gynecomastia (enlarged breast tissue)
  • Liver problems
  • Confusion*
  • Headache*
  • Dizziness*
  • Sedation*
  • Vision changes*

*These symptoms are usually associated with higher drug levels in the blood. Therapy will be held until symptoms improve and continued at a lower dose.

Not all patients who take mitotane will experience these side effects. Common side effects are in bold, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

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Tips for Families

Be sure to discuss these and other recommendations with your doctor or pharmacist.

  • Mitotane decreases hormones made by the adrenal gland and can affect the body’s response to stress or illness. Patients may need extra steroid medications during illness, injury, or stress. This is referred to as an adrenal crisis.
  • A doctor may prescribe medicine to reduce nausea and vomiting.
  • Sexually active patients should take steps to prevent pregnancy during treatment and for 6 months after completion of therapy or as long as drug levels are still present in the blood.
  • Patients should tell their doctor if they are pregnant or breastfeeding.
  • Caregivers should follow instructions for safe handling and disposal of the medicine and avoid contact with patient body fluids.

Mitotane at home:

  • Wear gloves when handling the medicine. Wear a mask if there is potential for exposure to crushed or broken tablets.
  • Take mitotane at the same time each day.
  • Take tablets with high-fat foods such as peanut butter or ice cream.
  • Swallow tablets whole. Do not crush, chew, or break unless otherwise instructed by a doctor or pharmacist. If tablets are crushed, wear a mask and gloves during preparation and place in food for administration.
  • Mitotane can be given by feeding tube. Follow the instructions given by your doctor or pharmacist.
  • Store the medicine at room temperature. 
  • If you miss a dose, skip the dose and go back to the usual schedule. Do not give 2 doses at the same time.
  • Do not use the medicine past the expiration date.
  • Follow instructions for safe handling, storage, and disposal.