Drug interactions
Alprazolam + Mitotane
Severity: Moderate
Alprazolam and Mitotane: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Mitotane is a strong CYP3A4 inducer whose effect persists for weeks after discontinuation. Alprazolam concentrations may fall substantially, reducing anxiolytic efficacy and risking withdrawal-type symptoms.
What this interaction means in plain words
Alprazolam and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Alprazolam belongs to Central Nervous System; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 by mitotane increases alprazolam clearance.
What to do
Monitor for loss of efficacy and titrate the alprazolam dose upward as needed. Reduce the dose again after mitotane is stopped as induction wanes.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Other interactions of Mitotane
- Abiraterone + Mitotane Major
Frequently asked questions
Can I take Alprazolam with Mitotane?
MediHelp rates the interaction as moderate. Alprazolam and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane is a strong CYP3A4 inducer whose effect persists for weeks after discontinuation. Alprazolam concentrations may fall substantially, reducing anxiolytic efficacy and risking withdrawal-type symptoms.
How serious is the interaction between Alprazolam and Mitotane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of efficacy and titrate the alprazolam dose upward as needed. Reduce the dose again after mitotane is stopped as induction wanes.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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