Drug interactions
Amiodarone + Mitotane
Severity: Moderate
Amiodarone 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 inducer of CYP3A4 and can lower amiodarone concentrations considerably, with a risk of loss of antiarrhythmic control. The induction effect persists for weeks after mitotane is stopped because of its long half-life.
What this interaction means in plain words
Amiodarone 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.
Amiodarone belongs to Cardiovascular; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 by mitotane increases amiodarone metabolism.
What to do
Monitor for arrhythmia recurrence and consider checking amiodarone and desethylamiodarone levels, adjusting the dose as needed. Reassess the dose after mitotane is discontinued.
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 Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Amiodarone with Mitotane?
MediHelp rates the interaction as moderate. Amiodarone 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 inducer of CYP3A4 and can lower amiodarone concentrations considerably, with a risk of loss of antiarrhythmic control. The induction effect persists for weeks after mitotane is stopped because of its long half-life.
How serious is the interaction between Amiodarone 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 arrhythmia recurrence and consider checking amiodarone and desethylamiodarone levels, adjusting the dose as needed. Reassess the dose after mitotane is discontinued.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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