Drug interactions
Aprepitant + Mitotane
Severity: Major
Aprepitant and Mitotane: major 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 potent CYP3A4 inducer with a long half-life and can markedly reduce aprepitant concentrations. This may cause loss of antiemetic protection for weeks after mitotane exposure.
What this interaction means in plain words
Aprepitant and Mitotane can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aprepitant belongs to Gastrointestinal Tract; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing aprepitant clearance.
What to do
Avoid relying on aprepitant for emetic prophylaxis; use alternative antiemetics such as a 5-HT3 antagonist with dexamethasone adjusted for induction. Monitor for breakthrough vomiting.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aripiprazole + Mitotane Major
Frequently asked questions
Can I take Aprepitant with Mitotane?
MediHelp rates the interaction as major. Aprepitant and Mitotane can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Mitotane is a potent CYP3A4 inducer with a long half-life and can markedly reduce aprepitant concentrations. This may cause loss of antiemetic protection for weeks after mitotane exposure.
How serious is the interaction between Aprepitant and Mitotane?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid relying on aprepitant for emetic prophylaxis; use alternative antiemetics such as a 5-HT3 antagonist with dexamethasone adjusted for induction. Monitor for breakthrough vomiting.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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