Drug interactions
Aripiprazole + Mitotane
Severity: Major
Aripiprazole 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 strong CYP3A4 inducer and can substantially lower aripiprazole concentrations, risking loss of psychiatric control. The induction can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Aripiprazole 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.
Aripiprazole belongs to Central Nervous System; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 increases aripiprazole clearance.
What to do
Aripiprazole labeling advises roughly doubling the dose with strong CYP3A4 inducers; titrate by clinical response. Reduce the dose again if mitotane is discontinued.
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 Aripiprazole
- Aripiprazole + Pimozide Contraindicated
- Aripiprazole + Thioridazine Contraindicated
- Amisulpride + Aripiprazole Major
- Aripiprazole + Arsenic trioxide Major
- Aripiprazole + Calcium / magnesium / potassium / sodium oxybates Major
- Aripiprazole + Carbamazepine Major
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 Aripiprazole with Mitotane?
MediHelp rates the interaction as major. Aripiprazole 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 strong CYP3A4 inducer and can substantially lower aripiprazole concentrations, risking loss of psychiatric control. The induction can persist for weeks after mitotane is stopped.
How serious is the interaction between Aripiprazole 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: Aripiprazole labeling advises roughly doubling the dose with strong CYP3A4 inducers; titrate by clinical response. Reduce the dose again if mitotane is discontinued.
What other medicines interact with Aripiprazole?
MediHelp also lists interactions of Aripiprazole with, for example, Pimozide, Thioridazine, Amisulpride. The full list is on the Aripiprazole page.
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