Drug interactions
Cyclophosphamide + Mitotane
Severity: Moderate
Cyclophosphamide 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 and may increase cyclophosphamide conversion to active metabolites, which could increase toxicity, while also increasing inactivation pathways. The net effect is unpredictable, and the inducing effect persists for weeks after mitotane is stopped.
What this interaction means in plain words
Cyclophosphamide 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.
Cyclophosphamide belongs to Oncology; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4 (and possibly other CYP enzymes), altering cyclophosphamide metabolism.
What to do
Monitor blood counts and for signs of cyclophosphamide toxicity or reduced efficacy. Adjust dosing based on clinical response, remembering the induction persists after mitotane discontinuation.
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 Cyclophosphamide
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 Cyclophosphamide with Mitotane?
MediHelp rates the interaction as moderate. Cyclophosphamide 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 and may increase cyclophosphamide conversion to active metabolites, which could increase toxicity, while also increasing inactivation pathways. The net effect is unpredictable, and the inducing effect persists for weeks after mitotane is stopped.
How serious is the interaction between Cyclophosphamide 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 blood counts and for signs of cyclophosphamide toxicity or reduced efficacy. Adjust dosing based on clinical response, remembering the induction persists after mitotane discontinuation.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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