Drug interactions
Erlotinib + Mitotane
Severity: Major
Erlotinib and Mitotane: major interaction.
Last updated Sources: US FDA label
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 and can markedly lower erlotinib plasma concentrations. This may reduce antitumor efficacy and lead to treatment failure.
What this interaction means in plain words
Erlotinib 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.
Erlotinib belongs to Oncology; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing the metabolic clearance of erlotinib.
What to do
Avoid the combination where possible and consider an alternative. If it cannot be avoided, monitor clinical response closely and consider erlotinib dose escalation with tolerability monitoring.
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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References
Other interactions of Erlotinib
- Amobarbital + Erlotinib Major
- Apalutamide + Erlotinib Major
- Carbamazepine + Erlotinib Major
- Cobicistat + Erlotinib Major
- Darunavir + Erlotinib Major
- Dexlansoprazole + Erlotinib 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 Erlotinib with Mitotane?
MediHelp rates the interaction as major. Erlotinib 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 and can markedly lower erlotinib plasma concentrations. This may reduce antitumor efficacy and lead to treatment failure.
How serious is the interaction between Erlotinib 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 the combination where possible and consider an alternative. If it cannot be avoided, monitor clinical response closely and consider erlotinib dose escalation with tolerability monitoring.
What other medicines interact with Erlotinib?
MediHelp also lists interactions of Erlotinib with, for example, Amobarbital, Apalutamide, Carbamazepine. The full list is on the Erlotinib page.
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