Drug interactions
Estradiol + Mitotane
Severity: Major
Estradiol 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 strongly induces CYP3A4, which can substantially lower estradiol levels and reduce efficacy. The induction persists for weeks after mitotane is stopped.
What this interaction means in plain words
Estradiol 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.
Estradiol belongs to Endocrine; Mitotane belongs to Oncology.
Why it happens
Strong induction of CYP3A4 increases estradiol metabolism.
What to do
Monitor symptom control and consider increasing the estradiol dose or switching to a transdermal route. Reassess after mitotane discontinuation as induction wanes.
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 Estradiol
- Anastrozole + Estradiol Contraindicated
- Estradiol + Fezolinetant Contraindicated
- Estradiol + Ospemifene Contraindicated
- Antithrombin alfa + Estradiol Major
- Antithrombin iii + Estradiol Major
- Estradiol + Exemestane 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 Estradiol with Mitotane?
MediHelp rates the interaction as major. Estradiol 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 strongly induces CYP3A4, which can substantially lower estradiol levels and reduce efficacy. The induction persists for weeks after mitotane is stopped.
How serious is the interaction between Estradiol 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: Monitor symptom control and consider increasing the estradiol dose or switching to a transdermal route. Reassess after mitotane discontinuation as induction wanes.
What other medicines interact with Estradiol?
MediHelp also lists interactions of Estradiol with, for example, Anastrozole, Fezolinetant, Ospemifene. The full list is on the Estradiol page.
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