Drug interactions
Hydrocodone + Mitotane
Severity: Moderate
Hydrocodone 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 potent, long-acting CYP3A4 inducer that lowers hydrocodone concentrations and may reduce analgesia. When mitotane is withdrawn, or the hydrocodone dose is increased to compensate, hydrocodone levels can rise and cause respiratory depression.
What this interaction means in plain words
Hydrocodone 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.
Hydrocodone belongs to Musculoskeletal; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 increases hydrocodone metabolism, and loss of induction later reverses this effect.
What to do
Monitor analgesic response and titrate hydrocodone as needed. After mitotane discontinuation, which is slow because of its long half-life, reduce the opioid dose and watch for sedation and respiratory depression.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrocodone and Mitotane, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone 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 Hydrocodone with Mitotane?
MediHelp rates the interaction as moderate. Hydrocodone 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 potent, long-acting CYP3A4 inducer that lowers hydrocodone concentrations and may reduce analgesia. When mitotane is withdrawn, or the hydrocodone dose is increased to compensate, hydrocodone levels can rise and cause respiratory depression.
How serious is the interaction between Hydrocodone 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 analgesic response and titrate hydrocodone as needed. After mitotane discontinuation, which is slow because of its long half-life, reduce the opioid dose and watch for sedation and respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
