Drug interactions
Ifosfamide + Mitotane
Severity: Major
Ifosfamide 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 potent CYP3A4 inducer and can increase ifosfamide conversion, including to neurotoxic and nephrotoxic chloroacetaldehyde. This raises the risk of encephalopathy and renal injury, and induction persists for weeks after mitotane is stopped.
What this interaction means in plain words
Ifosfamide 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.
Ifosfamide belongs to Oncology; Mitotane belongs to Oncology.
Why it happens
CYP3A4 induction by mitotane increases ifosfamide metabolism and toxic metabolite formation.
What to do
Monitor closely for CNS toxicity, renal function and myelosuppression, and consider ifosfamide dose adjustment or an alternative regimen.
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 Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
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 Ifosfamide with Mitotane?
MediHelp rates the interaction as major. Ifosfamide 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 increase ifosfamide conversion, including to neurotoxic and nephrotoxic chloroacetaldehyde. This raises the risk of encephalopathy and renal injury, and induction persists for weeks after mitotane is stopped.
How serious is the interaction between Ifosfamide 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 closely for CNS toxicity, renal function and myelosuppression, and consider ifosfamide dose adjustment or an alternative regimen.
What other medicines interact with Ifosfamide?
MediHelp also lists interactions of Ifosfamide with, for example, Adenovirus types 4 and 7 live, Measles mumps and rubella vaccine, Measles mumps and rubella vaccine live. The full list is on the Ifosfamide page.
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