Drug interactions
Ketamine + Mitotane
Severity: Moderate
Ketamine 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 strongly induces CYP3A4 and can speed ketamine clearance, which may reduce its effect, particularly after oral administration. Higher doses may be needed, and induction persists for weeks after mitotane is stopped.
What this interaction means in plain words
Ketamine 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.
Ketamine belongs to Central Nervous System; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 by mitotane increases ketamine metabolism.
What to do
Monitor for reduced ketamine efficacy and titrate to effect. Re-evaluate the dose when mitotane is stopped.
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 Ketamine
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 Ketamine with Mitotane?
MediHelp rates the interaction as moderate. Ketamine 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 strongly induces CYP3A4 and can speed ketamine clearance, which may reduce its effect, particularly after oral administration. Higher doses may be needed, and induction persists for weeks after mitotane is stopped.
How serious is the interaction between Ketamine 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 for reduced ketamine efficacy and titrate to effect. Re-evaluate the dose when mitotane is stopped.
What other medicines interact with Ketamine?
MediHelp also lists interactions of Ketamine with, for example, Benzhydrocodone / acetaminophen, Brexanolone, Buprenorphine buccal. The full list is on the Ketamine page.
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