Drug interactions
Lacosamide + Mitotane
Severity: Moderate
Lacosamide 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-lasting CYP3A4 inducer and may lower lacosamide concentrations. Induction persists for weeks after mitotane is stopped, and seizure control could be compromised.
What this interaction means in plain words
Lacosamide 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.
Lacosamide belongs to Central Nervous System; Mitotane belongs to Oncology.
Why it happens
Strong CYP3A4 induction by mitotane increases lacosamide clearance.
What to do
Monitor seizure frequency and consider measuring lacosamide levels, increasing the dose as needed. Reassess the dose after mitotane is discontinued.
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 Lacosamide
- Lacosamide + Zuranolone Major
- Atazanavir + Lacosamide Moderate
- Carbamazepine + Lacosamide Moderate
- Cenobamate + Lacosamide Moderate
- Clarithromycin + Lacosamide Moderate
- Daridorexant + Lacosamide Moderate
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 Lacosamide with Mitotane?
MediHelp rates the interaction as moderate. Lacosamide 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-lasting CYP3A4 inducer and may lower lacosamide concentrations. Induction persists for weeks after mitotane is stopped, and seizure control could be compromised.
How serious is the interaction between Lacosamide 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 seizure frequency and consider measuring lacosamide levels, increasing the dose as needed. Reassess the dose after mitotane is discontinued.
What other medicines interact with Lacosamide?
MediHelp also lists interactions of Lacosamide with, for example, Zuranolone, Atazanavir, Carbamazepine. The full list is on the Lacosamide page.
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