Drug interactions
Lapatinib + Mitotane
Severity: Major
Lapatinib 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, long-lasting CYP3A4 inducer and can markedly lower lapatinib exposure, risking loss of antitumor efficacy. The induction persists for weeks after mitotane is stopped.
What this interaction means in plain words
Lapatinib 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.
Lapatinib belongs to Oncology; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 by mitotane increases lapatinib metabolism.
What to do
Avoid the combination if possible and use an alternative therapy. If unavoidable, lapatinib dose escalation under close monitoring would be required, and the dose should be reduced again after mitotane 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 Lapatinib
- Dofetilide + Lapatinib Contraindicated
- Ibutilide + Lapatinib Contraindicated
- Lapatinib + Pimozide Contraindicated
- Lapatinib + Saquinavir Contraindicated
- Lapatinib + Thioridazine Contraindicated
- Adagrasib + Lapatinib 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 Lapatinib with Mitotane?
MediHelp rates the interaction as major. Lapatinib 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, long-lasting CYP3A4 inducer and can markedly lower lapatinib exposure, risking loss of antitumor efficacy. The induction persists for weeks after mitotane is stopped.
How serious is the interaction between Lapatinib 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: Avoid the combination if possible and use an alternative therapy. If unavoidable, lapatinib dose escalation under close monitoring would be required, and the dose should be reduced again after mitotane induction wanes.
What other medicines interact with Lapatinib?
MediHelp also lists interactions of Lapatinib with, for example, Dofetilide, Ibutilide, Pimozide. The full list is on the Lapatinib page.
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