Drug interactions
Lurasidone + Mitotane
Severity: Major
Lurasidone and Mitotane: major interaction.
Last updated Sources: US FDA label
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 strong CYP3A4 inducer and substantially lowers lurasidone exposure, which can lead to loss of antipsychotic efficacy. The induction may persist for weeks after mitotane is stopped because of its long half-life.
What this interaction means in plain words
Lurasidone 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.
Lurasidone belongs to Central Nervous System; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing the metabolism of lurasidone, a sensitive CYP3A4 substrate.
What to do
Lurasidone labeling recommends avoiding strong CYP3A4 inducers; use an alternative antipsychotic not dependent on CYP3A4. If combined, monitor psychiatric response closely.
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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References
Other interactions of Lurasidone
- Apalutamide + Lurasidone Contraindicated
- Atazanavir + Lurasidone Contraindicated
- Carbamazepine + Lurasidone Contraindicated
- Clarithromycin + Lurasidone Contraindicated
- Cobicistat + Lurasidone Contraindicated
- Conivaptan + Lurasidone 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 Lurasidone with Mitotane?
MediHelp rates the interaction as major. Lurasidone 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 strong CYP3A4 inducer and substantially lowers lurasidone exposure, which can lead to loss of antipsychotic efficacy. The induction may persist for weeks after mitotane is stopped because of its long half-life.
How serious is the interaction between Lurasidone 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: Lurasidone labeling recommends avoiding strong CYP3A4 inducers; use an alternative antipsychotic not dependent on CYP3A4. If combined, monitor psychiatric response closely.
What other medicines interact with Lurasidone?
MediHelp also lists interactions of Lurasidone with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Lurasidone page.
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