Drug interactions
Methylprednisolone + Mitotane
Severity: Major
Methylprednisolone 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 strong CYP3A4 inducer and substantially lowers exposure to methylprednisolone, risking inadequate steroid effect. Mitotane also increases cortisol-binding globulin and accelerates steroid metabolism, which matters for adrenal replacement.
What this interaction means in plain words
Methylprednisolone 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.
Methylprednisolone belongs to Endocrine; Mitotane belongs to Oncology.
Why it happens
Strong induction of CYP3A4 by mitotane increases methylprednisolone metabolic clearance.
What to do
Anticipate higher corticosteroid doses and titrate to clinical response; monitor for signs of adrenal insufficiency or loss of anti-inflammatory control.
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 Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella vaccine 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 Methylprednisolone with Mitotane?
MediHelp rates the interaction as major. Methylprednisolone 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 exposure to methylprednisolone, risking inadequate steroid effect. Mitotane also increases cortisol-binding globulin and accelerates steroid metabolism, which matters for adrenal replacement.
How serious is the interaction between Methylprednisolone 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: Anticipate higher corticosteroid doses and titrate to clinical response; monitor for signs of adrenal insufficiency or loss of anti-inflammatory control.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
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