Drug interactions
Mitotane + Nicardipine
Severity: Major
Mitotane and Nicardipine: 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 can substantially lower nicardipine concentrations, causing loss of blood pressure or angina control. The inducing effect develops over weeks and persists long after mitotane is stopped.
What this interaction means in plain words
Mitotane and Nicardipine 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 belongs to Oncology; Nicardipine belongs to Cardiovascular.
Why it happens
Mitotane induces CYP3A4, increasing nicardipine metabolism and reducing its exposure.
What to do
Monitor blood pressure and anginal symptoms and increase the nicardipine dose as needed, or switch to an antihypertensive not metabolized by CYP3A4. Reassess the dose after mitotane is discontinued.
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 Nicardipine
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 Mitotane with Nicardipine?
MediHelp rates the interaction as major. Mitotane and Nicardipine 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 can substantially lower nicardipine concentrations, causing loss of blood pressure or angina control. The inducing effect develops over weeks and persists long after mitotane is stopped.
How serious is the interaction between Mitotane and Nicardipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and anginal symptoms and increase the nicardipine dose as needed, or switch to an antihypertensive not metabolized by CYP3A4. Reassess the dose after mitotane is discontinued.
What other medicines interact with Nicardipine?
MediHelp also lists interactions of Nicardipine with, for example, Amifostine, Amlodipine-olmesartan-hydrochlorothiazide, Betrixaban. The full list is on the Nicardipine page.
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