Drug interactions
Mitotane + Norethisterone
Severity: Major
Mitotane and Norethisterone: 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 potent, long-lasting CYP3A4 inducer that substantially reduces exposure to norethisterone. Contraceptive failure and breakthrough bleeding may occur, and the induction persists long after mitotane is stopped.
What this interaction means in plain words
Mitotane and Norethisterone 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; Norethisterone belongs to Endocrine.
Why it happens
Mitotane induces CYP3A4, increasing norethisterone clearance.
What to do
Use a nonhormonal contraceptive method such as a copper IUD. Maintain it for months after stopping mitotane because of its long persistence.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mitotane and Norethisterone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Norethisterone
- Acitretin + Norethisterone Contraindicated
- Amobarbital + Norethisterone Major
- Apalutamide + Norethisterone Major
- Belzutifan + Norethisterone Major
- Bosentan + Norethisterone Major
- Brigatinib + Norethisterone 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 Mitotane with Norethisterone?
MediHelp rates the interaction as major. Mitotane and Norethisterone 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 that substantially reduces exposure to norethisterone. Contraceptive failure and breakthrough bleeding may occur, and the induction persists long after mitotane is stopped.
How serious is the interaction between Mitotane and Norethisterone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a nonhormonal contraceptive method such as a copper IUD. Maintain it for months after stopping mitotane because of its long persistence.
What other medicines interact with Norethisterone?
MediHelp also lists interactions of Norethisterone with, for example, Acitretin, Amobarbital, Apalutamide. The full list is on the Norethisterone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
