Drug interactions
Mitotane + Ondansetron
Severity: Moderate
Mitotane and Ondansetron: moderate 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 strongly induces CYP3A4 and can lower ondansetron concentrations. This may reduce antiemetic effect, though the effect is partly offset by other metabolic pathways.
What this interaction means in plain words
Mitotane and Ondansetron can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Mitotane belongs to Oncology; Ondansetron belongs to Gastrointestinal Tract.
Why it happens
Induction of CYP3A4 by mitotane increases ondansetron clearance.
What to do
Monitor for reduced antiemetic control and increase the ondansetron dose or switch agents if nausea is poorly controlled. The inducing effect of mitotane can persist for weeks after stopping.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ondansetron
- Apomorphine + Ondansetron Contraindicated
- Ondansetron + Thioridazine Contraindicated
- Ondansetron + Vandetanib Contraindicated
- Adagrasib + Ondansetron Major
- Amiodarone + Ondansetron Major
- Amisulpride + Ondansetron 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 Ondansetron?
MediHelp rates the interaction as moderate. Mitotane and Ondansetron can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane strongly induces CYP3A4 and can lower ondansetron concentrations. This may reduce antiemetic effect, though the effect is partly offset by other metabolic pathways.
How serious is the interaction between Mitotane and Ondansetron?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced antiemetic control and increase the ondansetron dose or switch agents if nausea is poorly controlled. The inducing effect of mitotane can persist for weeks after stopping.
What other medicines interact with Ondansetron?
MediHelp also lists interactions of Ondansetron with, for example, Apomorphine, Thioridazine, Vandetanib. The full list is on the Ondansetron page.
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