Drug interactions
Mitotane + Primaquine
Severity: Moderate
Mitotane and Primaquine: 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 is a potent CYP3A4 inducer and can lower concentrations of CYP3A4 substrates for weeks after use. Primaquine exposure may fall, possibly reducing its antimalarial effect.
What this interaction means in plain words
Mitotane and Primaquine 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; Primaquine belongs to Anti Parasitic.
Why it happens
Induction of CYP3A4 by mitotane, increasing primaquine metabolism.
What to do
Monitor for treatment failure or relapse and consider dose adjustment or an alternative agent. Be aware that the inductive effect persists after mitotane is stopped.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mitotane and Primaquine, 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.
Other interactions of Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine 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 Primaquine?
MediHelp rates the interaction as moderate. Mitotane and Primaquine 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 is a potent CYP3A4 inducer and can lower concentrations of CYP3A4 substrates for weeks after use. Primaquine exposure may fall, possibly reducing its antimalarial effect.
How serious is the interaction between Mitotane and Primaquine?
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 treatment failure or relapse and consider dose adjustment or an alternative agent. Be aware that the inductive effect persists after mitotane is stopped.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine 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.
