Drug interactions
Mitotane + Rolapitant
Severity: Major
Mitotane and Rolapitant: 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 strong CYP3A4 inducer with a very long duration of effect, and it can substantially lower rolapitant exposure. Antiemetic efficacy may be lost.
What this interaction means in plain words
Mitotane and Rolapitant 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; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Mitotane induces CYP3A4, increasing rolapitant clearance.
What to do
Avoid rolapitant and choose an antiemetic regimen not dependent on CYP3A4. Monitor for breakthrough emesis.
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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References
Other interactions of Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant 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 Rolapitant?
MediHelp rates the interaction as major. Mitotane and Rolapitant 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 with a very long duration of effect, and it can substantially lower rolapitant exposure. Antiemetic efficacy may be lost.
How serious is the interaction between Mitotane and Rolapitant?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid rolapitant and choose an antiemetic regimen not dependent on CYP3A4. Monitor for breakthrough emesis.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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