Drug interactions
Mitotane + Ruxolitinib
Severity: Major
Mitotane and Ruxolitinib: 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 strongly induces CYP3A4 and can substantially lower ruxolitinib concentrations. This may lead to loss of efficacy in myelofibrosis, polycythemia vera or graft-versus-host disease. The induction persists for weeks after mitotane is stopped because of its long half-life.
What this interaction means in plain words
Mitotane and Ruxolitinib 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; Ruxolitinib belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing the metabolism of ruxolitinib.
What to do
Monitor for reduced response and consider alternative therapy or ruxolitinib dose titration guided by response and blood counts. Remember that induction persists after mitotane discontinuation.
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 Ruxolitinib
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 Ruxolitinib?
MediHelp rates the interaction as major. Mitotane and Ruxolitinib 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 strongly induces CYP3A4 and can substantially lower ruxolitinib concentrations. This may lead to loss of efficacy in myelofibrosis, polycythemia vera or graft-versus-host disease. The induction persists for weeks after mitotane is stopped because of its long half-life.
How serious is the interaction between Mitotane and Ruxolitinib?
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 for reduced response and consider alternative therapy or ruxolitinib dose titration guided by response and blood counts. Remember that induction persists after mitotane discontinuation.
What other medicines interact with Ruxolitinib?
MediHelp also lists interactions of Ruxolitinib with, for example, Atazanavir, Ceritinib, Chloramphenicol. The full list is on the Ruxolitinib page.
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