Drug interactions
Mitotane + Sildenafil
Severity: Moderate
Mitotane and Sildenafil: 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 whose effect persists for weeks after stopping. It can greatly lower sildenafil exposure and cause treatment failure.
What this interaction means in plain words
Mitotane and Sildenafil 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; Sildenafil belongs to Genitourinary.
Why it happens
Mitotane induces CYP3A4, accelerating sildenafil metabolism.
What to do
Monitor for loss of sildenafil effect and consider an alternative or dose titration. Expect the interaction to last for weeks after mitotane is discontinued.
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 Sildenafil
- Amyl nitrite + Sildenafil Contraindicated
- Atazanavir + Sildenafil Contraindicated
- Cobicistat + Sildenafil Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contraindicated
- Glyceryl trinitrate pr + Sildenafil Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
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 Sildenafil?
MediHelp rates the interaction as moderate. Mitotane and Sildenafil 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 whose effect persists for weeks after stopping. It can greatly lower sildenafil exposure and cause treatment failure.
How serious is the interaction between Mitotane and Sildenafil?
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 loss of sildenafil effect and consider an alternative or dose titration. Expect the interaction to last for weeks after mitotane is discontinued.
What other medicines interact with Sildenafil?
MediHelp also lists interactions of Sildenafil with, for example, Amyl nitrite, Atazanavir, Cobicistat. The full list is on the Sildenafil page.
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