Drug interactions
Mitotane + Sunitinib
Severity: Major
Mitotane and Sunitinib: 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 long half-life and can markedly reduce sunitinib and active metabolite exposure. This may cause loss of efficacy, and the induction persists for weeks after mitotane stops.
What this interaction means in plain words
Mitotane and Sunitinib 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; Sunitinib belongs to Oncology.
Why it happens
Strong induction of CYP3A4 accelerates sunitinib metabolism.
What to do
Avoid the combination if possible. If necessary, monitor response closely and consider a sunitinib dose increase with careful tolerability monitoring.
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 Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib 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 Sunitinib?
MediHelp rates the interaction as major. Mitotane and Sunitinib 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 long half-life and can markedly reduce sunitinib and active metabolite exposure. This may cause loss of efficacy, and the induction persists for weeks after mitotane stops.
How serious is the interaction between Mitotane and Sunitinib?
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 the combination if possible. If necessary, monitor response closely and consider a sunitinib dose increase with careful tolerability monitoring.
What other medicines interact with Sunitinib?
MediHelp also lists interactions of Sunitinib with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Sunitinib page.
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