Drug interactions
Mitotane + Temsirolimus
Severity: Major
Mitotane and Temsirolimus: 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 half-life and can markedly lower temsirolimus and sirolimus exposure. This may reduce antitumor efficacy, and the effect can persist for weeks to months after mitotane is stopped.
What this interaction means in plain words
Mitotane and Temsirolimus 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; Temsirolimus belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing metabolism of temsirolimus and sirolimus.
What to do
Avoid the combination where possible; if required, consider a higher temsirolimus dose per labeling for strong inducers and monitor for loss of efficacy.
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 Temsirolimus
- Bcg vaccine live + Temsirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Temsirolimus Contraindicated
- Measles mumps and rubella vaccine live + Temsirolimus Contraindicated
- Measles mumps rubella and varicella vaccine live + Temsirolimus Contraindicated
- Measles vaccine + Temsirolimus Contraindicated
- Rotavirus oral vaccine live + Temsirolimus 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 Temsirolimus?
MediHelp rates the interaction as major. Mitotane and Temsirolimus 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 half-life and can markedly lower temsirolimus and sirolimus exposure. This may reduce antitumor efficacy, and the effect can persist for weeks to months after mitotane is stopped.
How serious is the interaction between Mitotane and Temsirolimus?
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 where possible; if required, consider a higher temsirolimus dose per labeling for strong inducers and monitor for loss of efficacy.
What other medicines interact with Temsirolimus?
MediHelp also lists interactions of Temsirolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Temsirolimus page.
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