Drug interactions
Mitotane + Terbinafine
Severity: Moderate
Mitotane and Terbinafine: 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, long-acting inducer of CYP3A4 and may substantially lower terbinafine concentrations. Reduced exposure may cause antifungal failure, and the induction persists for weeks after mitotane is stopped.
What this interaction means in plain words
Mitotane and Terbinafine 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; Terbinafine belongs to Anti Fungals.
Why it happens
Mitotane induces CYP3A4 and other enzymes, increasing terbinafine clearance.
What to do
Monitor antifungal response and consider an alternative or higher-intensity regimen if response is inadequate.
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 Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Desipramine + Terbinafine Major
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine 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 Terbinafine?
MediHelp rates the interaction as moderate. Mitotane and Terbinafine 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, long-acting inducer of CYP3A4 and may substantially lower terbinafine concentrations. Reduced exposure may cause antifungal failure, and the induction persists for weeks after mitotane is stopped.
How serious is the interaction between Mitotane and Terbinafine?
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 antifungal response and consider an alternative or higher-intensity regimen if response is inadequate.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Desipramine, Eliglustat. The full list is on the Terbinafine page.
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