Drug interactions
Mitotane + Upadacitinib
Severity: Major
Mitotane and Upadacitinib: 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-lasting effect and can substantially lower upadacitinib exposure. This may cause loss of efficacy.
What this interaction means in plain words
Mitotane and Upadacitinib 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; Upadacitinib belongs to Musculoskeletal.
Why it happens
Mitotane induces CYP3A4, increasing upadacitinib metabolism.
What to do
Avoid the combination, as labeling advises against strong CYP3A inducers. Because induction persists for weeks after mitotane is stopped, monitor efficacy and consider an alternative therapy.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mitotane and Upadacitinib, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Upadacitinib 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 Upadacitinib?
MediHelp rates the interaction as major. Mitotane and Upadacitinib 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-lasting effect and can substantially lower upadacitinib exposure. This may cause loss of efficacy.
How serious is the interaction between Mitotane and Upadacitinib?
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, as labeling advises against strong CYP3A inducers. Because induction persists for weeks after mitotane is stopped, monitor efficacy and consider an alternative therapy.
What other medicines interact with Upadacitinib?
MediHelp also lists interactions of Upadacitinib with, for example, Abrocitinib, Adenovirus types 4 and 7 live, Baricitinib. The full list is on the Upadacitinib page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
