Drug interactions
Mitotane + Venlafaxine
Severity: Moderate
Mitotane and Venlafaxine: 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 strong inducer of CYP3A4 and may lower venlafaxine and its active metabolite concentrations. This could reduce antidepressant effect, and the induction can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Mitotane and Venlafaxine 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; Venlafaxine belongs to Central Nervous System.
Why it happens
Mitotane induces CYP3A4, increasing venlafaxine clearance.
What to do
Monitor for loss of antidepressant response and increase the venlafaxine dose if needed. Reassess the dose 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 Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine 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 Venlafaxine?
MediHelp rates the interaction as moderate. Mitotane and Venlafaxine 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 strong inducer of CYP3A4 and may lower venlafaxine and its active metabolite concentrations. This could reduce antidepressant effect, and the induction can persist for weeks after mitotane is stopped.
How serious is the interaction between Mitotane and Venlafaxine?
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 antidepressant response and increase the venlafaxine dose if needed. Reassess the dose after mitotane is discontinued.
What other medicines interact with Venlafaxine?
MediHelp also lists interactions of Venlafaxine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Venlafaxine page.
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