Drug interactions
Mitotane + Zolpidem
Severity: Moderate
Mitotane and Zolpidem: 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 CYP3A4 inducer and can markedly lower zolpidem concentrations. The hypnotic effect may be reduced or lost. The induction can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Mitotane and Zolpidem 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; Zolpidem belongs to Central Nervous System.
Why it happens
Mitotane induces CYP3A4, increasing zolpidem metabolic clearance.
What to do
Monitor for loss of hypnotic efficacy and consider an alternative agent not dependent on CYP3A4. Avoid escalating zolpidem beyond the labeled maximum dose.
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 Zolpidem
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 Zolpidem?
MediHelp rates the interaction as moderate. Mitotane and Zolpidem 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 CYP3A4 inducer and can markedly lower zolpidem concentrations. The hypnotic effect may be reduced or lost. The induction can persist for weeks after mitotane is stopped.
How serious is the interaction between Mitotane and Zolpidem?
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 hypnotic efficacy and consider an alternative agent not dependent on CYP3A4. Avoid escalating zolpidem beyond the labeled maximum dose.
What other medicines interact with Zolpidem?
MediHelp also lists interactions of Zolpidem with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Benzhydrocodone / acetaminophen. The full list is on the Zolpidem page.
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