How long should you take mitotane?

Mitotane is suitable for inoperable functional and non-functional adrenocortical cancer. The recommended initial dose is 2g to 6g, taken orally three or four times a day. Gradually increase the dose until the blood concentration reaches 14-20mg/L, or reaches the tolerance level. Patients should take medications until resistance or severe toxicity develops. The patient's specific condition should be closely observed during the medication period. If adverse reactions occur, the doctor should be contacted immediately.

Mitotan is a white granular solid composed of transparent colorless crystals. It is odorless and has a slightly pleasant aromatic smell. It is soluble in ethanol and has a molecular weight of 320.05. The inactive ingredients in mitotane are:microcrystalline cellulose, polyethylene glycol3350, silica, and starch. Mitotane is an adrenal cytotoxic agent with an unknown mechanism of action. Mitotane alters the peripheral metabolism of steroids and directly inhibits the adrenocortex. A decrease in 17-hydroxycorticosteroids and an increase in the formation of 6-β-hydroxycortisol have been reported without a decrease in corticosteroid concentrations.

Mitotan is found in most tissues of the body; however, fat is the predominant site of distribution. After discontinuation of mitotane, the terminal plasma half-life ranges from 18 to 159 days (median is 53 days). Mitotane is converted to water-soluble metabolites. Unaltered mitotane was not found in urine or bile. Approximately 10% of the administered dose is recovered in the urine as water-soluble metabolites. Varying amounts of metabolites(1%-17%)are excreted into bile.

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