What should I pay attention to while taking MITOTANE?

Adrenocortical carcinoma is a rare cancer that responds poorly to cytotoxic treatments. MITOTANE is currently the only drug approved for adrenocortical cancer. Mitotane is indicated for the treatment of patients with inoperable functional or non-functioning adrenocortical carcinoma.

What should I pay attention to while taking mitotane?

1.Adrenal crisis in shock or severe trauma

In patients takingmitotaneadrenal crisis occurs in the setting of shock or severe trauma, and the response to shock is impaired. Use hydrocortisone, monitor for worsening of shock symptoms, and discontinue mitotane until resolution occurs.

2.Central nervous system toxicity

CNS toxicity, including sedation, somnolence, and dizziness, may occur with mitotanetreatment. Mitotane plasma concentrations exceeding20 mcg/mLare associated with a higher incidence of toxicity.

3.Adrenal Insufficiency

Treatment withmitotanecan result in adrenal insufficiency. Steroid replacement therapy was performed as clinically indicated. Measure free cortisol and adrenocorticotropic hormone(ACTH)levels for optimal steroid replacement.

4.Embryo-Fetal Toxicity

Taking it by pregnant women Mitotane can cause harm to the fetus. Abnormal pregnancy outcomes, such as preterm birth and early pregnancy loss, may occur in patients exposed to mitotane during pregnancy. Inform pregnant women of potential risks to the fetus. As long as mitotane plasma levels are detectable, females of reproductive potential are advised to use effective contraception during treatment with mitotane and after discontinuation of treatment.

5.Large ovarian cysts in premenopausal women

Large ovarian cysts, usually bilateral and multiple, have been reported in premenopausal patients receivingmitotane. Complications of these cysts, including adnexal torsion and hemorrhagic cyst rupture, have been reported. In some cases, improvement occurred after mitotane was discontinued. Advise female patients to seek medical care if they experience gynecological symptoms such as vaginal bleeding or pelvic pain.

Mitotan 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.

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