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Mitotane review
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Mitotane belongs to a class of drugs chemically similar to DDTs and is a derivative of DDDs.
The main action of mitotane is to alter steroid peripheral metabolism. This action directly suppresses the adrenal cortex, altering cortisone metabolism which will lead to hypocortisolism.
Mitotane is marketed under the brand name Lysodren. This drug is indicated for patients with inoperable adrenal cortical carcinoma of both types – functional and nonfunctional.
The recommended dosage for mitotane administration is 2 to 6 g of mitotane a day, given in divided doses three to four times a day. The dosage of mitotane may be incrementally increased per day, depending on the patient’s reaction to the drug.
Main side effects of mitotane usage include disturbances in the gastrointestinal area, central nervous system, and in the skin. Side effects occurring the gastrointestinal tract include anorexia, nausea, vomiting and diarrhea. Side effects such as lethargy, dizziness, vertigo and depression target the central nervous system. Skin rashes, hives and allergic reactions are some other side effects of the drug.
Mitotane is contraindicated in patients with known hypersensitivity to the drug and its known components.
Patients receiving drugs that induce hepatic enzyme induction should be monitored closely as they undergo mitotane treatment as mitotane accelerates metabolism of warfarin which affects the anti-coagulant properties of some drugs.
Mitotane treatment is to be stopped when a patient experiences shock or sever trauma as adrenal suppression is at its peak. Patients with known liver failure should be given caution prior to use of the drug, as the condition may interfere with mitotane metabolism and may have the drug accumulate in the system.
Tumors should be removed prior to use of the drug as to minimize the possibility of hemorrhage and infarctions. Use of the drug over a long time period may lead to brain damage and impairment of its functions. If the drug is to be used for more than two years, patients should undergo behavioral and neurological tests.
There are no known studies that show whether mitotane causes harm to the unborn child. However, the drug should be used only when there is clear need of its benefits. Women who are breastfeeding or planning to breastfeed should first consult their physicians prior to drug use. The potential benefits of the drug should always be weighed against the risks of the drug.
Mitotane has the following structural formula:
• Molecular formula of mitotane is C14H10Cl4
• Chemical IUPAC Name is 1-chloro-2-[2,2-dichloro-1-(4-chlorophenyl)-ethyl]-benzene
• Molecular weight is 320.04 g/mol
• Mitotane available : 500mg tablets
Brand name(s): Chloditan, Chlodithan, Chlodithane, Khlodithan, Lysodren, Mitotan, Mitotanum
Review published on: 14 September 2009
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