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Mitotane

Find out what mitotane is, how you have it and other important information about taking mitotane, a treatment for adrenal cortical cancer.

What it is

Mitotane pronounced my-toe-tain is a chemotherapy drug. It is also called Lysodren. It is used to treat a rare type of adrenal gland cancer (adrenal cortical cancer) that has spread or come back. 

How it works

Researchers are still looking into how mitotane works. We know that it reduces the amount of hormones produced by the adrenal gland. This can control or shrink the cancer for some time. 

How you have it

Mitotane are tablets you take 2 or 3 times a day. You take them with a glass of water during, or straight after, a meal. It is best to take them with foods that contain fats such as milk, chocolate or vegetable oils. 

Don't take a double dose of the mitotane if you forget to take it. Just continue with your usual dose. 

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

Steroids and mitotane

You may need to take a steroid when you are taking mitotane. This is because mitotane lowers the amount of natural steroids produced by the adrenal glands. These steroids help the body to react quickly in stressful situations such as a shock, injury or infection. 

If you have a severe injury or become very unwell you may need to stop taking mitotane. You have a card to carry saying you are taking mitotane. In the case of an accident or sudden illness the card tells the doctor you are taking mitotane and may also be taking steroids. 

When you have it

You start on a low dose of mitotane. Your doctor gradually increases the dose until you have the correct amount in your bloodstream. You might take a lot of tablets each day for the correct dose. 

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

You have regular blood tests to check the level of mitotane in your blood. At first you'll have these at least once a week. Once the level is stable you may be able to have the tests once a month. 

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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