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Drug Formulary
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mitotane

( MY-toe-tane )
Other Name(s): Lysodren®
Appearance: tablet
pdf download mitotane patient.pdf
pdf download mitotane pour le patient.pdf

Medication Information Sheet
mitotane (MY-toe-tane)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Lysodren®

Appearance:
tablet

What is this medication for?
For treating cancer arising from the adrenal glands.
What should I do before I have this medication?
  • Tell your doctor if you have/had significant medical condition(s), especially if you have / had recent shock, trauma or infection, kidney or liver problems, will be having surgery or other procedures, or if you have any allergies.
  • People who have cancer are at a higher risk of developing other cancers. Also, some cancer medications may increase this risk. You should discuss this with your doctor.
How will this medication affect sex, pregnancy and breastfeeding?
  • Mitotane may harm the unborn baby and should not be used by pregnant women.
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:►Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while on mitotane treatment.
  • Effects on Fertility: Probable
  • Effects on Fertility: Probable
How is this medication given?

  • Take it exactly as directed by your doctor. Make sure you understand the instructions.

  • Swallow whole with a glass of water, with or without food.  Do not crush or chew the tablets.
  • Take the dose at about the same times each day.  Ensure timing of the doses relative to meals is consistent.

  • If you miss a dose, take your next dose as scheduled. Do not double the dose to make up for the forgotten one.

     

What else do I need to know while on this medication?

  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain:

    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
    • Talk to your health care team before you start or stop these medications.
    • If you feel unwell, take your temperature before taking any of these medications. They may hide a fever. 
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Your doctor may give you steroid supplements while you are taking mitotane.  Make sure you understand and follow the instructions. 
  • Since your adrenal glands will not produce cortisol (a hormone) in reaction to severe stress, infections or injuries, you MUST tell any medical personnel that you are taking mitotane, as extra cortisol may need to be given to you. 
  •   Wear a medical bracelet or carry a card to let health care providers know that you are taking mitotane, and may need extra steroids.
How should I safely store this medication?

  • Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

  • Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.

What are the side effects of this medication?

The following side effects are common or severe. You may not have all of the side effects, while others may occur. Discuss with your doctor if you have any unusual or bothersome symptoms.

 

 

 

 

Side effects and what to do When to contact doctor?
More Common Side Effects

Poor Appetite; don't feel like eating

  • Eat foods that you like and try to eat regular small meals.
  • Use meal supplements if possible.  See a dietitian.
 Contact your health care team if no improvement or if severe

Diarrhea

  • Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine, orange or prune juice. Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
  • Take anti-diarrhea drug(s) if given to you by your doctor.
  • Also see Diarrhea pamphlet.*

 

 Contact your health care team if no improvement or if severe

Nausea and vomiting

  • Drink clear fluids and avoid large meals. Get fresh air and rest.
  • Limit spicy, fried foods or foods with a strong smell.
  • Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
  • Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
  • Also see Nausea & Vomiting pamphlet.*

 

 Contact your health care team if no improvement or if severe

Tiredness

  • Rest often; take naps if needed. Move slowly when getting up.
  • Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
  • Do not drive a motor vehicle or operate machinery when feeling tired.
 Contact your health care team if no improvement or if severe

Dizziness, drowsiness

  • Do not drive a motor vehicle or operate machinery if dizzy or drowsy.
  • Try to get up and move slowly.

 

 

 Contact your health care team if no improvement or if severe

Rash

  • Stay out of the sun; wear sunblock, a hat and cover exposed skin.
  • Use daily moisturizer.
 Contact your health care team if no improvement or if severe

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

 Get emergency medical help right away

Abnormal liver lab tests (may be severe)

  • Your doctor will monitor these regularly.  Call your doctor if you have yellowish skin or eyes, or unusual dark urine.
 Contact your health care team if no improvement or if severe

Inactive adrenal gland (muscle weakness, tiredness, darkening of skin, weight loss, not feel like eating)

 

 

 Contact your health care team as soon as possible (office hours)

Abnormal cholesterol or fat levels in the blood

  • Your doctor may monitor these regularly.

 

 Contact your health care team if no improvement or if severe

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Kidney problems (lower back pain, body swelling, also look for passing little or no urine, or recent unusual weight gain)

Irritation of the bladder wall (blood in urine, pain when passing urine, bladder pain)

 Get emergency medical help right away

Prolonged bleeding time

  • Let your health care team know if you will be having surgery or other procedures where bleeding is anticipated
 Get emergency medical help right away

Eye problems
(blurred vision or other unusual changes with your sight)

 Contact your health care team as soon as possible (office hours)

For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Funding & Reimbursement

Several payment sources exist for cancer drugs in Ontario, depending on the drug, disease indication, and how and where it is delivered.

View Funding & Reimbursement

Symptom Management

Many people living with cancer experience nausea, diarrhea and other symptoms from their treatment or disease.

View Symptom Management

Drug Safety and Administration

Find documents on drug safety and administration for healthcare providers, including calculations and recommendations.

View Drug Safety and Administration