Dizziness or fatigue may occur during medication, avoid driving or operating machinery. Immediately inform your doctor in case of trauma, infection, or illness.
Mitotane Contraindications
Hypersensitivity to mitotane or any component of the formulation is contraindicated.
Mitotane Precautions
1. Rapid Cytotoxic Effect
May cause tumor infarction or hemorrhage; for large metastatic tumors, preoperative surgical debulking is recommended whenever possible.
2. Neurotoxicity
Long-term high doses (>2 years) may lead to brain injury; regular neurobehavioral assessments are required.
3. Adrenal Effects
(1) Most patients develop adrenal insufficiency and require concomitant corticosteroid replacement therapy (a few may require permanent replacement).
(2) Shock/trauma/infection may precipitate acute adrenal crisis; withhold the drug and immediately administer corticosteroids.
(3) Upon discontinuation, if the patient is on steroids, closely monitor for signs of adrenal insufficiency.
4. Central Nervous System Effects
Somnolence, dizziness, and vertigo may occur.
Mitotane Special Population Precautions
1. Pregnancy: Category C (risk cannot be excluded).
2. Lactation: Drug may be excreted into breast milk; it is recommended to discontinue the drug and stop breastfeeding.
3. Pediatric use: Safety and efficacy have not been established.
4. Geriatric use: Response is not significantly different from younger patients, but dose selection should be cautious (see Dosage section).
5. Hepatic impairment: Use with caution (metabolism may be slowed).
Mitotane Common Adverse Reactions
Anorexia, nausea, vomiting, diarrhea, somnolence, rash.
