Detailed introduction to the contents and usage of Mitotane tablets

Mitotane is an oral anti-tumor drug used to treat adrenocortical carcinoma (ACC). As a synthetic derivative, mitotane is a drug with a pesticide-like structure, but it is mainly used clinically to selectively destroy adrenocortical cells, thereby inhibiting the production of adrenocortical hormones. It is often used as one of the first-choice drugs for postoperative adjuvant treatment of adrenal cancer or metastatic adrenocortical cancer. In some cases, it is also used to treat Cushing's syndrome.

In the instructions, mitotane tablets are usually provided as oral tablets. The recommended starting dose is generally 2 to 3 grams, divided into 2 to 3 times. It is best to take it after a meal or with food to reduce gastrointestinal discomfort. Subsequently, the dosage can be gradually increased according to the blood concentration and patient tolerance. The maximum dosage usually does not exceed 6 to 8 grams/ days. In order to obtain the therapeutic effect, it is recommended that the blood concentration be maintained between 14 and 20 µg/mL. Mitotane blood levels and related hormone levels should be measured regularly during treatment.

Special attention should be paid to adverse reactions and drug management during the use of mitotane. Common side effects include nausea, vomiting, diarrhea, fatigue, dizziness, drowsiness, weight loss, etc. Some patients may experience neurological effects such as ataxia or cognitive decline. In addition, because this drug inhibits the function of the adrenal cortex, patients are prone to secondary adrenal insufficiency. Therefore, most patients need to supplement glucocorticoids (such as hydrocortisone) during treatment, and closely monitor electrolytes, liver and kidney function and other indicators.

Finally, patients should strictly follow the doctor's instructions for individualized medication adjustments while using mitotane, and avoid unauthorized increases or decreases in dosage or sudden discontinuation of medication. During the initial stage of treatment and during dose adjustment, it is recommended to be hospitalized for observation to ensure safety. For patients of childbearing age, effective contraceptive measures should be used; lactating women should not use this drug. Mitotane is a specially managed drug and requires long-term management under the guidance of an experienced doctor, with regular follow-up visits to evaluate the treatment effect and side effect control.

Reference materials:https://go.drugbank.com/drugs/DB00648