What diseases does Mitotane tablets treat? What types of adrenal disease is it suitable for?

Mitotane is an adrenocortical inhibitor mainly used to treat adrenocortical carcinoma (ACC), especially those cases that cannot be surgically removed or have metastasized. It inhibits the function of adrenocortical cells and destroys adrenal tissue, thereby reducing hormone production and has a good effect on hormone-dependent tumors.

Mitotane is mainly indicated for patients with unresectable adrenocortical carcinoma (ACC), including locally advanced and metastatic patients. Because adrenocortical cancer is a rare but highly malignant tumor, mitotane can help inhibit tumor growth and reduce the symptoms of Cushing's syndrome caused by the adrenal glands' overproduction of corticosteroids (such as cortisol). Mitotane can also be used as adjuvant therapy for patients who still have residual disease after surgery or who are at higher risk of recurrence.

Mitotane is used to treat functional adrenal disorders such as Cushing's syndrome, particularly in cases of excessive cortisol secretion due to adrenal tumors. It selectively destroys adrenocortical cells and reduces the production of cortisol, thereby improving complications caused by Cushing's syndrome such as hypertension, diabetes, and osteoporosis.
Mitotane may also be used to control certain adrenal hyperplasia disorders, such as congenital adrenal hyperplasia (CAH), especially when traditional steroid therapy has failed. Because mitotane works by gradually reducing adrenal function, patients need to regularly monitor blood hormone levels during treatment and may need to supplement with glucocorticoids or mineralocorticoids to prevent side effects caused by excessive suppression of adrenal function, such as hypotension or electrolyte imbalance.
Reference: https://go.drugbank.com/drugs/DB00648