How many pills of Mitotane are most suitable and safer to take a day?

Mitotane is a specific drug used to treat adrenocortical cancer (ACC). It exerts anti-tumor effects by inhibiting steroid synthesis in adrenocortical cells and directly inducing tumor cell death. Since mitotane has a narrow therapeutic window and obvious individual differences, its daily dose needs to be strictly adjusted under the guidance of a doctor to take into account both efficacy and safety. It is generally recommended to start with a low dose, gradually increase it, and determine the most appropriate maintenance dose through blood concentration monitoring.

In clinical practice, the common dosage of mitotane is 2 to 6 g, usually divided into multiple oral administrations to reduce the risk of gastrointestinal irritation and malabsorption. The tablet specifications are mostly 500 mg. The specific number of tablets taken per day needs to be individually adjusted based on the patient's weight, tumor load, tolerance and blood drug concentration. Some guidelines recommend gradually increasing the dose to within the target blood concentration range (14–20 mg/L) while observing adrenal gland function and liver function to prevent severe toxic reactions caused by overdose.

Mitotan may cause side effects such as gastrointestinal discomfort, neuropsychiatric symptoms (such as headache, decreased concentration), abnormal liver function, and rash during use. In order to reduce these adverse reactions, it is recommended to take it 2–3 times a day. Taking it with or after a meal can improve drug absorption and reduce gastrointestinal irritation. At the same time, blood drug concentration should be measured regularly during medication, and the dose should be adjusted based on clinical symptoms, rather than simply taking a fixed dose based on standard doses.

In general, the number and dosage of mitotane taken daily need to be strictly individualized to achieve maximum efficacy and minimum toxicity. Doctors usually start with a low dose, gradually adjust to a maintenance dose range, and dynamically monitor blood drug concentrations and clinical indicators. Patients should follow medical advice during use, do not increase or decrease the dosage on their own, and pay attention to regular review of adrenal function, liver function and blood drug levels to ensure the safety and effectiveness of mitotane treatment.

Keyword tag:

Adrenocortical carcinoma (ACC), adrenocortical suppression, individualized dosage, blood drug concentration monitoring, liver function monitoring, drug side effects, gastrointestinal reactions, neuropsychiatric symptoms

Reference:https://reference.medscape.com/drug/lysodren-mitotane-342258