Drug Interaction Report

Bosutinib and Mitotane: Interaction Details

A pharmacist-reviewed analysis of the Bosutinib and Mitotane interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Mitotane

Lysodren
+

Bosutinib

Bosulif Bosulif®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 164 documented Bosutinib interactions, 125 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Reduced bosutinib exposure and reduced efficacy of bosutinib

Interaction Deep Dive

Avoid coadministration of bosutinib and a strong CYP3A inducer as this may decrease bosutinib plasma concentrations and reduce efficacy of bosutinib1. Coadministration of bosutinib and rifAMPin resulted in a 92% and 86% decrease in bosutinib AUC and Cmax, respectively 21.

Why it happens (mechanism)

Induction of CYP3A-mediated bosutinib metabolism

Literature reports

1 report — tap to read

a) Coadministration of a single dose of bosutinib 500 mg on day 1 and day 14 with rifAMPin 600 mg/day on days 8 through 17 to healthy volunteers (N=22) resulted in a 94% decrease in bosutinib AUC and 86% decrease in bosutinib Cmax 21.

Common questions

Can I take Bosutinib and Mitotane together?

Reduced bosutinib exposure and reduced efficacy of bosutinib Always confirm with your pharmacist or prescriber before making any change.

How serious is the Bosutinib and Mitotane interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Bosutinib or Mitotane need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Product Information: BOSULIF(R) oral tablets oral capsules, bosutinib oral tablets oral capsules. Pfizer Labs (per FDA), New York, NY, 2023. DailyMed
  2. Abbas R, Boni J, & Sonnichsen D: Effect of rifampin on the pharmacokinetics of bosutinib, a dual Src/Abl tyrosine kinase inhibitor, when administered concomitantly to healthy subjects. Drug Metabol Personal Ther 2015; 30(1):57-63. PubMed
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Mitotane

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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Mitotane + Activated Charcoal Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Slippery Elm Tragacanth + 9 more
Bosutinib + Activated Charcoal Asarabacca Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula + 164 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.