Mitotane and Brigatinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mitotane
Brigatinib
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.
What happens
Reduced brigatinib efficacy
Interaction Deep Dive
Avoid concomitant use of brigatinib and strong CYP3A4 inducers. When coadministered with rifampin, a strong CYP3A4 inducer, brigatinib exposure decreased by 80%1.
Why it happens (mechanism)
Induction of CYP3A4-mediated brigatinib metabolism
Literature reports
1 report — tap to read
a) When a single 180-mg dose of brigatinib was administered to study subjects receiving rifampin 600 mg/day, the brigatinib AUC decreased by 80% and Cmax decreased by 60% 1.
Common questions
Can I take Mitotane and Brigatinib together?
Reduced brigatinib efficacy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Mitotane and Brigatinib 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 Mitotane or Brigatinib 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 (1)
- Product Information: ALUNBRIG(TM) oral tablets, brigatinib oral tablets. ARIAD Pharmaceuticals, Inc (per FDA), Cambridge, MA, 2017. DailyMed
Keep reading about Mitotane
Keep reading about Brigatinib
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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