Mitotane with Osimertinib Interaction Details
Brand Names Associated with Mitotane
- Lysodren®
- Mitotane
Brand Names Associated with Osimertinib
- Osimertinib
- Tagrisso®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 29, 2023
Interaction Effect
Decreased osimertinib exposure and reduced efficacy
Interaction Summary
Avoid concomitant administration of osimertinib (a CYP3A substrate) with strong CYP3A inducers, as coadministration may result in decreased osimertinib exposure and reduced efficacy. In a drug interaction study in patients with advanced non-small cell lung cancer, when osimertinib was coadministered with rifampicin, a strong CYP3A inducer, the AUC and Cmax of osimertinib were decreased by 78% and 73% . If concurrent use is unavoidable, increase the osimertinib dosage to 160 mg once daily. Decrease osimertinib to 80 mg 3 weeks following discontinuation of the strong CYP3A inducer .
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Avoid concomitant administration of osimertinib (a CYP3A substrate) with strong CYP3A inducers, as coadministration may result in decreased osimertinib exposure and reduced efficacy. If concurrent use is unavoidable, increase the osimertinib dosage to 160 mg once daily. Decrease osimertinib to 80 mg 3 weeks following discontinuation of the strong CYP3A inducer.
Mechanism Of Interaction
Induction of CYP3A-mediated metabolism of osimertinib
Literature Reports
A) Concomitant use of osimertinib and rifampicin decreased osimertinib steady-state Cmax by about 73% and AUC (0 to end of dosing) by approximately 78% compared with osimertinib alone in a drug interaction study in patients with advanced non-small cell lung cancer (N=40). The induction effect of rifampicin was apparent within 7 days of initiation. Within 3 weeks of rifampicin discontinuation, osimertinib Cmax and AUC returned to levels seen before rifampicin administration. Patients received osimertinib 80 mg once daily on days 1 to 77 and rifampicin 600 mg once daily on days 29 to 49 .
Mitotane Overview
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Mitotane is used to treat cancer of the adrenal gland that can not be treated with surgery. Mitotane is in a class of medications called antineoplastic agents. It works by slowing growth or reducing the size of the tumor.
Osimertinib Overview
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Osimertinib is used to help prevent a certain type of non small-cell lung cancer (NSCLC) from returning after the tumor(s) has been removed by surgery in adults. It is also used as a first treatment for a certain type of NSCLC that has spread to other parts of the body in adults. Osimertinib is also used to treat certain types of NSCLC that has spread to other parts of the body in adults who could not be treated successfully with other similar chemotherapy medications. Osimertinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop or slow the spread of cancer cells and may help shrink tumors.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.