Mitotane with Voxelotor Interaction Details
Brand Names Associated with Mitotane
- Lysodren®
- Mitotane
Brand Names Associated with Voxelotor
- Oxbryta®
- Voxelotor
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 29, 2023
Interaction Effect
Decreased voxelotor plasma concentrations and reduced efficacy
Interaction Summary
Voxelotor is partially metabolized by CYP3A4 and concomitant use of voxelotor with rifampin (a strong CYP3A4 inducer) was predicted to decrease voxelotor AUC in patients by up to 40%. Avoid coadministration of voxelotor with strong CYP3A4 inducers. If concomitant use is required, increase the once-daily voxelotor dose to 2500 mg (tablets) in those 12 year or older; and in those 4 years to less than 12 years, 2500 mg (tablets) or 2400 mg (tablets for oral suspension) for those weighing 40 kg or more, 1500 mg for those weighing 20 kg to less than 40 kg, or 900 mg for those weighing 10 to less than 20 mg.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Avoid coadministration of voxelotor with strong CYP3A4 inducers. If concomitant use is required, increase the once-daily voxelotor dose to 2500 mg in those 12 year or older; and in those 4 years to less than 12 years, 2500 mg (tablets) or 2400 mg (tablets for oral suspension) for those weighing 40 kg or more, 1500 mg for those weighing 20 kg to less than 40 kg, or 900 mg for those weighing 10 to less than 20 mg.
Mechanism Of Interaction
Induction of CYP3A4-mediated metabolism of voxelotor
Literature Reports
A) Concomitant use of voxelotor with rifampin (a strong CYP3A4 inducer) is predicted to decrease voxelotor AUC by up to 40% .
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.
Voxelotor Overview
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Voxelotor is used to treat sickle cell disease (an inherited blood disease) in adults and children 4 years of age and older. Voxelotor is in a class of medications called hemoglobin S (HbS) polymerization inhibitors. It works by helping hemoglobin (a protein in red blood cells) to hold onto more oxygen and to stop red blood cells from becoming misshapen.
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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.