Drug & supplement interaction

American Pawpaw + Mitotane

Mitotane brand name: Lysodren.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between American Pawpaw and Mitotane in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Mitotane states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

American Pawpaw and Mitotane

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Mitotane and American Pawpaw in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

American Pawpaw safety at a glance

American Pawpaw overall Use caution The ripe fruit is generally eaten as food, but concentrated leaf, twig, and seed extracts may be toxic and lack good safety data.
Pregnancy Avoid There is not enough safety information, and concentrated extracts may be harmful, so avoid during pregnancy.
Breastfeeding Avoid Safety has not been studied, so avoid concentrated pawpaw supplements while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Mitotane and American Pawpaw? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Mitotane

Interactions in our licensed database are recorded against drug classes, not just single drug names. Mitotane is filed under a single classification — oral drugs. American Pawpaw has documented interactions with 1 drug class — the most serious being antineoplastics (minor) — and none of Mitotane’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

American Pawpaw Does Interact With Other Medications

American Pawpaw has 25 minor known drug interactions in our database — Mitotane isn’t one of them. If you take anything else, check it against the full list below.

Minor 25 No known interaction 2,805 (incl. Mitotane)
Taking anything else?

Check Another of Your Medications Against American Pawpaw

Covers the 2,830 medications we’ve checked against American Pawpaw. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests American Pawpaw and Mitotane May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • A skin rash Additional detail

    American Pawpaw

    “In general, American pawpaw is well tolerated. However, cases of urticaria, nausea, vomiting, bowel disturbances, headache, and faintness have been reported following ingestion of pawpaw fruit. Similarly, American pawpaw extract may cause vomiting when taken orally or contact dermatitis when applied topically.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
    2. 89429. McLaughlin JL. Paw paw and cancer: Annonaceous acetogenins from discover to commercial products. J Nat Prod. 2008;71:1311-1321.
    3. 1525. Avalos J, Rupprecht JK, McLaughlin JL, et al. Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba (Annonaceae). Contact Dermatitis 1993;29:33-5.

    “Orally, American pawpaw fruit can cause urticaria.

    Topically, American pawpaw extract can cause contact dermatitis.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in dermatitis.

    2 sources cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
    2. 1525. Avalos J, Rupprecht JK, McLaughlin JL, et al. Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba (Annonaceae). Contact Dermatitis 1993;29:33-5.

    Mitotane

    Listed in the ADVERSE REACTIONS section of the FDA label for Mitotane. Read the label on DailyMed ›

  • Vomiting / Nausea Additional detail

    American Pawpaw

    “Orally, American pawpaw fruit can cause nausea, vomiting, bowel disturbances, and burning of the throat and stomach. American pawpaw extract can cause vomiting when taken orally.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    2 sources cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
    2. 89429. McLaughlin JL. Paw paw and cancer: Annonaceous acetogenins from discover to commercial products. J Nat Prod. 2008;71:1311-1321.

    Mitotane

    Listed in the ADVERSE REACTIONS section of the FDA label for Mitotane. Read the label on DailyMed ›

  • Headache Additional detail

    American Pawpaw

    “Orally, American pawpaw fruit can cause headache and faintness.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in cluster headache.

    1 source cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI

    Mitotane

    Listed in the ADVERSE REACTIONS section of the FDA label for Mitotane. Read the label on DailyMed ›

Reported for American Pawpaw but not commonly for Mitotane: hives.

Effects for Mitotane come from the ADVERSE REACTIONS section of its FDA label; effects for American Pawpaw come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Mitotane Products Have a Food Rule — American Pawpaw Should Not Break It

At least one FDA label for a product containing Mitotane says to take it with food. If you take American Pawpaw on an empty stomach out of habit, keep them separate — and take Mitotane with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Mitotane products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION The recommended initial dose of LYSODREN is 2000 mg to 6000 mg orally, in three or four divided doses per day with food.

From the Dosage and Administration section of the FDA label we read for Mitotane — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Mitotane

This page covers American Pawpaw only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mitotane page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Mitotane page

“Mitotane (Lysodren) is chemotherapy for adrenal cancer, and doses are adjusted based on blood levels, so a supplement list like this one deserves genuine attention rather than a shrug. All 17 entries work the same basic way, by changing how much mitotane your gut actually takes in.”

Reviewed by 2 · Jul 18, 2026

Open the Mitotane interaction page

How much people look this up

Where American Pawpaw and Mitotane Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement American Pawpaw
Steady interest

#736 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Mitotane
Top half

#1,203 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every American Pawpaw reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The American Pawpaw and Mitotane records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About American Pawpaw

What is American Pawpaw?

American Pawpaw
  • Anticancer interest
  • Lice and head lice treatment (topical)
  • Traditional digestive remedy
  • General wellness/antioxidant
  • Insecticide (historical seed use)

American pawpaw is a North American fruit tree whose leaves, twigs, and seeds contain compounds called acetogenins that have shown cancer-cell-killing activity in laboratory studies. However, strong human evidence for any health benefit is lacking, and the seeds, bark, and unripe parts can be toxic, so supplements should be used cautiously and only under professional guidance.

Asimina triloba · Annonaceae · Fruit, seeds, bark, leaves, and twigs · Fresh fruit, capsules, extracts, and standardized acetogenin products

An interaction check asks whether these two react with each other — it does not ask whether American Pawpaw is a good idea for someone in your situation. Here is what our American Pawpaw record says about it on its own.

American Pawpaw: dosing

There is no established standardized dose for American pawpaw supplements. Products vary widely in strength and which part of the plant they use, which makes safe dosing hard to determine.If you choose to use a pawpaw product, follow the directions on the label and do not exceed them.

From our American Pawpaw monograph — the full record covers uses, side effects and every documented interaction.

Read the full American Pawpaw monograph & all interactions
Medication

About Mitotane

What Is Mitotane Used For?

Brand name: Lysodren

Lysodren (mitotane) tablets are indicated for the treatment of inoperable adrenocortical carcinoma (ACC) — a rare cancer of the adrenal gland's outer layer (the cortex). It can be used whether or not the tumor is actively producing hormones (functional or nonfunctional).

Because the cancer cannot be removed surgically in these patients, Lysodren works to suppress and damage the adrenal tissue itself, helping to control the disease.

See full Mitotane drug information
Keep checking

Other Drugs & American Pawpaw

Browse every other medication we’ve checked against American Pawpaw — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
25Minor
2,804No known interaction
25 Minor 2,804 No interaction
Minor

25 interactions

No interaction 2,804 drugs checked — show the list

We also checked American Pawpaw against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,804 medications checked with no known interaction — see the full American Pawpaw list.

See the full American Pawpaw interactions page
See every supplement checked against Mitotane, ranked by severity
Evidence & sources

American Pawpaw References

The 4 references that drive our American Pawpaw monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Avalos J, Rupprecht JK, McLaughlin JL, et al. Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba (Annonaceae). Contact Dermatitis 1993;29:33-5.
  2. McCage, C. M., Ward, S. M., Paling, C. A., Fisher, D. A., Flynn, P. J., and McLaughlin, J. L. Development of a paw paw herbal shampoo for the removal of head lice. Phytomedicine 2002;9(8):743-748. PubMed
  3. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
  4. McLaughlin JL. Paw paw and cancer: Annonaceous acetogenins from discover to commercial products. J Nat Prod. 2008;71:1311-1321.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking American Pawpaw and Mitotane Together: Common Questions

Is it safe to take American Pawpaw with Mitotane?
We do not list a known interaction between American Pawpaw and Mitotane. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do American Pawpaw and Mitotane have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take American Pawpaw and Mitotane at the same time of day?
At least one FDA label for a product containing Mitotane says to take it with food. If you take American Pawpaw on an empty stomach out of habit, keep them separate and take Mitotane with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Mitotane products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the American Pawpaw and Mitotane combination checked?
Interactions in our licensed database are recorded against drug classes. Mitotane is filed under 1 classification, and American Pawpaw has documented interactions with 1 drug class — none of Mitotane's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does American Pawpaw interact with any other medications?
Yes. American Pawpaw has 25 documented drug interactions in our database — Mitotane is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Mitotane interact with any supplements?
Yes. Mitotane has documented interactions with 17 supplements in our database — American Pawpaw is not one of them. The Mitotane interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

American Pawpaw monograph Uses, safety profile, and every drug interaction in one place Mitotane drug information The full plain-English guide to this medication Mitotane supplement interactions Every supplement checked against Mitotane, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Mitotane and American Pawpaw?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.