Mitant 25mg Capsule

About

Mitotane is a specialized adrenolytic agent primarily indicated for the treatment of adrenocortical carcinoma (ACC), a rare and aggressive malignancy originating from the adrenal cortex. Its therapeutic action is multifaceted, involving direct cytotoxic effects on adrenocortical cells, which leads to their atrophy and necrosis. Beyond its direct tumoricidal activity, mitotane also exerts a significant inhibitory effect on adrenal steroidogenesis at multiple enzymatic steps. This dual mechanism effectively reduces the excessive production of cortisol, androgens, and estrogens, thereby controlling the hormonal symptoms frequently associated with functional ACC, such as Cushing's syndrome. As a highly lipophilic compound, mitotane has a prolonged half-life and accumulates in adipose tissue, necessitating careful dose titration and long-term monitoring due to its narrow therapeutic index and potential for significant adverse effects.

Uses

• Treatment of adrenocortical carcinoma.
• Management of Cushing's syndrome due to ACC.
• Adjuvant therapy after surgical resection of ACC.
• Control of hypercortisolism symptoms.

Directions For Use

Taken orally, usually in divided doses with food to improve absorption and reduce gastrointestinal side effects.

Benefits

• Reduces tumor size in adrenocortical carcinoma.
• Controls symptoms of hypercortisolism.
• Prolongs survival in some ACC patients.
• Can be used in metastatic and unresectable disease.
• Offers a targeted approach to adrenal cancer.
• Helps manage hormonal imbalances.

Side Effects

• Nausea and vomiting
• Diarrhea
• Anorexia
• Lethargy
• Dizziness
• Skin rash
• Adrenal insufficiency
• CNS toxicity (somnolence, confusion)
• Hypercholesterolemia
• Hypertriglyceridemia
• Hepatotoxicity
• Leukopenia

Safety Measures

• Alcohol - Avoid alcohol due to potential for increased CNS depression and liver toxicity.
• Pregnancy - Contraindicated in pregnancy due to teratogenicity; use highly effective contraception.
• Breastfeeding - Discontinue breastfeeding as mitotane is excreted in breast milk and can cause serious adverse effects in infants.
• Liver - Use with extreme caution in patients with hepatic impairment; monitor liver function closely.
• Kidney - Use with caution in patients with renal impairment; monitor for increased toxicity.
• Lung - Generally safe for lung conditions, but monitor for any unusual respiratory symptoms.

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