Skip to main content

Drug Interactions between Cleocin Phosphate and mitotane

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

clindamycin mitotane

Applies to: Cleocin Phosphate (clindamycin) and mitotane

MONITOR: Coadministration with strong CYP450 3A4 inducers may decrease plasma concentrations and antimicrobial effects of clindamycin, which is metabolized predominantly by the isoenzyme. In a pharmacokinetic analysis among patients (n=34) with staphylococcal osteoarticular infection receiving treatment with clindamycin (600 mg 3 times a day) and either rifampin (a strong CYP450 3A4 inducer; 600 mg twice a day) or levofloxacin (500 mg twice a day), clindamycin mean trough concentrations and Cmax values for patients treated with levofloxacin were 4.7 and 10.2 mcg/mL, respectively, compared to 0.79 and 3.48 mcg/mL, respectively, for patients treated with rifampin. However, while these findings confirm rifampin is an effective inducer of clindamycin, this combination has been used clinically with some success. The extent of the interaction or clinical use with other 3A4 inducers has not been established.

MANAGEMENT: Monitor closely for diminished therapeutic response to clindamycin during coadministration with strong CYP450 3A4 inducers. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever a strong CYP450 3A4 inducer is added to or withdrawn from therapy with clindamycin. An alternative agent with no or minimal CYP450 3A4-inducing activity may also be considered.

References

  1. (2002) "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn
  2. Bernard A, Kermarrec G, Parize P, et al. (2015) "Dramatic reduction of clindamycin serum concentration in staphylococcal osteoarticular infection patients treated with the oral clindamycin-rifampicin combination." J Infect, 71, p. 200-6

Switch to consumer interaction data

Drug and food interactions

Moderate

mitotane food

Applies to: mitotane

ADJUST DOSING INTERVAL: Fat-rich food enhances the absorption of mitotane. One study evaluated blood levels of mitotane (o,p'-DDD) after subjects ingested a single dose of 2 g administered using various delivery vehicles (e.g., tablets, granules, milk, chocolate or oil emulsion). Mitotane plasma levels were significantly higher for milk, chocolate, and oil emulsion when compared to those who received tablets or granules alone. In the same study, mitotane levels were evaluated in subjects following long-term treatment (total dose of 200 g over 30 to 60 days) in tablet, oil emulsion, or milk formulations. Significantly higher mean plasma levels were recorded in subjects who received mitotane as an oil emulsion or mixed in milk, when compared to tablets alone. Additionally, the recovery of o,p'-DDD from the feces was about 5 times higher in subjects who received tablets alone, suggesting absorption was reduced when compared to subjects who received mitotane mixed with a fat-rich vehicle (e.g., oil emulsion or milk).

GENERALLY AVOID: Concomitant use of mitotane with central nervous system (CNS) depressants, including alcohol, may potentiate adverse effects such as somnolence and sedation.

MANAGEMENT: According to product labeling, mitotane tablets should be taken during meals containing fat-rich food (e.g., milk, chocolate, or oil) and with a full glass of water. Patients should be advised to avoid or limit consumption of alcohol and to avoid activities requiring mental alertness such as driving or operating hazardous machinery until they know how the medication affects them.

References

  1. (2023) "Product Information. Lysodren (mitotane)." HRA Pharma America
  2. (2023) "Product Information. Lysodren (mitotane)." Medunik Canada
  3. (2023) "Product Information. Lysodren (mitotane)." HRA Pharma UK & Ireland Ltd
  4. Moolenaar AJ, van Slooten H, van Seters AP, Smeenk D (2023) Blood levels of o,p-DDD following administration in various vehicles after a single dose and during long-term treatment https://link.springer.com/article/10.1007/BF00258213
View all 4 references

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer