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Drug Interactions between mitotane and Symbicort

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

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Interactions between your drugs

Moderate

mitotane budesonide

Applies to: mitotane and Symbicort (budesonide / formoterol)

The following interaction applies to orally and rectally administered formulations of budesonide that are typically used in the treatment of inflammatory bowel disease like ulcerative colitis or Crohn's disease. It does not apply to budesonide that is administered via oral inhalation (for the treatment of asthma or COPD) or other routes. -- mitotane may reduce the levels of budesonide in your intestine or bowel. Contact your doctor if your symptoms worsen or your condition changes. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications, including mitotane or budesonide, without first talking to your doctor.

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Minor

budesonide formoterol

Applies to: Symbicort (budesonide / formoterol) and Symbicort (budesonide / formoterol)

Information for this minor interaction is available on the professional version.

Drug and food interactions

Moderate

mitotane food

Applies to: mitotane

Consumer information for this interaction is not currently available.

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. "Product Information. Lysodren (mitotane)." HRA Pharma America (2023):
  2. "Product Information. Lysodren (mitotane)." Medunik Canada (2023):
  3. "Product Information. Lysodren (mitotane)." HRA Pharma UK & Ireland Ltd (2023):
  4. Moolenaar AJ, van Slooten H, van Seters AP, Smeenk D "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" (2023):
View all 4 references
Moderate

budesonide food

Applies to: Symbicort (budesonide / formoterol)

You should avoid the regular consumption of large amounts of grapefruits and grapefruit juice while taking budesonide. Grapefruit can raise the levels of budesonide in your body and lead to increased side effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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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

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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.

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