Drug Interactions between Cartia XT and mitotane

Alcohol can lower your blood pressure and add to the effects of dilTIAZem. You may experience dizziness, lightheadedness, fainting, or a rapid heartbeat if you drink alcohol with dilTIAZem, especially when you first start taking the medication or just after a dose increase. Grapefruit juice may also increase the effects of dilTIAZem in some people by increasing its levels in the blood. You may want to limit alcohol intake and avoid excessive consumption of grapefruit and grapefruit juice during treatment with dilTIAZem. However, if you have been regularly consuming grapefruit or grapefruit juice with dilTIAZem, do not alter the amounts of these products in your diet without first talking to your doctor or other healthcare professional. Contact your doctor if your condition changes or you experience increased side effects of dilTIAZem such as headache, irregular heartbeat, swelling, unexplained weight gain, or chest pain. Orange juice is not expected to interact.

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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.

Using dilTIAZem together with multivitamin with minerals can decrease the effects of dilTIAZem. Talk with your doctor before using dilTIAZem and multivitamin with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take 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 without first talking to your doctor.

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