Drug Interactions between mitotane and sirolimus

High fat food significantly enhances the absorption of mitotane. You should take each dose of mitotane with a full meal containing high fat (e.G., containing milk, chocolate, or oil) and with a full glass of water. Taking mitotane on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Talk to your doctor if you have questions or have difficulty taking mitotane with food. It is best to avoid or limit the consumption of alcohol, as it can increase drowsiness or other nervous system side effects of mitotane. You should also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. 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.

Grapefruit and grapefruit juice may interact with sirolimus and could lead to potentially dangerous effects. Avoid eating grapefruit or drinking grapefruit juice while you are taking sirolimus. Also, you should preferably take sirolimus at least one hour before eating. If you do take it with food, you should take it each time with food to avoid changes in sirolimus levels. The oral liquid form of sirolimus must be mixed with water or orange juice only. Do not use grapefruit juice to mix this medication.