Mitotane is also known by the brand name Lysodren. This medication destroys cells of the adrenocortex. The adrenocortex, also called the adrenal cortex, is a section of adrenal gland that sits on top of the kidneys. Mitotane is usually used for patients whose cancer cannot be treated surgically and for patients whose cancer has metastasized.
As a chemical, mitotane resembles the insecticides DDD and DDT, although mitotane does not harm people as these do. Scientists do not understand why, but the drug causes damage to the adrenocortex in such a way as to be helpful for some patients with adrenocortical tumors. In addition, mitotane restricts the ability of the gland to produce chemicals.
The dose of mitotane given to patients varies, although between four and eight grams (0.12-0.25 oz) per day is a typical dose. Patients vary in how much mitotane they tolerate, some patients tolerating two grams (0.1 oz) per day while others tolerate sixteen grams (0.5 oz) per day. The doses are given orally. At the beginning of the therapy, the patient may receive 500 milligrams of mitotane twice a day. At any one time a third or a quarter of an entire day's dose is taken. If the patient has difficulty tolerating a certain dose, the doctors may adjust this and use a somewhat smaller dose. Mitotane should be given for at least three months. If the medicine is effective, it may be continued indefinitely. However, most patients respond to the x-ray treatment of the pituitary gland and so do not need mitotane treatment to continue indefinitely.
Many doctors use mitotane in conjunction with radiation therapy directed to the pituitary gland, but other approaches to this medicine may also be taken.
Many patients on mitotane should receive adrenocorticosteroids.
Four out of five patients receiving mitotane experience anorexia and nausea and vomiting. About one-third of patients experience lethargy and sleepiness. Roughly one in five develop skin problems with the medicine. However, patients who experience these side effects do not have to stop taking the medication, although the doctor may lower the dose the person is receiving.
Mitotane should not be given with spironolactone (a diuretic/water pill).
—The outer part of adrenal gland that sits on top of the kidneys.
—A condition of uncontrolled lack or loss of desire for food.