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Lysodren  (Mitotane)   

Warning: During treatment, Lysodren must be physically handled very carefully. Always wear protective rubber gloves when handling the tablets. Never crush or break a tablet. Discard tablets that have broken accidentally – your doctor or pharmacist can explain how to do this safely. This is because the broken or crushed tablet can be very dangerous if it contacts your skin. If this does happen, be sure to carefully wash the contacted area with soap and water.  

You must monitor your progress and contact your doctor immediately if you notice signs of infection. These include fever, chills, flu symptoms, sore throat, nausea and vomiting, loss of appetite, or unusual weakness. If you do develop an infection, this may require temporarily postponing treatment with this medication. Your physician will determine if you should stop taking the drug, and when you can start again. 

An excellent way to prepare for any potential problems is to carry an ID card or wear a medical alert bracelet that says you are taking mitotane. Then any doctor, dentist, or emergency medical care provider will know that you are undergoing this treatment. 

Indication: Lysodren or mitotane is a medication used for the treatment of certain cancers.  It works as interference to the growth and spread of cancerous cells.  In particular, this drug is used to treat adrenal cortical carcinoma, cancer of the adrenal gland.

 

Dosage: Lysodren comes as a tablet to be taken by mouth. However, the administration of Lysodren must be performed very carefully.  It is common to receive the first few doses in a hospital where you can be monitored constantly, and be prepared in the event of any serious side effects.  It is important that you follow the instructions of your physician to the letter.  Make sure not to take the drug in larger amounts or for a longer period of time than recommended.  This medication can be taken with or without food.

Storage: store Lysodren at room temperature (15-25 ° C), away from heat, light and moisture. Always keep your medications out of the reach of children . Lysodren and all drugs should not be used beyond the expiration date printed on the container.      

Overdose: it is very important that you take Lysodren as indicated by your health care provider. Regardless of the circumstance, do not take Lysodren more often. Even when taken at normal dose , Lysodren can reduce the amount of steroid hormones (cortisol) synthesized by the adrenal cortex, which can lead to the development of life-threatening conditions. If you think you have taken an overdose, contact your doctor or the poison control center nearest you as soon as possible. 

Missing dose: Take Lysodren as indicated your doctor or pharmacist. In case you forget to take a dose, take the missed one as soon as you remember it. However, if it is almost time for your next dose, do not double the next dose to recover the missed one; it can be dangerous. Contact your doctor or wait to go back to your regular schedule.  

Contraindications : It is important to discuss your current health and life situations with your physician before beginning to use a new drug.

Lysodren is contraindicated in cases of allergy to it or any of its ingredients. Before beginning a treatment with Lysodren, tell your doctor if you are: 

·         breast-feeding 

·         Pregnant or may become pregnant 

·         Had or having surgery (including dental surgery). 

Mechanism of action (MOA): Lysodren is an antineoplastic agent that works by reducing the amount of steroid hormones synthesized by the adrenal cortex, which slows or stops division or reproduction of cancer cells that need these hormones to survive.  

Interactions: Make sure to inform your physician of all the drugs you are currently taking, including prescriptions, over-the-counter medicines, herbal medicines, and vitamins.  In particular, tell your doctor if you use any medicines that induce sleep on a regular basis.  This includes cold / allergy medicine, sedatives, narcotic pain drugs, sleeping pills, muscle relaxants, and medicine for anxiety, depression, or seizures.  Any of these can add to the sleepy feeling induced by mitotane.  Specific drugs to flag are any blood thinner such as warfarin (Coumadin) or spironolactone (Aldactone).  Make sure your doctor knows of any new drug you may start taking during the treatment.

Side effects: in certain patients, lysodren can lead to the following side effects:     

  • hair loss
  • nausea
  • vomiting
  • diarrhea
  • dizziness
  • insomnia or sleep problems
  • lack of energy
  • decreased appetite
  • unusual drowsiness
  • Rash or changes in skin color

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms:  

  • vision changes
  • anxiety or nervousness
  • severe depression symptoms
  • confusion
  • fast or irregular heartbeat

 

  • high fever or shaking chills
  • excessive sweating, mainly at night
  • abdominal or side pain
  • sudden low or high blood pressure
  • Purple, blue, or black discoloration of the skin