Understanding Mitotane: Uses, Mechanism, and Considerations
Mitotane is a specialized medication primarily used in the treatment of adrenal cortical carcinoma, a rare type of cancer affecting the adrenal glands. Unlike standard chemotherapy agents, Mitotane has a unique mechanism of action that targets adrenal cells specifically, reducing the production of certain steroid hormones and helping to control tumor growth. It is considered both an adrenolytic and cytotoxic agent, meaning it can destroy adrenal tissue while also exerting direct anti-cancer effects.
The administration of Mitotane is typically oral, with tablets that need to be taken several times daily. Because of its slow onset and prolonged half-life, careful monitoring of blood levels is crucial to ensure the drug remains within a therapeutic range. Physicians often start patients on lower doses, gradually increasing the amount to minimize side effects while maximizing effectiveness. Regular blood tests help track hormone levels, liver function, and the concentration of Mitotane in the bloodstream.
Mitotane’s effects on the adrenal glands can lead to both desired and unintended consequences. On the positive side, it can significantly reduce excess hormone production that might cause symptoms such as high blood pressure, fatigue, and fluid retention. However, because the drug targets adrenal function, patients may develop adrenal insufficiency over time, necessitating hormone replacement therapy. This makes adherence to medical guidance and frequent follow-ups essential for safety and effectiveness.
Side effects of Mitotane can vary from mild to severe. Common reactions include nausea, vomiting, loss of appetite, and dizziness. Some patients report neurological symptoms such as confusion, tremors, or difficulty concentrating, especially at higher doses. Because the medication is highly lipophilic and accumulates in fatty tissues, side effects can persist even after doses are reduced. Supportive care, lifestyle adjustments, and sometimes temporary dose modifications are often required to help manage these issues.