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Home > Drug Category > Cancer Medications > Lysodren and Equivalent

Lysodren Information

Lysodren (Mitotane) is a prescription medication used to treat cancer of the adrenal glands (adrenocortical carcinoma), an exceptionally rare and aggressive cancer of the adrenal glands. It is used for both functional (producing excess steroids) and non-functional tumors that cannot be effectively removed through surgery, have recurred after initial treatment with chemotherapy, or have spread to other parts of the body. This medication has also been found useful for treating severe Cushing’s syndrome when other treatments have failed to control cortisol levels. Its active ingredient, mitotane, is an adrenolytic agent in the cytotoxic antineoplastic class of drugs.

It appears to work by inducing selective destruction of the adrenal cortex cells, likely through a combination of mitochondrial damage and the inhibition of enzymes necessary for steroid biosynthesis. This mechanism is critical because adrenocortical cancer typically involves the overgrowth of malignant cells in the adrenal cortex, which often leads to a life-threatening overproduction of hormones like cortisol. By acting as a targeted chemical adrenalectomy, mitotane helps reduce the overall tumor burden and suppresses the severe hormonal imbalances that characterize the disease. While it is quite a potent therapy with a significant side-effect profile, its ability to both kill cancer cells and control debilitating symptoms may suggest why it remains a standard of care for this difficult condition. This medication’s unique chemical structure, a derivative of the insecticide Dichlorodiphenyltrichloroethane, allows it to accumulate in fatty tissues, which might explain its long-lasting effect on the body even after treatment stops.

Lysodren Side Effects

Like other medications, mitotane can cause some side effects. Common side effects of this medication include loss of appetite, nausea, vomiting, diarrhea, low sex drive, dizziness or lightheadedness, changes in certain hormones and fat levels in the blood. Contact your doctor if these mild side effects persist or worsen.

Stop taking this medicine and contact your doctor immediately if you experience any serious side effects, including the following:
• Allergic reactions such as breathing difficulties, body itching, body rash, skin blistering, swelling of the face, mouth, tongue, lips, or throat;
• Adrenal Insufficiency or crisis with symptoms like severe weakness, confusion, pain in the lower back and legs, abdominal pain, dizziness, craving salt, areas of darkened skin, fainting episodes;
• Bleeding problems such as unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding;
• Depression with symptoms like poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide;
• Infection with symptoms like fever or chills, severe diarrhea, shortness of breath, prolonged dizziness;
• Liver problems with symptoms like nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine;
• Nervous system problems such as severe headache, slurred speech, difficulty speaking, loss of coordination or balance, confusion;
• Ovarian cysts with symptoms like bloating, lower abdominal or pelvic pain, lower back pain, vaginal bleeding;
• Underactive thyroid gland with symptoms like dry skin, constipation, weight gain, fatigue, aches, pains, stiffness, and intolerance to cold.
• Urinating difficulties;
• Vision changes like blurred vision, double vision, clouding of the lens, and vision loss

Inform your doctor about any other side effects you notice that are not listed here.

Lysodren Precautions

Do not take this medication if you are allergic to mitotane, other ingredients in Lysodren, or any other medicines. Before you start taking this medication, ensure that you inform your doctor about any prior or current medical conditions, including the following:
• Active infection, injury, or illness;
• Bleeding disorders;
• Kidney disease;
• Liver disease;
• Ovarian cysts

Mitotane can cause lightheadedness or dizziness. It is important to exercise caution when driving, operating machinery, or performing other tasks requiring mental alertness. In situations of physical stress, such as major surgery or trauma, the body can’t mount a cortisol response while on this medication, leading to a life-threatening crisis. Therefore, it is important to inform your doctor that you are taking this medication before undergoing any surgical operation. Mitotane is classified as a Category D drug for pregnancy, meaning there is evidence of harmful risk to the developing fetus. It should be used only during pregnancy if the potential benefits outweigh the potential risks. Women of childbearing age should use effective contraception while taking mitotane. It should also not be used while breastfeeding. Since the drug is fat-soluble, it is highly likely to be excreted in breast milk, posing a serious risk of toxicity to a nursing infant. This medication is not recommended for use in children.

Other medications like spironolactone can actually block the effects of mitotane, rendering the cancer treatment less effective. Also, many drugs, including certain anticonvulsants, statins, and even hormonal birth control, may become less effective when taken alongside Lysodren. Therefore, before using this medication, inform your doctor about any other medications you are taking, including herbal medicines and supplements, to determine whether it is safe to use with Lysodren. Take this medication orally, preferably with food to reduce gastrointestinal side effects. The starting dose is usually low and gradually increased based on your response to treatment and tolerability. Your doctor will monitor mitotane levels and adjust the dose to achieve the desired therapeutic effect. Regular liver and adrenal function tests are necessary throughout treatment. You should follow your doctor’s instructions carefully to avoid potential side effects. Store this medication away from moisture, heat, and direct light; and keep it out of the reach of children.

Do I need a prescription to order Lysodren?

Yes, a prescription is required from your physician to order Lysodren.