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Mitotane, marketed as Lysodren, is associated with several important safety considerations that patients and healthcare providers should be aware of. Below are key warnings and precautions to ensure safe use of this medication:

• Stress Response and Emergency Situations: Mitotane may impair your body's ability to handle physical stress, such as during surgery or severe illness. Inform your healthcare provider or dentist that you are taking mitotane if you are scheduled for surgery or face a medical emergency. It may be necessary to temporarily discontinue mitotane and use corticosteroids instead.

• Adrenal Gland Function: Mitotane can lead to insufficient cortisol production by the adrenal glands, a hormone crucial for stress management. Regular monitoring of hormone levels through blood tests is essential. Steroid medication may be prescribed to maintain hormonal balance.

• Central Nervous System Effects: The medication can cause drowsiness, weakness, or dizziness, particularly with higher blood levels of mitotane. Regular blood tests will help determine the appropriate dosage, and adjustments may be made to minimize these side effects.

• Risks to Pregnancy: Mitotane poses risks to an unborn baby, including potential harm or miscarriage. Women who can become pregnant should use effective contraception during treatment and continue until the doctor confirms the medication is cleared from the body. Notify your healthcare provider immediately if pregnancy occurs during or after treatment.

• Ovarian Cysts in Premenopausal Women: Some women who have not reached menopause may develop ovarian cysts while on mitotane. Symptoms such as unusual vaginal bleeding or pelvic pain should be reported to your healthcare provider. These symptoms might resolve after discontinuing the medication.

Consult your healthcare provider for personalized advice and to address any concerns regarding the use of mitotane. Regular monitoring and communication with your healthcare team are essential for managing potential risks and ensuring safe treatment.

When taking this medication, you may experience some common side effects such as dizziness, nausea, vomiting, diarrhea, and loss of appetite. These effects can occur in a significant number of individuals. To help reduce dizziness, try rising slowly from sitting or lying positions. Additionally, some people may experience depression, loss of balance, or a rash. While these side effects are usually mild, it's important to consult your healthcare provider if they persist or worsen.

There are other side effects that some users might encounter, including confusion, headache, weakness, slurred speech, vision issues, and liver problems. A few people may also experience low thyroid levels, risk of infection or bleeding, and breast enlargement or tenderness. If you notice any of these symptoms, especially if they become severe, contact your healthcare provider.

Serious side effects, though rare, require immediate medical attention. These include severe allergic reactions characterized by rash, itching, swelling, severe dizziness, or trouble breathing. An adrenal crisis, presenting as severe lightheadedness, dizziness, weakness, sweating, stomach pain, nausea, vomiting, or loss of consciousness, is also considered serious. If you experience any of these, seek urgent medical care. Lastly, this medication might affect blood cell counts, leading to symptoms such as unusual tiredness, pale skin, persistent sore throat, fever, chills, or easy bruising/bleeding. Promptly inform your doctor if you experience any of these symptoms.

It's important to be aware that this medication can accelerate the elimination of other drugs from your body, which might alter their effectiveness. Some medications potentially affected include cobicistat, doravirine, isavuconazonium, lurasidone, naldemedine, nifedipine, ranolazine, tamoxifen, and voriconazole. Additionally, this drug may reduce the efficacy of hormonal birth control methods such as pills, patches, or rings, which could lead to unintended pregnancy. It's advisable to discuss with your healthcare provider whether you should use an additional reliable form of birth control while taking this medication. If you notice any new spotting or breakthrough bleeding, inform your doctor, as these could indicate your birth control is less effective.

Furthermore, inform your doctor or pharmacist if you are using other products that may cause drowsiness, including alcohol, marijuana, antihistamines (like cetirizine or diphenhydramine), sleep or anxiety medications (such as alprazolam, diazepam, or zolpidem), muscle relaxants (like carisoprodol or cyclobenzaprine), and opioid pain medications (such as codeine or hydrocodone). Carefully check the labels of all your medications, including any for allergies or colds, as they might contain ingredients that can cause drowsiness. Your pharmacist can guide you on the safe use of these products.

Lysodren (mitotane) may also interact with various medications or supplements. Always ensure your doctor and pharmacist are aware of all other medications or supplements you are taking, whether prescribed, over-the-counter, or herbal. Some medications should not be used with Lysodren, such as atazanavir, daclatasvir, dasabuvir, and others. In some cases, using Lysodren with certain drugs like abemaciclib, abiraterone acetate, or apremilast may not be recommended, but if necessary, your doctor might adjust the dosage or frequency of use. Additionally, using Lysodren with certain medications may increase the risk of side effects, so your doctor might need to modify your treatment plan accordingly. Always communicate openly with your healthcare provider about all your medications to ensure safe and effective treatment.