Mitotane
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Mitotane
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| Systematic (IUPAC) name | |
| 1-chloro-2-[2,2-dichloro-1-(4-chlorophenyl)-ethyl]-benzene | |
| Identifiers | |
| CAS number | |
| ATC code | L01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C14H10Cl4 |
| Mol. mass | 320.04 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 40% |
| Protein binding | 6% |
| Metabolism | ? |
| Half life | 18 to 159 days |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
C |
| Legal status |
presciption required |
| Routes | oral (500mg tablets) |
Mitotane, or o,p'-DDD, is a medication used in the treatment of the rare disease adrenocortical carcinoma. It is an isomere chemically to DDT and is a derivative of DDD.[1]
It has been produced by Bristol Myers Squibb SpA but it is marketed as an orphan drug due to the small number of patients in need of it. Its administration occurs in cases where the tumour cannot be surgically omitted. A 2007 study of 177 patients shows a significant increase in the recurrence-free interval after radical surgery followed by Mitotane when compared to surgery alone.[2]
Mitotane alters steroid peripheral metabolism, directly suppresses the adrenal cortex and alters cortisone metabolism leading to hypocortisolism. Side effects as reported by Schteinberg et al. include anorexia and nausea (88%), diarrhea (38%), vomiting (23%), decreased memory and ability to concentrate (50%), rash (23%), gynecomastia (50%), arthralgia (19%), and leukopenia (7%).[3]
Its trade name is Lysodren.
[edit] Veterinary use
Mitotane is also used to treat pituitary-dependent Cushing's syndrome in canines. The medication is used in the controlled destruction of adrenal tissue, leading to a decrease in cortisol production.[4]
[edit] References
- ^ Information from PubChem
- ^ Terzolo M, Angeli A, Fassnacht M, Daffara F, Tauchmanova L, Conton PA, Rossetto R, Buci L, Sperone P, Grossrubatscher E, Reimondo G, Bollito E, Papotti M, Saeger W, Hahner S, Koschker AC, Arvat E, Ambrosi B, Loli P, Lombardi G, Mannelli M, Bruzzi P, Mantero F, Allolio B, Dogliotti L, Berruti A.. "Adjuvant mitotane treatment for adrenocortical carcinoma". N Engl J Med. 2007 Jun 7;356(23):2372-80..
- ^ Schteinberg DE, Motazedi A, NoonanRA, Thompson NW. "Treatment of Adrenal Carcinomas". Arch.Surg. (1982) 117:1142-9.
- ^ Canine Cushing’s Syndrome: Diagnosis and Treatment
[edit] External links
- FDA Label
- V. P. Komissarenko1, I. S. Chelnakova and A. S. Mikosha. “Effect of o,p-dichlorodiphenyldichloroethane and perthane in vitro on glutathione reductase activity in the adrenals of dogs and guinea pigs.”
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