Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C14H10Cl4 |
| Molecular Weight | 320.041 |
| Optical Activity | ( + / - ) |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
ClC(Cl)C(C1=CC=C(Cl)C=C1)C2=CC=CC=C2Cl
InChI
InChIKey=JWBOIMRXGHLCPP-UHFFFAOYSA-N
InChI=1S/C14H10Cl4/c15-10-7-5-9(6-8-10)13(14(17)18)11-3-1-2-4-12(11)16/h1-8,13-14H
| Molecular Formula | C14H10Cl4 |
| Molecular Weight | 320.041 |
| Charge | 0 |
| Count |
|
| Stereochemistry | RACEMIC |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 0 |
| Optical Activity | ( + / - ) |
DescriptionSources: http://www.drugbank.ca/drugs/DB00648Curator's Comment: Description was created based on several sources, including
https://www.drugs.com/cdi/mitotane.html
Sources: http://www.drugbank.ca/drugs/DB00648
Curator's Comment: Description was created based on several sources, including
https://www.drugs.com/cdi/mitotane.html
Mitotane is an oral chemotherapeutic agent indicated in the treatment of inoperable adrenal cortical carcinoma of both functional and nonfunctional types. Mitotane can best be described as an adrenal cytotoxic agent, although it can cause adrenal inhibition, apparently without cellular destruction. The administration of Mitotane alters the extra-adrenal metabolism of cortisol in man; leading to a reduction in measurable 17-hydroxy corticosteroids, even though plasma levels of corticosteroids do not fall. The drug apparently causes increased formation of 6-B-hydroxyl cortisol. Its biochemical mechanism of action is unknown, although data are available to suggest that the drug modifies the peripheral metabolism of steroids as well as directly suppressing the adrenal cortex. Mitotane is used for treatment of inoperable adrenocortical tumours; Cushing's syndrome
Originator
Sources: http://adisinsight.springer.com/drugs/800042998
Curator's Comment: # Bristol-Myers Squibb
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL2033 Sources: http://www.genome.jp/dbget-bin/www_bget?dr:D00420 |
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Target ID: GO:0006927 Sources: https://www.ncbi.nlm.nih.gov/pubmed/23507702 |
38.0 µM [IC50] | ||
Target ID: GO:0034651 Sources: https://www.ncbi.nlm.nih.gov/pubmed/22546480 |
|||
Target ID: CHEMBL1908 Sources: http://www.drugbank.ca/drugs/DB00648 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | LYSODREN Approved UseLYSODREN is indicated in the treatment of inoperable adrenal cortical carcinoma of both functional and nonfunctional types. Launch Date2003 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
14.3 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/24057287/ |
2 g 3 times / day multiple, oral dose: 2 g route of administration: Oral experiment type: MULTIPLE co-administered: |
MITOTANE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
11.3 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/24057287/ |
1 g 3 times / day multiple, oral dose: 1 g route of administration: Oral experiment type: MULTIPLE co-administered: |
MITOTANE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
790 mg × day/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/24057287/ |
2 g 3 times / day multiple, oral dose: 2 g route of administration: Oral experiment type: MULTIPLE co-administered: |
MITOTANE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
543 mg × day/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/24057287/ |
1 g 3 times / day multiple, oral dose: 1 g route of administration: Oral experiment type: MULTIPLE co-administered: |
MITOTANE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
105 day EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/38244214/ |
0.93 g 3 times / day multiple, oral dose: 0.93 g route of administration: Oral experiment type: MULTIPLE co-administered: |
MITOTANE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy, 51.4+/-11.9 Health Status: unhealthy Age Group: 51.4+/-11.9 Sex: M+F Sources: |
Disc. AE: Anorexia, Nausea... AEs leading to discontinuation/dose reduction: Anorexia (grade 1-2) Sources: Nausea (grade 1-2) Vomiting (grade 1-2) Diarrhea (grade 1-2) Abdominal pain (grade 1-2) |
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Disc. AE: Central nervous system toxicity, Fetal damage... AEs leading to discontinuation/dose reduction: Central nervous system toxicity Sources: Fetal damage Ovarian cyst Adrenal insufficiency |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Abdominal pain | grade 1-2 Disc. AE |
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy, 51.4+/-11.9 Health Status: unhealthy Age Group: 51.4+/-11.9 Sex: M+F Sources: |
| Anorexia | grade 1-2 Disc. AE |
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy, 51.4+/-11.9 Health Status: unhealthy Age Group: 51.4+/-11.9 Sex: M+F Sources: |
| Diarrhea | grade 1-2 Disc. AE |
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy, 51.4+/-11.9 Health Status: unhealthy Age Group: 51.4+/-11.9 Sex: M+F Sources: |
| Nausea | grade 1-2 Disc. AE |
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy, 51.4+/-11.9 Health Status: unhealthy Age Group: 51.4+/-11.9 Sex: M+F Sources: |
| Vomiting | grade 1-2 Disc. AE |
2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy, 51.4+/-11.9 Health Status: unhealthy Age Group: 51.4+/-11.9 Sex: M+F Sources: |
| Adrenal insufficiency | Disc. AE | 2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
| Central nervous system toxicity | Disc. AE | 2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
| Fetal damage | Disc. AE | 2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
| Ovarian cyst | Disc. AE | 2 g 3 times / day multiple, oral Recommended Dose: 2 g, 3 times / day Route: oral Route: multiple Dose: 2 g, 3 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 4.0 |
strong | likely (co-administration study) Comment: LYSODREN’s CYP induction effect leads to an increase in dosage requirements for warfarin. Closely monitor patients for a change in anticoagulant dosage requirements when administering LYSODREN to patients receiving coumarin-type anticoagulants Page: 4.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Human sex hormone-binding globulin binding affinities of 125 structurally diverse chemicals and comparison with their binding to androgen receptor, estrogen receptor, and α-fetoprotein. | 2015-02 |
|
| FDA-approved drugs and other compounds tested as inhibitors of human glutathione transferase P1-1. | 2013-09-05 |
|
| Mutational analyses of epidermal growth factor receptor and downstream pathways in adrenocortical carcinoma. | 2013-07 |
|
| Mitotane alters mitochondrial respiratory chain activity by inducing cytochrome c oxidase defect in human adrenocortical cells. | 2013-06 |
|
| Influence of the CYP2B6 polymorphism on the pharmacokinetics of mitotane. | 2013-06 |
|
| Interferon-β is a potent inhibitor of cell growth and cortisol production in vitro and sensitizes human adrenocortical carcinoma cells to mitotane. | 2013-06 |
|
| The effect of mitotane on viability, steroidogenesis and gene expression in NCI‑H295R adrenocortical cells. | 2013-03 |
|
| Mitotane induces CYP3A4 expression via activation of the steroid and xenobiotic receptor. | 2013-03 |
|
| [Surgery of the adrenal gland]. | 2012-11 |
|
| Differential effect of DDT, DDE, and DDD on COX-2 expression in the human trophoblast derived HTR-8/SVneo cells. | 2012-11 |
|
| Effects of mitotane on gene expression in the adrenocortical cell line NCI-H295R: a microarray study. | 2012-09 |
|
| The organochlorine o,p'-DDT plays a role in coactivator-mediated MAPK crosstalk in MCF-7 breast cancer cells. | 2012-09 |
|
| Mitotane exhibits dual effects on steroidogenic enzymes gene transcription under basal and cAMP-stimulating microenvironments in NCI-H295 cells. | 2012-08-16 |
|
| Ribonucleotide reductase large subunit (RRM1) gene expression may predict efficacy of adjuvant mitotane in adrenocortical cancer. | 2012-06-15 |
|
| Preclinical investigation of nanoparticle albumin-bound paclitaxel as a potential treatment for adrenocortical cancer. | 2012-01 |
|
| Biphasic hormonal responses to the adrenocorticolytic DDT metabolite 3-methylsulfonyl-DDE in human cells. | 2010-02-01 |
|
| (2S)-1,1-Dichloro-2-(2-chloro-phen-yl)-2-(4-chloro-phen-yl)ethane. | 2009-01-14 |
|
| Cushing's disease in dogs and humans. | 2009-01 |
|
| Preclinical targeting of the type I insulin-like growth factor receptor in adrenocortical carcinoma. | 2009-01 |
|
| Organochlorine-mediated potentiation of the general coactivator p300 through p38 mitogen-activated protein kinase. | 2009-01 |
|
| Mitotane increases the radiotherapy inhibitory effect and induces G2-arrest in combined treatment on both H295R and SW13 adrenocortical cell lines. | 2008-06 |
|
| A novel pretreatment approach for fast determination of organochlorine pesticides in biotic samples. | 2008-05 |
|
| Modulation of proteomic profile in H295R adrenocortical cell line induced by mitotane. | 2008-03 |
|
| Effect of o,p'-DDD and Li+ on apoptotic DNA fragmentation in conventionally normal and tumour tissues of human adrenal cortex. | 2007-11-23 |
|
| Tailored hormonal therapy in secretory adrenocortical cancer. | 2007-07 |
|
| Adrenocortical cancer: pathophysiology and clinical management. | 2007-03 |
|
| Acute hepatopathy associated with mitotane administration in a dog. | 2006-07-11 |
|
| Mitotane has an estrogenic effect on sex hormone-binding globulin and corticosteroid-binding globulin in humans. | 2006-06 |
|
| Recombinant human estrogen, androgen and progesterone receptors for detection of potential endocrine disruptors. | 2004-02 |
|
| Study of 202 natural, synthetic, and environmental chemicals for binding to the androgen receptor. | 2003-10 |
|
| Development of a fish reporter gene system for the assessment of estrogenic compounds and sewage treatment plant effluents. | 2002-09 |
|
| A phase II trial of combination chemotherapy and surgical resection for the treatment of metastatic adrenocortical carcinoma: continuous infusion doxorubicin, vincristine, and etoposide with daily mitotane as a P-glycoprotein antagonist. | 2002-05-01 |
|
| Cytochrome P450-catalyzed binding of 3-methylsulfonyl-DDE and o,p'-DDD in human adrenal zona fasciculata/reticularis. | 2002-03 |
|
| Inhibition of androgen receptor-dependent transcriptional activity by DDT isomers and methoxychlor in HepG2 human hepatoma cells. | 1998-07 |
|
| A patient with adrenocortical carcinoma: characterization of its biological activity and drug resistance profile. | 1997-03 |
|
| Interaction of environmental chemicals with the estrogen and progesterone receptors from the oviduct of the American alligator. | 1996-12 |
|
| Identification of environmental chemicals with estrogenic activity using a combination of in vitro assays. | 1996-10 |
|
| Alterations in Ca2+ transport ATPase and P-glycoprotein expression can mediate resistance to thapsigargin. | 1994-03-18 |
|
| Comparison of the adrenalytic activity of mitotane and a methylated homolog on normal adrenal cortex and adrenal cortical carcinoma. | 1993 |
|
| Expression of P-glycoprotein in relation to clinical manifestation, treatment and prognosis of adrenocortical cancer. | 1993 |
|
| Neuropsychologic and neurologic side effects of mitotane and reversibility of symptoms. | 1992-09 |
|
| Possible mechanism and treatment of o,p'DDD-induced hypercholesterolaemia. | 1992-09 |
|
| Reversible mental deterioration and neurological disturbances with o,p'-DDD therapy. | 1992 |
|
| Mitotane enhances cytotoxicity of chemotherapy in cell lines expressing a multidrug resistance gene (mdr-1/P-glycoprotein) which is also expressed by adrenocortical carcinomas. | 1991-07 |
|
| [Idiopathic intracranial hypertension during treatment of Cushing's disease with mitotane]. | 1987-12-12 |
|
| [Neurotoxicity of mitotane therapy of adrenocortical carcinoma (5 cases) and Cushing's syndrome (7 cases)]. | 1987-05-23 |
|
| Toxicity, ultrastructural effects, and metabolic studies with 1-(o-chlorophenyl)-1-(p-chlorophenyl)-2,2-dichloroethane(o,p'-DDD) and its methyl analog in the guinea pig and rat. | 1987-01 |
|
| Primary hypogonadism associated with o,p' DDD (mitotane) therapy. | 1987 |
|
| [The effects of o,p'-DDD on human adrenal steroid synthesis]. | 1984-07-20 |
|
| Mitotane use in inoperable adrenal cortical carcinoma. | 1973-03-05 |
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/dosage/mitotane.html
Usual Adult Dose for Adrenal Cortical Carcinoma
-Initial Dose: 2 to 6 g orally per day in 3 to 4 divided doses
-Maintenance Dose: 9 to 10 g orally per day in 3 to 4 divided doses
-Maximum Dose: May increase up to 16 g orally per day, if tolerated, in 3 to 4 divided doses; the highest doses used in studies were 18 to 19 g per day.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/22546480
Mitotane (10-40uM) inhibited basal and cAMP-induced cortisol secretion in human adrenocortical cancer NCI-H295 cells.
| Substance Class |
Chemical
Created
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| Record UNII |
78E4J5IB5J
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Validated (UNII)
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WHO-ATC |
L01XX23
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EMA ASSESSMENT REPORTS |
LYSODREN (AUTHORIZED: ADRENAL CORTEX NEOPLASMS)
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LIVERTOX |
NBK548445
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NCI_THESAURUS |
C2355
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EU-Orphan Drug |
EU/3/02/102
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WHO-VATC |
QL01XX23
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6957
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D008939
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53-19-0
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C664
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200-166-6
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m7571
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1445007
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DB00648
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2597
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CHEMBL1670
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MITOTANE
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7004
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38721
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N0000185506
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PRIMARY | Cytochrome P450 3A4 Inducers [MoA] |
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ENANTIOMER -> RACEMATE |
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ACTIVE MOIETY |