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=C(Cl)C=CC=C2
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 |
---|---|---|---|---|
11.3 mg/L EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/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 |
|
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 |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
543 mg × day/L EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/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 |
|
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 |
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: Page: p.264 |
unhealthy, 51.4+/-11.9 n = 12 Health Status: unhealthy Condition: Adrenal cortical carcinoma Age Group: 51.4+/-11.9 Sex: M+F Population Size: 12 Sources: Page: p.264 |
Disc. AE: Anorexia, Nausea... AEs leading to discontinuation/dose reduction: Anorexia (grade 1-2) Sources: Page: p.264Nausea (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: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Adrenal cortical carcinoma Sources: Page: p.1 |
Disc. AE: Central nervous system toxicity, Fetal damage... AEs leading to discontinuation/dose reduction: Central nervous system toxicity Sources: Page: p.1Fetal 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: Page: p.264 |
unhealthy, 51.4+/-11.9 n = 12 Health Status: unhealthy Condition: Adrenal cortical carcinoma Age Group: 51.4+/-11.9 Sex: M+F Population Size: 12 Sources: Page: p.264 |
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: Page: p.264 |
unhealthy, 51.4+/-11.9 n = 12 Health Status: unhealthy Condition: Adrenal cortical carcinoma Age Group: 51.4+/-11.9 Sex: M+F Population Size: 12 Sources: Page: p.264 |
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: Page: p.264 |
unhealthy, 51.4+/-11.9 n = 12 Health Status: unhealthy Condition: Adrenal cortical carcinoma Age Group: 51.4+/-11.9 Sex: M+F Population Size: 12 Sources: Page: p.264 |
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: Page: p.264 |
unhealthy, 51.4+/-11.9 n = 12 Health Status: unhealthy Condition: Adrenal cortical carcinoma Age Group: 51.4+/-11.9 Sex: M+F Population Size: 12 Sources: Page: p.264 |
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: Page: p.264 |
unhealthy, 51.4+/-11.9 n = 12 Health Status: unhealthy Condition: Adrenal cortical carcinoma Age Group: 51.4+/-11.9 Sex: M+F Population Size: 12 Sources: Page: p.264 |
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: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Adrenal cortical carcinoma Sources: Page: p.1 |
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: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Adrenal cortical carcinoma Sources: Page: p.1 |
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: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Adrenal cortical carcinoma Sources: Page: p.1 |
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: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Adrenal cortical carcinoma Sources: Page: p.1 |
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 |
---|---|---|
Mitotane use in inoperable adrenal cortical carcinoma. | 1973 Mar 5 |
|
[The effects of o,p'-DDD on human adrenal steroid synthesis]. | 1984 Jul 20 |
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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 Jan |
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[Neurotoxicity of mitotane therapy of adrenocortical carcinoma (5 cases) and Cushing's syndrome (7 cases)]. | 1987 May 23 |
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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 Jul |
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Identification of environmental chemicals with estrogenic activity using a combination of in vitro assays. | 1996 Oct |
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Growth stimulation of a rat pituitary cell line MtT/E-2 by environmental estrogens in vitro and in vivo. | 1999 Aug |
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Phenobarbital induction of CYP2B1/2 in primary hepatocytes: endocrine regulation and evidence for a single pathway for multiple inducers. | 1999 Feb 15 |
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Decreased cortisol secretion by adrenal glands perfused with the P-glycoprotein inhibitor valspodar and mitotane or doxorubicin. | 2000 Apr |
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Molecular and pharmacological evidence for modulation of kinin B(1) receptor expression by endogenous glucocorticoids hormones in rats. | 2001 Jan |
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[Therapy of the adrenocortical carcinoma with Lysodren (o,p'-DDD). Therapeutic management by monitoring o,p'-DDD blood levels]. | 2001 Jul 15 |
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Cytochrome P450-catalyzed binding of 3-methylsulfonyl-DDE and o,p'-DDD in human adrenal zona fasciculata/reticularis. | 2002 Mar |
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Acute hepatopathy associated with mitotane administration in a dog. | 2006 Jul-Aug |
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Mitotane increases the radiotherapy inhibitory effect and induces G2-arrest in combined treatment on both H295R and SW13 adrenocortical cell lines. | 2008 Jun |
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Modulation of proteomic profile in H295R adrenocortical cell line induced by mitotane. | 2008 Mar |
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A novel pretreatment approach for fast determination of organochlorine pesticides in biotic samples. | 2008 May |
|
Cushing's disease in dogs and humans. | 2009 Jan |
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Preclinical targeting of the type I insulin-like growth factor receptor in adrenocortical carcinoma. | 2009 Jan |
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Organochlorine-mediated potentiation of the general coactivator p300 through p38 mitogen-activated protein kinase. | 2009 Jan |
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(2S)-1,1-Dichloro-2-(2-chloro-phen-yl)-2-(4-chloro-phen-yl)ethane. | 2009 Jan 14 |
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Biphasic hormonal responses to the adrenocorticolytic DDT metabolite 3-methylsulfonyl-DDE in human cells. | 2010 Feb 1 |
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Mitotane exhibits dual effects on steroidogenic enzymes gene transcription under basal and cAMP-stimulating microenvironments in NCI-H295 cells. | 2012 Aug 16 |
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Preclinical investigation of nanoparticle albumin-bound paclitaxel as a potential treatment for adrenocortical cancer. | 2012 Jan |
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Ribonucleotide reductase large subunit (RRM1) gene expression may predict efficacy of adjuvant mitotane in adrenocortical cancer. | 2012 Jun 15 |
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[Surgery of the adrenal gland]. | 2012 Nov |
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Differential effect of DDT, DDE, and DDD on COX-2 expression in the human trophoblast derived HTR-8/SVneo cells. | 2012 Nov |
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Effects of mitotane on gene expression in the adrenocortical cell line NCI-H295R: a microarray study. | 2012 Sep |
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The organochlorine o,p'-DDT plays a role in coactivator-mediated MAPK crosstalk in MCF-7 breast cancer cells. | 2012 Sep |
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Mutational analyses of epidermal growth factor receptor and downstream pathways in adrenocortical carcinoma. | 2013 Jul |
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Mitotane alters mitochondrial respiratory chain activity by inducing cytochrome c oxidase defect in human adrenocortical cells. | 2013 Jun |
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Influence of the CYP2B6 polymorphism on the pharmacokinetics of mitotane. | 2013 Jun |
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Interferon-β is a potent inhibitor of cell growth and cortisol production in vitro and sensitizes human adrenocortical carcinoma cells to mitotane. | 2013 Jun |
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The effect of mitotane on viability, steroidogenesis and gene expression in NCI‑H295R adrenocortical cells. | 2013 Mar |
|
Mitotane induces CYP3A4 expression via activation of the steroid and xenobiotic receptor. | 2013 Mar |
|
FDA-approved drugs and other compounds tested as inhibitors of human glutathione transferase P1-1. | 2013 Sep 5 |
|
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 Feb |
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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admin
on
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Sat Dec 16 05:00:54 GMT 2023
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Sat Dec 16 05:00:54 GMT 2023
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Record UNII |
78E4J5IB5J
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Record Status |
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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4211
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100000085449
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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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78E4J5IB5J
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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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ENANTIOMER -> RACEMATE |
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METABOLITE -> PARENT |
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ACTIVE MOIETY |