U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

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
Structure of MITOTANE

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

HIDE SMILES / InChI

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 ( + / - )

Description
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

Curator's Comment: # Bristol-Myers Squibb

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
LYSODREN

Approved Use

LYSODREN is indicated in the treatment of inoperable adrenal cortical carcinoma of both functional and nonfunctional types.

Launch Date

2003
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
11.3 mg/L
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
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

AUC

ValueDoseCo-administeredAnalytePopulation
543 mg × day/L
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
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

Doses

DosePopulationAdverse 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)
Nausea (grade 1-2)
Vomiting (grade 1-2)
Diarrhea (grade 1-2)
Abdominal pain (grade 1-2)
Sources: Page: p.264
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
Fetal damage
Ovarian cyst
Adrenal insufficiency
Sources: Page: p.1
AEs

AEs

AESignificanceDosePopulation
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

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer
Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
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
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Mitotane use in inoperable adrenal cortical carcinoma.
1973 Mar 5
[The effects of o,p'-DDD on human adrenal steroid synthesis].
1984 Jul 20
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
[Neurotoxicity of mitotane therapy of adrenocortical carcinoma (5 cases) and Cushing's syndrome (7 cases)].
1987 May 23
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
Identification of environmental chemicals with estrogenic activity using a combination of in vitro assays.
1996 Oct
Growth stimulation of a rat pituitary cell line MtT/E-2 by environmental estrogens in vitro and in vivo.
1999 Aug
Phenobarbital induction of CYP2B1/2 in primary hepatocytes: endocrine regulation and evidence for a single pathway for multiple inducers.
1999 Feb 15
Decreased cortisol secretion by adrenal glands perfused with the P-glycoprotein inhibitor valspodar and mitotane or doxorubicin.
2000 Apr
Molecular and pharmacological evidence for modulation of kinin B(1) receptor expression by endogenous glucocorticoids hormones in rats.
2001 Jan
[Therapy of the adrenocortical carcinoma with Lysodren (o,p'-DDD). Therapeutic management by monitoring o,p'-DDD blood levels].
2001 Jul 15
Cytochrome P450-catalyzed binding of 3-methylsulfonyl-DDE and o,p'-DDD in human adrenal zona fasciculata/reticularis.
2002 Mar
Acute hepatopathy associated with mitotane administration in a dog.
2006 Jul-Aug
Mitotane increases the radiotherapy inhibitory effect and induces G2-arrest in combined treatment on both H295R and SW13 adrenocortical cell lines.
2008 Jun
Modulation of proteomic profile in H295R adrenocortical cell line induced by mitotane.
2008 Mar
A novel pretreatment approach for fast determination of organochlorine pesticides in biotic samples.
2008 May
Cushing's disease in dogs and humans.
2009 Jan
Preclinical targeting of the type I insulin-like growth factor receptor in adrenocortical carcinoma.
2009 Jan
Organochlorine-mediated potentiation of the general coactivator p300 through p38 mitogen-activated protein kinase.
2009 Jan
(2S)-1,1-Dichloro-2-(2-chloro-phen-yl)-2-(4-chloro-phen-yl)ethane.
2009 Jan 14
Biphasic hormonal responses to the adrenocorticolytic DDT metabolite 3-methylsulfonyl-DDE in human cells.
2010 Feb 1
Mitotane exhibits dual effects on steroidogenic enzymes gene transcription under basal and cAMP-stimulating microenvironments in NCI-H295 cells.
2012 Aug 16
Preclinical investigation of nanoparticle albumin-bound paclitaxel as a potential treatment for adrenocortical cancer.
2012 Jan
Ribonucleotide reductase large subunit (RRM1) gene expression may predict efficacy of adjuvant mitotane in adrenocortical cancer.
2012 Jun 15
[Surgery of the adrenal gland].
2012 Nov
Differential effect of DDT, DDE, and DDD on COX-2 expression in the human trophoblast derived HTR-8/SVneo cells.
2012 Nov
Effects of mitotane on gene expression in the adrenocortical cell line NCI-H295R: a microarray study.
2012 Sep
The organochlorine o,p'-DDT plays a role in coactivator-mediated MAPK crosstalk in MCF-7 breast cancer cells.
2012 Sep
Mutational analyses of epidermal growth factor receptor and downstream pathways in adrenocortical carcinoma.
2013 Jul
Mitotane alters mitochondrial respiratory chain activity by inducing cytochrome c oxidase defect in human adrenocortical cells.
2013 Jun
Influence of the CYP2B6 polymorphism on the pharmacokinetics of mitotane.
2013 Jun
Interferon-β is a potent inhibitor of cell growth and cortisol production in vitro and sensitizes human adrenocortical carcinoma cells to mitotane.
2013 Jun
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
Patents

Sample Use Guides

In Vivo Use Guide
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
Mitotane (10-40uM) inhibited basal and cAMP-induced cortisol secretion in human adrenocortical cancer NCI-H295 cells.
Substance Class Chemical
Created
by admin
on Sat Dec 16 05:00:54 GMT 2023
Edited
by admin
on Sat Dec 16 05:00:54 GMT 2023
Record UNII
78E4J5IB5J
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
MITOTANE
EMA EPAR   HSDB   INN   JAN   MART.   MI   ORANGE BOOK   USAN   USP   USP-RS   VANDF   WHO-DD  
INN   USAN  
Official Name English
Mitotane [WHO-DD]
Common Name English
MITOTANE [EMA EPAR]
Common Name English
MITOTANE [USAN]
Common Name English
O,P'-DDD
Common Name English
MITOTANE [MI]
Common Name English
CHLODITAN
Brand Name English
MITOTANE [USP IMPURITY]
Common Name English
MITOTANE [ORANGE BOOK]
Common Name English
CB-313
Code English
O,P'-TDE
Common Name English
NSC-38721
Code English
mitotane [INN]
Common Name English
CB 313
Code English
MITOTANE [MART.]
Common Name English
O,P'-DDD,O P'-TDE
Common Name English
MITOTANE [HSDB]
Common Name English
MITOTAN
Common Name English
CHLODITHANE
Brand Name English
OPEPRIM
Brand Name English
MITOTANE [JAN]
Common Name English
MITOTANE [USP-RS]
Common Name English
BENZENE, 1-CHLORO-2-(2,2-DICHLORO-1-(4-CHLOROPHENYL)ETHYL)-, (±)-
Systematic Name English
(±)-1,1-DICHLORO-2-(O-CHLOROPHENYL)-2-(P-CHLOROPHENYL)ETHANE
Common Name English
LYSODREN
Brand Name English
MITOTANE [USP MONOGRAPH]
Common Name English
BENZENE, 1-CHLORO-2-(2,2-DICHLORO-1-(4-CHLOROPHENYL)ETHYL)-
Systematic Name English
MITOTANE [VANDF]
Common Name English
Classification Tree Code System Code
WHO-ATC L01XX23
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
EMA ASSESSMENT REPORTS LYSODREN (AUTHORIZED: ADRENAL CORTEX NEOPLASMS)
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
LIVERTOX NBK548445
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
NCI_THESAURUS C2355
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
EU-Orphan Drug EU/3/02/102
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
WHO-VATC QL01XX23
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
Code System Code Type Description
DRUG CENTRAL
1820
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
IUPHAR
6957
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
EVMPD
SUB09010MIG
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
MESH
D008939
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
CAS
53-19-0
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
NCI_THESAURUS
C664
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
EPA CompTox
DTXSID9020372
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
DAILYMED
78E4J5IB5J
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
PUBCHEM
4211
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
SMS_ID
100000085449
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
ECHA (EC/EINECS)
200-166-6
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
MERCK INDEX
m7571
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY Merck Index
RS_ITEM_NUM
1445007
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
DRUG BANK
DB00648
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
INN
2597
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
ChEMBL
CHEMBL1670
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
WIKIPEDIA
MITOTANE
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
RXCUI
7004
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY RxNorm
FDA UNII
78E4J5IB5J
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
HSDB
3240
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
NSC
38721
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY
NDF-RT
N0000185506
Created by admin on Sat Dec 16 05:00:54 GMT 2023 , Edited by admin on Sat Dec 16 05:00:54 GMT 2023
PRIMARY Cytochrome P450 3A4 Inducers [MoA]
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