Mitotane

Identification

Summary

Mitotaneis an adrenal cortex inhibitor used to treat adrenocortical tumors and Cushing's syndrome.

Brand Names
Lysodren
Generic Name
Mitotane
DrugBank Accession Number
DB00648
Background

A derivative of the insecticide dichlorodiphenyldichloroethane that specifically inhibits cells of the adrenal cortex and their production of hormones. It is used to treat adrenocortical tumors and causes CNS damage, but no bone marrow depression.

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 320.041
Monoisotopic: 317.953661148
Chemical Formula
C14H10Cl4
Synonyms
  • Mitotan
  • Mitotane
  • Mitotano
  • Mitotanum
External IDs
  • CB 313
  • CB-313
  • NSC 38721

Pharmacology

Indication

For treatment of inoperable adrenocortical tumours; Cushing's syndrome

Reduce drug development failure rates
Build, train, & validate machine-learning models
with evidence-based and structured datasets.
See how
Build, train, & validate predictive machine-learning models with structured datasets.
See how
Associated Conditions
Contraindications & Blackbox Warnings
Avoid life-threatening adverse drug events
Improve clinical decision support with information oncontraindications & blackbox warnings, population restrictions, harmful risks, & more.
Learn more
Avoid life-threatening adverse drug events & improve clinical decision support.
Learn more
Pharmacodynamics

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.

Mechanism of action

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.

Target Actions Organism
ACytochrome P450 11B1, mitochondrial
inducer
Humans
UEstrogen receptor alpha Not Available Humans
UProgesterone receptor Not Available Humans
UAndrogen receptor
antagonist
Humans
UAdrenodoxin, mitochondrial
unknown
Humans
Absorption

About 40% oral Lysodren is absorbed

的体积分布

Not Available

Protein binding

6%

Metabolism

Hepatic and renal

Route of elimination

A variable amount of metabolite (1%-17%) is excreted in the bile and the balance is apparently stored in the tissues.

Half-life

18-159 days

Clearance

Not Available

Adverse Effects
Improve decision support & research outcomes
With structured adverse effects data, including:blackbox warnings, adverse reactions, warning & precautions, & incidence rates.
Learn more
Improve decision support & research outcomes with our structured adverse effects data.
Learn more
Toxicity

Not Available

Pathways
Not Available
Pharmacogenomic Effects/ADRsBrowse all" title="" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
Not Available

Interactions

Drug InteractionsLearn More" title="" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction
1,2-Benzodiazepine The metabolism of 1,2-Benzodiazepine can be increased when combined with Mitotane.
Abemaciclib The metabolism of Abemaciclib can be increased when combined with Mitotane.
Abiraterone The metabolism of Abiraterone can be increased when combined with Mitotane.
Acalabrutinib The metabolism of Acalabrutinib can be increased when combined with Mitotane.
Acenocoumarol The metabolism of Acenocoumarol can be increased when combined with Mitotane.
Acetaminophen The metabolism of Acetaminophen can be increased when combined with Mitotane.
Adagrasib The serum concentration of Adagrasib can be decreased when it is combined with Mitotane.
Albendazole 阿苯达唑可以增加时的新陈代谢n combined with Mitotane.
Alectinib The metabolism of Alectinib can be increased when combined with Mitotane.
Alfentanil The metabolism of Alfentanil can be increased when combined with Mitotane.
Identify potential medication risks
Easily compare up to 40 drugs with our drug interaction checker.
Get severity rating, description, and management advice.
Learn more
Food Interactions
  • Take with or without food. The absorption is unaffected by food.

Products

Drug product information from 10+ global regions
Our datasets provide approved product information including:
dosage, form, labeller, route of administration, and marketing period.
Access now
Access drug product information from over 10 global regions.
Access now
International/Other Brands
Lisodren (Bristol-Myers Squibb)/Opeprim (Yakult Honsha)
Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image
Lysodren Tablet 500 mg/1 Oral HRA Pharma Rare Diseases 1978-10-15 Not applicable US flag
Lysodren Tablet 500 mg Oral HRA Pharma Rare Diseases 2016-09-08 Not applicable EU flag
Lysodren Tablet 500 mg/1 Oral E.R. Squibb & Sons, L.L.C. 2009-06-01 2021-03-31 US flag
Lysodren Tablet 500 mg Oral HRA Pharma Rare Diseases 1979-12-31 Not applicable Canada flag

Categories

ATC Codes
L01XX23 — Mitotane
Drug Categories
Chemical TaxonomyProvided byClassyfire
Description
This compound belongs to the class of organic compounds known as diphenylmethanes. These are compounds containing a diphenylmethane moiety, which consists of a methane wherein two hydrogen atoms are replaced by two phenyl groups.
Kingdom
Organic compounds
Super Class
Benzenoids
Class
Benzene and substituted derivatives
Sub Class
Diphenylmethanes
Direct Parent
Diphenylmethanes
Alternative Parents
Chlorobenzenes/Aryl chlorides/Organochlorides/沪元drocarbon derivatives/Alkyl chlorides
Substituents
Alkyl chloride/Alkyl halide/Aromatic homomonocyclic compound/Aryl chloride/Aryl halide/Chlorobenzene/Diphenylmethane/Halobenzene/沪元drocarbon derivative/Organochloride
Molecular Framework
Aromatic homomonocyclic compounds
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
78E4J5IB5J
CAS number
53-19-0
InChI Key
JWBOIMRXGHLCPP-UHFFFAOYSA-N
InChI
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
IUPAC Name
1-chloro-4-[2,2-dichloro-1-(2-chlorophenyl)ethyl]benzene
SMILES
ClC(Cl)C(C1=CC=C(Cl)C=C1)C1=CC=CC=C1Cl

References

General References
  1. FDA Approved Drug Products: LYSODREN (mitotane) tablets [Link]
Human Metabolome Database
HMDB0014786
KEGG Drug
D00420
PubChem Compound
4211
PubChem Substance
46508319
ChemSpider
4066
BindingDB
50239991
RxNav
7004
ChEBI
6954
ChEMBL
CHEMBL1670
Therapeutic Targets Database
DAP000033
PharmGKB
PA164746157
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Mitotane
MSDS
Download (57 KB)

Clinical Trials

Clinical TrialsLearn More" title="" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count
3 Active Not Recruiting Treatment Stage I Adrenocortical Carcinoma/Stage II Adrenocortical Carcinoma/Stage III Adrenocortical Carcinoma/Stage IV Adrenocortical Carcinoma 1
3 Completed Treatment Adrenocortical Carcinoma 1
3 Recruiting Treatment ENSAT Stage I Adrenal Cortex Carcinoma/ENSAT Stage II Adrenal Cortex Carcinoma/ENSAT Stage III Adrenal Cortex Carcinoma 1
3 Unknown Status Treatment Adrenocortical Carcinoma 1
2 Completed Treatment Adrenocortical Carcinoma 1
2 Recruiting Treatment Adrenocortical Carcinoma 1
2 Terminated Treatment Recurrent Adrenocortical Carcinoma/Stage III Adrenocortical Carcinoma/Stage IV Adrenocortical Carcinoma 1
1 Completed Treatment Prostate Cancer 1
Not Available Completed Not Available Adrenocortical Carcinoma 1

Pharmacoeconomics

Manufacturers
  • Bristol myers squibb
Packagers
  • B&B Pharmaceuticals
  • Bristol-Myers Squibb Co.
  • Mead Johnson and Co.
Dosage Forms
Form Route Strength
Tablet Oral 500 mg
Tablet Oral 500 mg/1
Prices
Unit description Cost Unit
Mitotane powder 7.75USD g
Lysodren 500 mg tablet 5.13USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
Property Value Source
melting point (°C) 77 °C PhysProp
water solubility 0.1 mg/L (at 25 °C) BIGGAR,JW & RIGGS,RI (1974)
logP 6 Not Available
logS -6.51 ADME Research, USCD
Predicted Properties
Property Value Source
Water Solubility 9.42e-06 mg/mL ALOGPS
logP 6.08 ALOGPS
logP 6.11 Chemaxon
logS -7.5 ALOGPS
Physiological Charge 0 Chemaxon
沪元drogen Acceptor Count 0 Chemaxon
沪元drogen Donor Count 0 Chemaxon
Polar Surface Area 0 Å2 Chemaxon
Rotatable Bond Count 3 Chemaxon
Refractivity 79.97 m3·mol-1 Chemaxon
Polarizability 29.93 Å3 Chemaxon
Number of Rings 2 Chemaxon
Bioavailability 1 Chemaxon
Rule of Five No Chemaxon
Ghose Filter No Chemaxon
Veber's Rule Yes Chemaxon
MDDR-like Rule No Chemaxon
Predicted ADMET Features
Property Value Probability
Human Intestinal Absorption + 0.9942
Blood Brain Barrier + 0.9905
Caco-2 permeable + 0.8815
P-glycoprotein substrate Non-substrate 0.8053
P-glycoprotein inhibitor I Non-inhibitor 0.9004
P-glycoprotein inhibitor II Non-inhibitor 0.988
Renal organic cation transporter Non-inhibitor 0.7959
CYP450 2C9 substrate Non-substrate 0.7899
CYP450 2D6 substrate Non-substrate 0.818
CYP450 3A4 substrate Non-substrate 0.7045
CYP450 1A2 substrate Inhibitor 0.9542
CYP450 2C9 inhibitor Inhibitor 0.7241
CYP450 2D6 inhibitor Non-inhibitor 0.9349
CYP450 2C19 inhibitor Inhibitor 0.8993
CYP450 3A4 inhibitor Non-inhibitor 0.8629
CYP450 inhibitory promiscuity High CYP Inhibitory Promiscuity 0.8
Ames test Non AMES toxic 0.9751
Carcinogenicity Non-carcinogens 0.575
Biodegradation Not ready biodegradable 0.9596
Rat acute toxicity 2.1911 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.9221
hERG inhibition (predictor II) Non-inhibitor 0.875
ADMET data is predicted usingadmetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Download (8.84 KB)
Spectra
Spectrum Spectrum Type Splash Key
Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available
GC-MS Spectrum - GC-EI-Q GC-MS splash10-000i-2590000000-2d3f8090ffa4733bf9ee
Mass Spectrum (Electron Ionization) MS splash10-000i-2690000000-770065ddc57899130a31
Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
1H NMR Spectrum 1D NMR Not Applicable
13C NMR Spectrum 1D NMR Not Applicable

Targets

Build, predict & validate machine-learning models
Use our structured and evidence-based datasets tounlock new
insights and accelerate drug research.
Learn more
Use our structured and evidence-based datasets to unlock new insights and accelerate drug research.
Learn more
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Inducer
General Function
Steroid 11-beta-monooxygenase activity
Specific Function
Has steroid 11-beta-hydroxylase activity. In addition to this activity, the 18 or 19-hydroxylation of steroids and the aromatization of androstendione to estrone have also been ascribed to cytochro...
Gene Name
CYP11B1
Uniprot ID
P15538
Uniprot Name
Cytochrome P450 11B1, mitochondrial
Molecular Weight
57572.44 Da
References
  1. Lindhe O, Skogseid B, Brandt I: Cytochrome P450-catalyzed binding of 3-methylsulfonyl-DDE and o,p'-DDD in human adrenal zona fasciculata/reticularis. J Clin Endocrinol Metab. 2002 Mar;87(3):1319-26. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Zinc ion binding
Specific Function
Nuclear hormone receptor. The steroid hormones and their receptors are involved in the regulation of eukaryotic gene expression and affect cellular proliferation and differentiation in target tissu...
Gene Name
ESR1
Uniprot ID
P03372
Uniprot Name
Estrogen receptor
Molecular Weight
66215.45 Da
References
  1. Scippo毫升,Argiris C, Van De Weerdt C,穆勒M, Willemsen P, Martial J, Maghuin-Rogister G: Recombinant human estrogen, androgen and progesterone receptors for detection of potential endocrine disruptors. Anal Bioanal Chem. 2004 Feb;378(3):664-9. Epub 2003 Oct 25. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Zinc ion binding
Specific Function
The steroid hormones and their receptors are involved in the regulation of eukaryotic gene expression and affect cellular proliferation and differentiation in target tissues. Progesterone receptor ...
Gene Name
PGR
Uniprot ID
P06401
Uniprot Name
Progesterone receptor
Molecular Weight
98979.96 Da
References
  1. Scippo毫升,Argiris C, Van De Weerdt C,穆勒M, Willemsen P, Martial J, Maghuin-Rogister G: Recombinant human estrogen, androgen and progesterone receptors for detection of potential endocrine disruptors. Anal Bioanal Chem. 2004 Feb;378(3):664-9. Epub 2003 Oct 25. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Antagonist
General Function
Zinc ion binding
Specific Function
Steroid hormone receptors are ligand-activated transcription factors that regulate eukaryotic gene expression and affect cellular proliferation and differentiation in target tissues. Transcription ...
Gene Name
AR
Uniprot ID
P10275
Uniprot Name
Androgen receptor
Molecular Weight
98987.9 Da
References
  1. Maness SC, McDonnell DP, Gaido KW: Inhibition of androgen receptor-dependent transcriptional activity by DDT isomers and methoxychlor in HepG2 human hepatoma cells. Toxicol Appl Pharmacol. 1998 Jul;151(1):135-42. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Unknown
General Function
Iron ion binding
Specific Function
Participates in the synthesis of thyroid hormones. Essential for the synthesis of various steroid hormones, participates in the reduction of mitochondrial cytochrome P450 for steroidogenesis. Trans...
Gene Name
FDX1
Uniprot ID
P10109
Uniprot Name
Adrenodoxin, mitochondrial
Molecular Weight
19392.475 Da
References
  1. Kandul SV, Iatsyk MI, Kononenko VIa: [Comparative study of the effect of chloditan on the concentration of cytochrome P-450 and adrenodoxin in various organs of the dog and rat]. Fiziol Zh. 1986 Sep-Oct;32(5):579-84. [Article]
  2. Cabrini DA, Campos MM, Tratsk KS, Merino VF, Silva JA Jr, Souza GE, Avellar MC, Pesquero JB, Calixto JB: Molecular and pharmacological evidence for modulation of kinin B(1) receptor expression by endogenous glucocorticoids hormones in rats. Br J Pharmacol. 2001 Jan;132(2):567-77. [Article]
  3. Cai W, Counsell RE, Schteingart DE, Sinsheimer JE, Vaz AD, Wotring LL: Adrenal proteins bound by a reactive intermediate of mitotane. Cancer Chemother Pharmacol. 1997;39(6):537-40. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inducer
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Inducer
General Function
Serine-type endopeptidase inhibitor activity
Specific Function
Major thyroid hormone transport protein in serum.
Gene Name
SERPINA7
Uniprot ID
P05543
Uniprot Name
Thyroxine-binding globulin
Molecular Weight
46324.12 Da
References
  1. CYTOMEL (liothyronine) FDA label [File]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Androgen binding
Specific Function
Functions as an androgen transport protein, but may also be involved in receptor mediated processes. Each dimer binds one molecule of steroid. Specific for 5-alpha-dihydrotestosterone, testosterone...
Gene Name
SHBG
Uniprot ID
P04278
Uniprot Name
Sex hormone-binding globulin
Molecular Weight
43778.755 Da
References
  1. Nader N, Raverot G, Emptoz-Bonneton A, Dechaud H, Bonnay M, Baudin E, Pugeat M: Mitotane has an estrogenic effect on sex hormone-binding globulin and corticosteroid-binding globulin in humans. J Clin Endocrinol Metab. 2006 Jun;91(6):2165-70. Epub 2006 Mar 21. [Article]
  2. van Seters AP, Moolenaar AJ: Mitotane increases the blood levels of hormone-binding proteins. Acta Endocrinol (Copenh). 1991 May;124(5):526-33. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Steroid binding
Specific Function
Major transport protein for glucocorticoids and progestins in the blood of almost all vertebrate species.
Gene Name
SERPINA6
Uniprot ID
P08185
Uniprot Name
Corticosteroid-binding globulin
Molecular Weight
45140.49 Da
References
  1. Nader N, Raverot G, Emptoz-Bonneton A, Dechaud H, Bonnay M, Baudin E, Pugeat M: Mitotane has an estrogenic effect on sex hormone-binding globulin and corticosteroid-binding globulin in humans. J Clin Endocrinol Metab. 2006 Jun;91(6):2165-70. Epub 2006 Mar 21. [Article]
  2. Tron'ko MD: [Effect of chlodithane (o,p'-DDD) on transcortin binding ability in Itsenko-Cushing's disease]. Fiziol Zh. 1970 Nov-Dec;16(6):844-5. [Article]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
References
  1. Gagliano T, Gentilin E, Benfini K, Di Pasquale C, Tassinari M, Falletta S, Feo C, Tagliati F, Uberti ED, Zatelli MC: Mitotane enhances doxorubicin cytotoxic activity by inhibiting P-gp in human adrenocortical carcinoma cells. Endocrine. 2014 Dec;47(3):943-51. doi: 10.1007/s12020-014-0374-z. Epub 2014 Aug 6. [Article]

Drug created at June 13, 2005 13:24 / Updated at April 11, 2023 21:33