(Lysodren ) Mitotane. for the. Take your. 6:00pm as. you. Take your. prescribed. mitotane. review for

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1 (Lysodren ) Information for Patients and Families Mitotane Mitotane (Lysodren ) is an oral medicine that your doctor prescribed for the treatmentt of your cancer. Please take your mitotane as directed by your prescriber. How is this medication taken? Take your mitotane at approximately the same time each day, but before 6:00pm as it can keep you awake at night. Doses do not have to be evenly timed apart; you can take the pills twice a day, three times a day, four times a day, etc. Choose what works best for you. Take your mitotane with food, preferably food with fat. Examples of food with fat are milk, peanut butter, butter, etc. Contact your cancer clinic if you are unable to take mitotane as prescribed d, including if you are unable to swalloww the tablet. Are theree any drugs or foods I should avoid with mitotane therapy? There are multiple drug and herbal interactions with mitotane. Please contact your cancer clinic or the UMCCCC oral medications for cancer therapy service if you are taking or interested in taking any new over-the- than counter medication, vitamin, or herbal product or if a physician other your oncologist has prescribed any new medication for you. We will review for the risk of interaction with mitotane. Some examples of medication ns/herbal products that may interact include: spironolactone (Aldactone) and selegiline (Deprenyl, Eldepryl, Emsam).

2 What else should I know about mitotane? You should wear a medical bracelet that says Adrenal Insufficiency You will most likely need to be on hydrocortisone (Cortef) replacement therapy (unless you have a cortisol producing tumor that has not been removed yet) There are labs we will need monitor you for monthly: o Mitotane Level o Thyroid levels (FT4, TSH) o Hormone levels (testosterone, free testosterone, LH, FSH) o Common electrolytes such as sodium, potassium, calcium o Glucose o Cortisol, ACTH o Renin, aldosterone o Liver enzymes o Cholesterol (At the beginning & every 3 months) o Cortisol in your urine When you have reached a therapeutic level of mitotane, your monthly lab requirements will change to every 3 months except when additional labs may be needed What side effects can occur with mitotane therapy? This information does not cover all possible side effects. Refer to the attached information for each chemotherapy agent for further information. Common Side Effects What Can I Do? When to Call the Clinic Diarrhea Stay well-hydrated Take loperamide (Imodium) 4 mg at onset of diarrhea and up to 2 mg every 2 hours until diarrhea- Unable to stay hydrated (not able to drink 8-10 cups of liquid per day) - CONTACT IMMEDIATELY Multiple episodes of diarrhea unrelieved by anti- 2

3 Common Side Effects What Can I Do? When to Call the Clinic free for 12 hours Avoid fatty, greasy or spicy foods that may increase diarrhea Eat smaller, more frequent meals/snacks diarrheal medication like loperamide (if no response in 24 hours of treatment or if waking in the night with diarrhea) Nausea/Vomiting Decreased Appetite Fatigue/Difficulty Staying Awake Difficulty Sleeping Emotional Changes/Anxiety/Panic Attacks Stay well-hydrated Use anti-nausea medication prescribed by the clinic Eat smaller, more frequent meals/snacks (avoid empty stomach) Stay well-hydrated Eat smaller, more frequent meals/snacks that are high in calories Don t over-exert yourself Rest when you re tired Try to go to bed at the same time & get up in the morning at the same time every day Have a calming bedtime routine Decreased Libido Rash Avoid direct sunlight (cover exposed areas of skin and use sunscreen) Use antihistamines 3 Unable to stay hydrated or hold down fluid (not able to drink 8-10 cups of liquid per day) CONTACT IMMEDIATELY The anti-nausea medication prescribed is not working Unable to stay hydrated- CONTACT IMMEDIATELY Unable to eat Unable to perform normal daily activities If rash becomes bothersome, if there are any open areas, or if you are unable to perform normal daily activities due to the rash

4 Common Side Effects What Can I Do? When to Call the Clinic (anti-itch) medications as prescribed Apply non-scented lotion to affected areas to avoid dryness If rash is itchy despite use of antihistamine medications If the skin is bleeding or looks red and/or infected If multiple areas of the body are affected by the rash Low or High Blood Pressure Blood pressure over 150/90 or less than 100/60 or as instructed by your clinic provider Underactive Thyroid Function The clinic will monitor your labs to assess Medication may be needed to control low thyroid levels Less Common Side What Can I Do? Effects Liver Dysfunction The clinic will monitor your labs to assess Breast Tenderness Increase in blood lipids The clinic will monitor your labs to assess Medication may be needed to control cholesterol levels in the blood If you always feel tired, are low on energy, or unusually cold all the time Weight gain, slowed thinking, skin dryness, constipation, low energy, or joint pain or stiffness are other posible symptoms When to Call the Clinic Yellowing of eyes or skin 4

5 More information: This document should be combined with What to Expect, A Guide to Oral Chemotherapy Treatment at the University of Michigan and the Oral Medications for Cancer Therapy documents. Ask your nurse or pharmacist for these documents if you did not receive them, or for more information, visit the Patient Education Resource Center in the Cancer Center. Who to Call With Questions For medical emergencies call 911. For symptoms or possible side effects related to your medications, please call your Cancer Center clinic. For questions about drug coverage, ability to receive the medication, drug interactions with over-the-counter medications, herbal products and new prescription medications or help in remembering to take your medication, please contact the Oral Medications for Cancer Therapy Service at or. This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician The Regents of the University of Michigan Document #0529 / Revised September

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