Mitotane
別名: Lysodren
- **Give with Food:** Always administer this medication immediately after a meal (preferably one containing some fat or oil) to ensure proper absorption. - **Watch for Side Effects:** The goal of this drug is to reduce cortisol levels, but it can sometimes reduce them too much. Watch your pet closely for signs of an "Addisonian crisis," which include **lethargy, weakness, vomiting, diarrhea, or a sudden loss of appetite**. - **Stop if Sick:** If your pet stops eating or shows any of the above signs, **stop giving the medication immediately** and contact your veterinarian. You may be instructed to give a rescue dose of a steroid (like prednisone). - **Safety Precautions:** Mitotane is a potent cytotoxic drug. Wear gloves when handling the tablets, or wash your hands thoroughly afterward. Keep the medication strictly out of reach of children and other pets. - **Stress:** Your pet may need extra steroid medication during times of stress, such as surgery, boarding, or acute illness. Discuss this with your vet.
劑量必須由獸醫按你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
用途
- Hyperadrenocorticism
- Medical treatment of hyperadrenocorticism
- Pituitary-dependent hyperadrenocorticism (Induction - Protocol A)
- Pituitary-dependent hyperadrenocorticism (Maintenance - Protocol A)
- Pituitary-dependent hyperadrenocorticism (Induction - Protocol B)
- Pituitary-dependent hyperadrenocorticism (Maintenance - Protocol B)
- Pituitary-dependent hyperadrenocorticism (Induction - Protocol C)
- Pituitary-dependent hyperadrenocorticism (Maintenance - Protocol C)
- Total adrenal ablation (Alternative Protocol D)
- Total adrenal ablation (Alternative Protocol E)
- Palliative medical treatment of adrenal carcinomas or adenomas
- Pituitary-dependent hyperadrenocorticism (Induction)
給藥方式
可能的副作用
- Lethargy
- Ataxia
- Weakness
- Anorexia (loss of appetite)
- Vomiting
- Diarrhea
- Neurologic signs (uncommon)
- Liver changes (congestion, centrolobular atrophy, fatty degeneration)
- Iatrogenic hypoadrenocorticism (requiring long-term glucocorticoid/mineralocorticoid replacement in ~5% of dogs)
- Anorexia
- Diarrhoea
- Acute-onset neurological signs (2-3 weeks post-initiation)
- Iatrogenic hypoadrenocorticism
注意事項與禁忌
- Known hypersensitivity to mitotane
- Pregnancy (FDA Category C in humans; Class D in veterinary medicine - embryotoxic/teratogenic)
- Patients that are not eating well (should never be administered to anorexic animals)
- Not recommended in cats (trilostane is more effective and mitotane efficacy is highly variable)
- > **Warning:** Mitotane should never be administered to animals that are not eating well. * **Diabetes Mellitus:** Concurrent diabetes requires close monitoring as insulin requirements may rapidly decrease during initial treatment. * **Organ Dysfunction:** Dogs with preexisting renal or hepatic disease should receive the drug with extreme caution and intense monitoring. * **Stress Supplementation:** All dogs receiving mitotane therapy must receive additional glucocorticoid supplementation if undergoing physiological stress (e.g., surgery, trauma, acute illness). * **Human Safety:** Mitotane is a cytotoxic drug. Caregivers should avoid direct skin contact (wear gloves) and wash hands after administration.
藥物相互作用
- CNS Depressants: Additive depressant effects may be seen if used concomitantly.
- Insulin: Diabetic dogs receiving insulin may have their insulin requirements rapidly decreased when mitotane therapy is instituted.
- Phenobarbital: Can induce enzymes and reduce the efficacy of mitotane; conversely, mitotane can induce hepatic microsomal enzymes and increase the metabolism of phenobarbital.
- Spironolactone: Has been demonstrated to block the action of mitotane in dogs; an alternate diuretic is recommended.
- Barbiturates: Increases the hepatic metabolism of mitotane
- Corticosteroids: Increases the hepatic metabolism of mitotane
常見問題
Mitotane用於寵物有甚麼用途？
- **Give with Food:** Always administer this medication immediately after a meal (preferably one containing some fat or oil) to ensure proper absorption. - **Watch for Side Effects:** The goal of this drug is to reduce cortisol levels, but it can sometimes reduce them too much. Watch your pet closely for signs of an "Addisonian crisis," which include **lethargy, weakness, vomiting, diarrhea, or a sudden loss of appetite**. - **Stop if Sick:** If your pet stops eating or shows any of the above signs, **stop giving the medication immediately** and contact your veterinarian. You may be instructed to give a rescue dose of a steroid (like prednisone). - **Safety Precautions:** Mitotane is a potent cytotoxic drug. Wear gloves when handling the tablets, or wash your hands thoroughly afterward. Keep the medication strictly out of reach of children and other pets. - **Stress:** Your pet may need extra steroid medication during times of stress, such as surgery, boarding, or acute illness. Discuss this with your vet.
Mitotane對我的寵物安全嗎？
劑量必須由獸醫按你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
本文僅供一般健康教育，不能取代專業獸醫意見。如寵物身體不適，請諮詢獸醫。