التداخل بين ميثيل بريدنيزولون وميتوتان

If shock, severe trauma or infection occurs or develops, temporarily discontinue LYSODREN and administer exogenous steroids.

Monitor for both glucocorticoid and mineralocorticoid insufficiency and replace systemic corticosteroids accordingly.

Due to increased steroid clearance and increase of steroid-binding protein, high-dose replacement therapy may be required and free cortisol and corticotropin (ACTH) should be monitored to adapt the systemic corticosteroids.

Hormone binding protein Mitotane has been shown to increase plasma levels of hormone binding proteins (e.g., sex hormone-binding globulin (SHBG) and corticosteroid-binding globulin (CBG)).

Steroid replacement may be necessary.

Hepatic Enzyme Inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin) : Drugs which induce cytochrome P450 3A4 enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased.