Fludrocortisone and Mitotane interaction

Fludrocortisone and Mitotane: the Mitotane prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Mitotane (Lysodren) label · effective 2026-03-03

Major

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

Boxed warningby drug classView label on DailyMed
Moderate

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

Warnings and precautionsby drug classView label on DailyMed
Moderate

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.

Warnings and precautionsby drug classView label on DailyMed
Moderate

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)).

Warnings and precautionsby drug classView label on DailyMed
Minor

Steroid replacement may be necessary.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.