Verify Mitotane (o,p'-DDD)

Drug JSON

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{
  "slug": "mitotane",
  "nameEn": "Mitotane (o,p'-DDD)",
  "nameTh": "ไมโทเทน",
  "class": "Antineoplastic — adrenolytic agent (Cushing's / adrenal carcinoma)",
  "mechanism": "cytotoxic adrenolytic — เป็นพิษต่อเซลล์ของ adrenal cortex โดยตรง (zona fasciculata/reticularis) ทำลายเนื้อเยื่อที่สร้าง cortisol; ใช้รักษา hyperadrenocorticism (Cushing) และมะเร็งต่อมหมวกไต",
  "brandNamesTh": [
    "Lysodren"
  ],
  "indications": [
    {
      "text": "pituitary-dependent hyperadrenocorticism (Cushing) และ adrenal tumor/carcinoma ในสุนัข — ทางเลือกแทน trilostane (กลไกต่างกัน: mitotane ทำลายต่อม, trilostane ยับยั้งเอนไซม์)",
      "cites": [
        "vca-mitotane",
        "tvp-cushing-t"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "⚠️ ยาเคมีบำบัด PPE; ⚠️ เสี่ยง iatrogenic hypoadrenocorticism (Addisonian crisis) — ต้อง monitor ACTH stim test + มี prednisolone สำรองให้เจ้าของ; GI/neuro toxicity; ให้พร้อมอาหารไขมัน (ดูดซึม); titrate ระวัง (overdose = adrenal necrosis สมบูรณ์)",
      "cites": [
        "vca-mitotane",
        "tvp-cushing-t"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "เบื่ออาหาร อาเจียน ซึม อ่อนแรง (อาจเป็นสัญญาณ hypocortisolism), ataxia; ⚠️ Addisonian crisis ถ้าทำลายต่อมมากเกิน",
      "cites": [
        "vca-mitotane"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Pituitary-dependent hyperadrenocorticism — specialist",
      "route": "PO",
      "dose": "induction 35–50 mg/kg/วัน PO นาน 5–10 วัน (จน ACTH stim normalize) แล้ว maintenance 35–50 mg/kg/สัปดาห์ — ⚠️ ACTH stim monitoring + pred สำรอง",
      "notes": "adrenal tumor: 50–75 mg/kg/วัน นานกว่า",
      "cites": [
        "vca-mitotane",
        "tvp-cushing-t"
      ]
    }
  ],
  "monitoring": [
    {
      "text": "ACTH stimulation test (ก่อน + ระหว่าง induction/maintenance); เฝ้า Addisonian crisis; electrolyte",
      "cites": [
        "vca-mitotane"
      ]
    }
  ],
  "citations": [
    {
      "id": "vca-mitotane",
      "type": "monograph",
      "title": "Mitotane — VCA Animal Hospitals",
      "url": "https://vcahospitals.com/know-your-pet/mitotane",
      "year": 2025,
      "note": "Clinical veterinary drug reference.",
      "cid": null
    },
    {
      "id": "tvp-cushing-t",
      "type": "guideline",
      "title": "Cushing's Disease in Dogs: Therapy Options (mitotane vs trilostane) — Today's Veterinary Practice",
      "url": "https://todaysveterinarypractice.com/endocrinology/cushings-disease-dog-therapy/",
      "year": 2025,
      "note": "Clinical veterinary drug reference.",
      "cid": null
    },
    {
      "id": "wikipedia-mitotane",
      "type": "monograph",
      "title": "Mitotane — Wikipedia",
      "year": 2026,
      "url": "https://en.wikipedia.org/wiki/Mitotane",
      "note": "Tertiary cross-check for class + mechanism. CC BY-SA 4.0. Not sole authority.",
      "cid": null
    }
  ],
  "mirroredFrom": [
    {
      "id": "who-atc",
      "name": "WHO ATC/DDD Index",
      "url": "https://www.whocc.no/atc_ddd_index/",
      "asOfDate": "2026-05-31",
      "license": "WHO publication, free for use with attribution"
    }
  ],
  "mirrorCIDs": [],
  "codes": {
    "atc": {
      "code": "L01XX23",
      "name": "Mitotane",
      "level": 5
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-31",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-31",
  "version": 1,
  "changelog": [
    {
      "version": 1,
      "date": "2026-05-31",
      "summary": "New entry — clinical content compiled from cited authoritative sources (Merck Veterinary Manual / Tufts CardioRush / VCA / dvm360 / peer-reviewed), cross-checked. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ]
}

Public keys used

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