DDInter1233 DDInter133
Mitotane is an adrenolytic isomer of the insecticide dichlorodiphenyldichloroethane (DDD) - itself a metabolite of dichlorodiphenyltrichloroethane (DDT) - that inhibits cells of the adrenal cortex and their production of hormones. It has been in use since 1959 for the treatment of inoperable adrenocortical carcinoma and is used off-label for the management of Cushing's syndrome.
Atorvastatin (Lipitor®), is a lipid-lowering drug included in the statin class of medications. By inhibiting the endogenous production of cholesterol in the liver, statins lower abnormal cholesterol and lipid levels, and ultimately reduce the risk of cardiovascular disease. More specifically, statin medications competitively inhibit the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) Reductase, which catalyzes the conversion of HMG-CoA to mevalonic acid. This conversion is a critical metabolic reaction involved in the production of several compounds involved in lipid metabolism and transport, including cholesterol, low-density lipoprotein (LDL) (sometimes referred to as "bad cholesterol"), and very-low-density lipoprotein (VLDL). Prescribing statins is considered standard practice for patients following any cardiovascular event, and for people who are at moderate to high risk of developing cardiovascular disease. The evidence supporting statin use, coupled with minimal side effects and long term benefits, has resulted in wide use of this medication in North America.[A181087, A181406] Atorvastatin and other statins including [lovastatin], [pravastatin], [rosuvastatin], [fluvastatin], and [simvastatin] are considered first-line treatment options for dyslipidemia.[A181087, A181406] The increasing use of this class of drugs is largely attributed to the rise in cardiovascular diseases (CVD) (such as heart attack, atherosclerosis, angina, peripheral artery disease, and stroke) in many countries. An elevated cholesterol level (elevated low-density lipoprotein (LDL) levels in particular) is a significant risk factor for the development of CVD.[A181087,A181553] Several landmark studies demonstrate that the use of statins is associated with both a reduction in LDL levels and CVD risk.[A181090,A181093,A181096,A181427,A181475,A181538] Statins were shown to reduce the incidences of all-cause mortality, including fatal and non-fatal CVD, as well as the need for surgical revascularization or angioplasty following a heart attack.[A181087, A181406] Some evidence has shown that even for low-risk individuals (with <10% risk of a major vascular event occurring within five years) statin use leads to a 20%-22% relative reduction in the number of major cardiovascular events (heart attack, stroke, coronary revascularization, and coronary death) for every 1 mmol/L reduction in LDL without any significant side effects or risks.[A181397, A181403] Atorvastatin was first synthesized in 1985 by Dr. Bruce Roth and approved by the FDA in 1996. It is a pentasubstituted pyrrole formed by two contrasting moieties with an achiral heterocyclic core unit and a 3,5-dihydroxypentanoyl side chain identical to its parent compound. Unlike other members of the statin group, atorvastatin is an active compound and therefore does not require activation.
Mitotane {u} (Compound) downregulates {v} (Gene) HMGCR
HMGCR {u} (Gene) is bound by {v} (Compound) Atorvastatin
Mitotane {u} (Compound) resembles {v} (Compound) Carbinoxamine
Carbinoxamine {u} (Compound) binds {v} (Gene) CYP2C9
CYP2C9 {u} (Gene) is bound by {v} (Compound) Atorvastatin
Mitotane {u} (Compound) downregulates {v} (Gene) HMGCR
HMGCR {u} (Gene) is bound by {v} (Compound) and {u} (Gene) is upregulated by {v} (Compound) Pitavastatin
Pitavastatin {u} (Compound) resembles {v} (Compound) Atorvastatin
Mitotane {u} (Compound) resembles {v} (Compound) Butoconazole
Butoconazole {u} (Compound) resembles {v} (Compound) Miconazole
Miconazole {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Atorvastatin
Mitotane {u} (Compound) downregulates {v} (Gene) HMGCR
HMGCR {u} (Gene) is associated with {v} (Disease) coronary artery disease
coronary artery disease {u} (Disease) is treated by {v} (Compound) Atorvastatin
Mitotane {u} (Compound) binds {v} (Gene) CYP11B1
CYP11B1 {u} (Gene) is bound by {v} (Compound) Fluconazole
Fluconazole {u} may lead to a major life threatening interaction when taken with {v} Atorvastatin
Mitotane {u} (Compound) downregulates {v} (Gene) HMGCR
HMGCR {u} (Gene) regulates {v} (Gene) FOXO4
FOXO4 {u} (Gene) is upregulated by {v} (Compound) Atorvastatin
Mitotane {u} (Compound) binds {v} (Gene) CYP11A1
CYP11A1 {u} (Gene) is bound by {v} (Compound) Dexamethasone
Dexamethasone {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Atorvastatin
Mitotane {u} (Compound) binds {v} (Gene) CYP11B1
CYP11B1 {u} (Gene) is associated with {v} (Disease) hypertension
hypertension {u} (Disease) is treated by {v} (Compound) Atorvastatin
Mitotane {u} (Compound) resembles {v} (Compound) Econazole
Econazole {u} (Compound) downregulates {v} (Gene) PCNA
PCNA {u} (Gene) is downregulated by {v} (Compound) Atorvastatin
Mitotane (Compound) downregulates HMGCR (Gene) and HMGCR (Gene) is bound by Atorvastatin (Compound)
Mitotane (Compound) resembles Carbinoxamine (Compound) and Carbinoxamine (Compound) binds CYP2C9 (Gene) and CYP2C9 (Gene) is bound by Atorvastatin (Compound)
Mitotane (Compound) downregulates HMGCR (Gene) and HMGCR (Gene) is bound by Pitavastatin (Compound) and HMGCR (Gene) is upregulated by Pitavastatin (Compound) and Pitavastatin (Compound) resembles Atorvastatin (Compound)
Mitotane (Compound) resembles Butoconazole (Compound) and Butoconazole (Compound) resembles Miconazole (Compound) and Miconazole may cause a moderate interaction that could exacerbate diseases when taken with Atorvastatin
Mitotane (Compound) downregulates HMGCR (Gene) and HMGCR (Gene) is associated with coronary artery disease (Disease) and coronary artery disease (Disease) is treated by Atorvastatin (Compound)
Mitotane (Compound) binds CYP11B1 (Gene) and CYP11B1 (Gene) is bound by Fluconazole (Compound) and Fluconazole may lead to a major life threatening interaction when taken with Atorvastatin
Mitotane (Compound) downregulates HMGCR (Gene) and HMGCR (Gene) regulates FOXO4 (Gene) and FOXO4 (Gene) is upregulated by Atorvastatin (Compound)
Mitotane (Compound) binds CYP11A1 (Gene) and CYP11A1 (Gene) is bound by Dexamethasone (Compound) and Dexamethasone may cause a moderate interaction that could exacerbate diseases when taken with Atorvastatin
Mitotane (Compound) binds CYP11B1 (Gene) and CYP11B1 (Gene) is associated with hypertension (Disease) and hypertension (Disease) is treated by Atorvastatin (Compound)
Mitotane (Compound) resembles Econazole (Compound) and Econazole (Compound) downregulates PCNA (Gene) and PCNA (Gene) is downregulated by Atorvastatin (Compound)