DDInter1233 DDInter1480
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.
Pitolisant is a selective antagonist or inverse agonist of the histamine H3 receptor used to treat type 1 or 2 narcolepsy. Narcolepsy is a chronic neurological disorder that affects 1 in 2,000 individuals and is characterized by excessive daytime sleepiness, abnormal REM sleep manifestations, sleep paralysis and hypnagogic hallucinations. About 60-70% of patients with narcolepsy experience cataplexy, which is a sudden loss of muscle tone triggered by positive or negative emotions. Histaminergic neuron signalling in the brain plays a role in maintaining wakefulness; by blocking histamine autoreceptors, pitolisant enhances the activity of histaminergic neurons, as well as increasing the signalling of other neurotransmitters in the brain. In a European clinical trial of adult patients with narcolepsy, there was a reduction in the Epworth Sleepiness Scale (ESS) score from pitolisant therapy compared to placebo. The therapeutic effectiveness of pitolisant was comparable to that of [modafinil]. Pitolisant therapy was also effective in treating refractory sleepiness in adolescent patients with narcolepsy, where it decreased ESS score and increased the mean sleep onset latency. Adolescent patients with cataplexy also experienced a slight improvement in the frequency and severity of symptoms ; however, the safety of use in adolescent or paediatric patients have not been established with pitolisant. Commonly marketed under the trade name Wakix, oral pitolisant was approved by the EMA in 2016 for the treatment of narcolepsy with or without cataplexy. FDA approved the use of pitolisant in 2019 for excessive daytime sleepiness (EDS) associated with narcolepsy in adults.
Mitotane {u} (Compound) resembles {v} (Compound) Carbinoxamine
Carbinoxamine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) resembles {v} (Compound) Carbinoxamine
Carbinoxamine {u} (Compound) resembles {v} (Compound) Bisacodyl
Bisacodyl {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) resembles {v} (Compound) Chlorpheniramine
Chlorpheniramine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Cobicistat
Cobicistat {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) resembles {v} (Compound) Carbinoxamine
Carbinoxamine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Triprolidine
Triprolidine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) resembles {v} (Compound) Cloperastine
Cloperastine {u} (Compound) resembles {v} (Compound) Carbinoxamine
Carbinoxamine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) binds {v} (Gene) CYP11B1
CYP11B1 {u} (Gene) is bound by {v} (Compound) Hydrocortisone
Hydrocortisone {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) resembles {v} (Compound) Carbinoxamine
Carbinoxamine {u} (Compound) resembles {v} (Compound) and {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Chlorpheniramine
Chlorpheniramine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) binds {v} (Gene) CYP11A1
CYP11A1 {u} (Gene) is bound by {v} (Compound) Terbinafine
Terbinafine {u} may lead to a major life threatening interaction when taken with {v} Pitolisant
Mitotane {u} (Compound) upregulates {v} (Gene) ADGRE5
ADGRE5 {u} (Gene) is upregulated by {v} (Compound) Isotretinoin
Isotretinoin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane {u} (Compound) resembles {v} (Compound) Chlorpheniramine
Chlorpheniramine {u} (Compound) resembles {v} (Compound) and {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Carbinoxamine
Carbinoxamine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Mitotane (Compound) resembles Carbinoxamine (Compound) and Carbinoxamine may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) resembles Carbinoxamine (Compound) and Carbinoxamine (Compound) resembles Bisacodyl (Compound) and Bisacodyl may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) resembles Chlorpheniramine (Compound) and Chlorpheniramine may cause a moderate interaction that could exacerbate diseases when taken with Cobicistat and Cobicistat may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) resembles Carbinoxamine (Compound) and Carbinoxamine may cause a moderate interaction that could exacerbate diseases when taken with Triprolidine and Triprolidine may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) resembles Cloperastine (Compound) and Cloperastine (Compound) resembles Carbinoxamine (Compound) and Carbinoxamine may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) binds CYP11B1 (Gene) and CYP11B1 (Gene) is bound by Hydrocortisone (Compound) and Hydrocortisone may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) resembles Carbinoxamine (Compound) and Carbinoxamine (Compound) resembles Chlorpheniramine (Compound) and Carbinoxamine may cause a moderate interaction that could exacerbate diseases when taken with Chlorpheniramine and Chlorpheniramine may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) binds CYP11A1 (Gene) and CYP11A1 (Gene) is bound by Terbinafine (Compound) and Terbinafine may lead to a major life threatening interaction when taken with Pitolisant
Mitotane (Compound) upregulates ADGRE5 (Gene) and ADGRE5 (Gene) is upregulated by Isotretinoin (Compound) and Isotretinoin may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Mitotane (Compound) resembles Chlorpheniramine (Compound) and Chlorpheniramine (Compound) resembles Carbinoxamine (Compound) and Chlorpheniramine may cause a moderate interaction that could exacerbate diseases when taken with Carbinoxamine and Carbinoxamine may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant