Mitotane

Overview
Mitotane, or o,p'-DDD, is a medication used in the treatment of the rare disease adrenocortical carcinoma. It is an isomere chemically to DDT and is a derivative of DDD.

It has been produced by Bristol Myers Squibb SpA but it is marketed as an orphan drug due to the small number of patients in need of it. Its administration occurs in cases where the tumour cannot be surgically omitted. A 2007 study of 177 patients shows a significant increase in the recurrence-free interval after radical surgery followed by Mitotane when compared to surgery alone.

Mitotane alternates steroides peripheral metabolism, represses directly the adrenal cortex and alternates cortisone metabolism leading to hypocortisolism. Side effects as reported by Schteinberg et al. include anorexia and nausea (88%), diarrhea (38%), vomiting (23%), decreased memory and ability to concentrate (50%), rash (23%), gynecomastia (50%), arthralgia (19%), and leukopenia (7%).

Its trade name is Lysodren.

Veterinary use
Mitotane is also used to treat pituitary-dependent Cushing's syndrome in canines. The medication is used in the controlled destruction of adrenal tissue, leading to a decrease in cortisol production.