Influence of mitotane on the hypoprothrombinemic effect of warfarin.

Mitotane (o,p'-DDD) is closely related to the organochlorine insecticides and shares their effects on drug metabolism. We have reported the first documented interaction of mitotane and warfarin in a human being. Because the potential for significant toxicity is great when mitotane and warfarin are used concomitantly, caution is recommended when titrating warfarin therapy in patients receiving mitotane. Other drugs susceptible to the influence of enzyme inducers should also be given with caution to patients receiving mitotane.