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Mitotane (o,p'-DDD)

Prescription
Adrenolytic Agent
Last reviewed 21 Apr 2026 · PetCare.AI Editorial Team
Species
Dog, Cat
Brands
1 available
Interactions
3 documented
Formulations
1

Mechanism of action

Selectively destroys the zona fasciculata and zona reticularis of the adrenal cortex (adrenocorticolytic), reducing cortisol production. Does not affect the zona glomerulosa (aldosterone) at standard doses. Used for Cushing's disease (PDH and ADH).

At a glance

Class
Adrenolytic Agent
Schedule
Prescription
Storage
Store at room temperature; handle with gloves (potential human health hazard)

Dosing

🐕

Dog

Used for pituitary-dependent and adrenal-dependent hyperadrenocorticism
Dose
25–50 mg/kg
Route
PO (with fatty food)
Frequency
q12h (loading); weekly (maintenance)
🐈

Cat

Feline Cushing's is rare
Dose
25–50 mg/kg
Route
PO
Frequency
q24h

Formulations

💊

Other — 1

Strength
—

Storage

Store at room temperature; handle with gloves (potential human health hazard)

Safety

Monitoring parameters

ACTH stimulation test at day 7–10 of loading, then monthly initiallyElectrolytes (Na, K — Addisonian crisis)Liver enzymesClinical signsHave prednisone available for emergency replacement

Interactions

Major — 1

Spironolactone
major
Mitotane destroys adrenal cortex. Spironolactone blocks remaining aldosterone activity. Combined: severe mineralocorticoid deficiency (hyperkalemia, hyponatremia, hypotension).
Management: Avoid. If diuretic needed during mitotane therapy, use furosemide (not potassium-sparing diuretic).

Moderate — 2

Phenobarbital
moderate
Both are CYP enzyme inducers. Phenobarbital may accelerate mitotane metabolism, reducing its adrenolytic efficacy.
Management: May need higher mitotane dose. Monitor ACTH stimulation test response closely.
Prednisolone
moderate
Mitotane destroys adrenal cortex. Exogenous prednisolone needed for Addisonian crisis but interferes with ACTH stim test interpretation.
Management: Keep prednisolone available for emergencies. Withhold prednisolone 24h before ACTH stim tests for mitotane monitoring.

Brands

Other markets

Lysodren

FAQs

Frequently asked questions

›What is Mitotane (o,p'-DDD)?
Mitotane (o,p'-DDD) is a adrenolytic agent used in pets. Selectively destroys the zona fasciculata and zona reticularis of the adrenal cortex (adrenocorticolytic), reducing cortisol production. Does not affect the zona glomerulosa (aldosterone) at standard doses. Used for Cushing's disease (PDH and ADH).
›What is Mitotane (o,p'-DDD) used for in pets?
Mitotane (o,p'-DDD) is used in veterinary medicine for: Used for pituitary-dependent and adrenal-dependent hyperadrenocorticism; Feline Cushing's is rare.
›What is the Mitotane (o,p'-DDD) dose for dogs?
For dogs, Mitotane (o,p'-DDD) is typically dosed as follows — Used for pituitary-dependent and adrenal-dependent hyperadrenocorticism: 25–50 mg/kg PO (with fatty food) q12h (loading); weekly (maintenance). Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›What is the Mitotane (o,p'-DDD) dose for cats?
For cats, Mitotane (o,p'-DDD) is typically dosed as follows — Feline Cushing's is rare: 25–50 mg/kg PO q24h. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›Does Mitotane (o,p'-DDD) need a prescription?
Yes. Mitotane (o,p'-DDD) is a prescription medication and should only be administered under veterinary supervision.

References

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →