Monitor Closely (one)mitotane decreases levels of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Observe. Mitotane is a solid inducer of cytochrome P-4503A4; observe when coadministered with CYP3A4 substrates for doable dosage adjustments.Ergotism manifested by intense arterial vasoconstriction, producing indicator