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Check Intently (1)mitotane decreases amounts of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Watch. Mitotane is a solid inducer of cytochrome P-4503A4; check when coadministered with CYP3A4 substrates for attainable dosage adjustments.Check Closely (1)pirtobrutinib will enhance the degree or result of ergotamine