Monitor Intently (one)mitotane decreases levels of ergotamine by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Keep track of. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for feasible dosage changes.Headache, intermittent claudication, muscle pains, numbness, or coldnes