Monitor Intently (one)mitotane decreases amounts of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Observe. Mitotane is a solid inducer of cytochrome P-4503A4; observe when coadministered with CYP3A4 substrates for probable dosage adjustments.Ergotamine: Alpha-adrenergic blocking agent with immediate stimulating ef