Observe Closely (one)mitotane decreases amounts of ergotamine by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Observe. Mitotane is a powerful inducer of cytochrome P-4503A4; watch when coadministered with CYP3A4 substrates for achievable dosage adjustments.dronedarone will improve the stage or effect of ergotamine by impacting