Mitoxantrone (Novantrone )

Warning: Mitoxantrone is a drug that should only ever be taken intravenously.  It should never be injected under the skin, into a muscle, or into the spinal cord.  Due to the nature of this medication, it should only be administered by a doctor who is experienced with the use of drugs related to chemotherapy.  Infrequently, this medication causes heart problems, including heart failure, though this is rarely fatal.  This may occur during the course of treatment or years afterwards.  Very rarely, patients receiving Mitoxantrone have developed secondary cancers.

Indications:  Mitoxantrone is a drug used to treat leukemia and prostate cancer; when used to treat leukemia, Mitoxantrone is used in combination with other drugs. Mitoxantrone might be combined with steroids to relieve the pain of advanced prostate cancer when that cancer hasn’t responded to any other treatments.  It is part of the anthracenedione drug class and works by slowing or stopping the growth and spread of certain cells, including cancer cells.  Mitoxantrone may also be used to treat multiple sclerosis.  When used in this way, Mitoxantrone will stop certain cells associated with the body’s immune system from reaching the spinal cord and brain and causing damage.

Additionally, Mitoxantrone is used in the treatment of the following cancers:

  • liver cancer
  • breast cancer
  • non-Hodgkin’s lymphoma (cancer of lymph cells).

Dosage: You will receive each dose of Mitoxantrone in a hospital or clinic under the administration of a nurse or doctor. This is because Mitoxantrone is a drug that is injected into a vein (intravenously). Mitoxantrone will also need to be prepared before it is given to you.  The FDA has stated that you should not give this medication to yourself.

If the Mitoxantrone injection is being used in the treatment of leukemia, you will receive this drug on an ongoing basis based on your condition and how well you respond to the treatment. Patients receiving Mitoxantrone as part of the treatment for prostate cancer will usually be given a dose every 21 days. If Mitoxantrone is being used to treat multiple sclerosis, it usually is administered once every three months for two to three years (for a total of eight to twelve doses). Be aware that Mitoxantrone is a treatment for multiple sclerosis, not a cure.

Overdose: overdosing Mitoxantrone can lead to serious health problems. Even at normal dose, Mitoxantrone can severely damage the bone marrow, and cause a decrease in white blood cells and platelets. Mitoxantrone may also cause kidney damage and /or serious heart problems, even years after the treatment has ended. In fragile patients, Mitoxantrone can lead to death. Although rare, Mitoxantrone increase the risk for developing leukemia in some patients. The risk is higher when the drug is taken in high dose or in combination with other chemotherapy medications.

Those adverse effects vary from one patient to another; no physician can tell how your body is going to react to Mitoxantrone. Therefore, to reduce the risk of complications, avoid anything that might weaken your immune system and the risk of infection. During the treatment, keep all appointments with your doctor. Contact your doctor immediately if you experience any symptom that indicates complications (see side effects below).

Interactions: Some medications that may interact with Mitoxantrone include natalizumab and other cancer drugs.  This is not a complete list of possible drug interactions, so be sure to tell your doctor about any other medications you are taken now or have recently taken. Drug interactions can cause severe side effects or may cause Mitoxantrone to not be as effective.

Contraindications:  If you have any of the following conditions, tell your doctor before beginning to take Mitoxantrone: Therapy-related acute leukemia, chronic heart failure, infection caused by a virus, liver problems, severe liver disease, seizures, pregnancy, anemia, or decreased white blood cells.  This is not a complete list of contraindications, so discuss any questions with your doctor.

Side effects: Mitoxantrone not only attack cancer cells but also non malignant cells, which often leads to adverse effects in most patients; most common Mitoxantrone side effects include:

  • diarrhea
  • blue-green discoloration of urine
  • headache
  • nausea and vomiting
  • temporary hair loss
  • ulcers in the mouth and lips
  • bluish whites of the eyes
  • reduced urine volume
  • Stomach pain.

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor immediately if you experience any of these symptoms:

  • fainting
  • dizziness
  • pale skin
  • seizures
  • unusual bleeding or bruising
  • small red or purple dots on the skin
  • depression
  • infection signs such as hives, itching, rash, etc.
  • difficulty swallowing
  • shortness of breath
  • yellowing of the skin or eyes
  • Redness, pain, swelling or burning at the injection site

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