Mitoxantrone

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|Mitoxantrone

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MITOXANTRONE (Systemic)

Some commonly used brand names are:

In the U.S.—

  • Novantrone

In Canada—

  • Novantrone

Category

  • Antineoplastic

Description

Mitoxantrone (mye-toe-ZAN-trone) belongs to the general group of medicines known as antineoplastics. It is used to treat some kinds of cancer. It is also used to treat some forms of multiple sclerosis (MS). This medicine will not cure MS, but may extend the time between relapses.

Mitoxantrone seems to interfere with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by mitoxantrone, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with mitoxantrone, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Mitoxantrone is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

  • Parenteral
  • Injection (U.S. and Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For mitoxantrone, the following should be considered:

Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to mitoxantrone.

Pregnancy—Tell your doctor if you are pregnant or if you intend to have children. There is a chance that this medicine may cause birth defects if either the male or female is receiving it at the time of conception or if it is taken during pregnancy. Mitoxantrone has been reported to cause low birth weight and slow growth of the kidney in rats and premature birth in rabbits. In addition, many cancer medicines may cause sterility, which could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving mitoxantrone. Tell your doctor right away if you think you have become pregnant while receiving mitoxantrone.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. It is not known whether mitoxantrone passes into breast milk. However, because mitoxantrone may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—There is no specific information comparing use of mitoxantrone in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of mitoxantrone in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving mitoxantrone, it is especially important that your health care professional know if you are taking any of the following:

  • Amphotericin B by injection (e.g., Fungizone) or
  • Antithyroid agents (medicine for overactive thyroid) or
  • Azathioprine (e.g., Imuran) or
  • Chloramphenicol (e.g., Chloromycetin) or
  • Colchicine or
  • Flucytosine (e.g., Ancobon) or
  • Ganciclovir (e.g., Cytovene) or
  • Interferon (e.g., Intron A, Roferon-A) or
  • Plicamycin (e.g., Mithracin) or
  • Zidovudine (e.g., AZT, Retrovir) or
  • If you have been treated with radiation or cancer medicines—Mitoxantrone may increase the effects of these medicines or radiation on the blood
  • Probenecid (e.g., Benemid) or
  • Sulfinpyrazone (e.g., Anturane)—Mitoxantrone may increase the concentration of uric acid in the blood. Since these medicines are used to lower uric acid levels, they may not work as well in patients receiving mitoxantrone

Other medical problems—The presence of other medical problems may affect the use of mitoxantrone. Make sure you tell your doctor if you have any other medical problems, especially:

  • Chickenpox (including recent exposure) or
  • Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
  • Gout (history of) or
  • Kidney stones—Mitoxantrone may increase levels of uric acid in the body, which can cause gout or kidney stones
  • Heart disease—Risk of heart problems caused by mitoxantrone may be increased
  • Infection—Mitoxantrone may decrease your body"s ability to fight infection
  • Liver disease—Effects of mitoxantrone may be increased because of slower removal from the body

Proper Use of This Medicine

Mitoxantrone is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are receiving mitoxantrone, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

Mitoxantrone often causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if your stomach is upset. Ask your health care professional for ways to lessen these effects.

Dosing—The dose of mitoxantrone will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient"s size, and whether or not other medicines are also being taken. If you are receiving mitoxantrone at home, follow your doctor"s orders or the directions on the label . If you have any questions about the proper dose of mitoxantrone, ask your doctor.

Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with mitoxantrone, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor"s approval . Mitoxantrone may lower your body"s resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Mitoxantrone can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way cancer medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Black, tarry stools; cough or shortness of breath

Less common

Blood in urine or stools; fast or irregular heartbeat; fever or chills; lower back or side pain; painful or difficult urination; pinpoint red spots on skin; swelling of feet and lower legs; unusual bleeding or bruising

Check with your health care professional as soon as possible if any of the following side effects occur:

More common

Sores in mouth and on lips; stomach pain

Less common

Decrease in urination; seizures; sore, red eyes; yellow eyes or skin

Rare

Blue skin at place of injection; pain or redness at place of injection; skin rash

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome:

More common

Body aches or pains; congestion; constipation; diarrhea; dryness or soreness of throat; headache; irregular menstrual periods; longer or heavier menstrual periods; nausea and vomiting; oral bleeding; runny nose; sneezing; stuffy nose; tender, swollen glands in neck

Mitoxantrone may cause the urine to turn a blue-green color. It may also cause the whites of the eyes to turn a blue color. These effects are normal and last for only 1 or 2 days after each dose is given.

This medicine often causes a temporary loss of hair. After treatment with mitoxantrone has ended, normal hair growth should return.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your health care professional.

Revised: 11/28/2000

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