Mitoxantrone Warnings and Precautions

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Mitoxantrone, the generic version of Novantrone, is an injectable medication that can be prescribed in combination with other medications or alone. It is most often prescribed in the treatment of nonlymphocytic leukemia and advanced prostate cancer. It is classified as a cancer medication, medically known as an antineoplastic or anthracenediones. It can also be prescribed for other cancers, specifically other leukemias. Some forms of multiple sclerosis may also benefit from this medication by it making relapses more infrequent. This medication works by interfering with the growth of cancer cells which will lead to their eventual destruction.

How is this Medication Used?

The dosage of this medication is very individualized and will be determined based on the patient’s response to the drug, body size, and medical condition. The patient’s doctor will provide detailed instructions on how to mix this medication, handle it, and self-inject. This medication should not be used if the liquid is discolored or has visual particles in it. If this drug comes into contact with the eyes or skin, immediate and thorough flushing of the area is required. If the medication gets in the eye, patients must seek immediate medical attention after flushing their eye for fifteen minutes.

Side Effects

Mitoxantrone side effects occur in most patients. The common ones include nausea, diarrhea, unusual fatigue, vomiting, and headache. These tend to subside after a while and not eating before a dose, eating smaller meals more frequently, and limiting activity can help to relieve these. Dehydration may occur due to severe vomiting, nausea, and diarrhea. This happens infrequently, but patients experiencing an abnormal reduction in urination, lack of tears, increased thirst, dizziness or lightheadedness, abnormal dry mouth, or wrinkled, pale skin should contact their doctor immediately. Patients may also notice their hair is thinning or hair loss. The hair most often grows back after this medication is stopped. Urine may temporarily become a green-blue color, but this is harmless and normal.

Serious side effects are found to affect many patients. These warrant contacting the patient’s doctor immediately and include:

  • Menstrual changes
  • Numbness and tingling
  • Unusual bleeding or bruising
  • Seizure
  • Sores or pain in throat and mouth
  • Infection


Contraindications of this drug include:

  • Drug allergies, especially to mitoxantrone
  • Blood or bleeding disorders
  • Liver disease
  • Heart disease and disorders
  • Radiation treatment

Drug Interactions

Other drugs and medications can often not be taken with this one. These include:

  • Natalizumab
  • Anti-cancer drugs, especially anthracyclines

Warnings and Precautions

This medication must only be administered directly into a vein. If it accidentally leaks into muscle or skin, severe damage can result. Infrequently, serious heart problems can result, including heart failure. If a patient experiences irregular heartbeat, sudden weight gain, shortness of breath, or feet/ankle swelling they must notify their doctor immediately.

In very rare cases, a new cancer, such as secondary leukemia, may develop in those using this medication. When this medication is combined with radiation therapy of certain other anti-cancer drugs, this rare complication is possible.

Before surgery or dental treatment, notify the health care provider. Those who are breastfeeding or pregnant must avoid this drug. Women must also not get pregnant when using this medication. Patients must talk to their doctor before getting any immunizations or vaccinations and must avoid contact with those who have had a recent influenza or polio vaccine. Patients must also be very careful to not get bruises, cuts, or other injuries.


RxList. (2010). Novantrone. Retrieved on September 9, 2010 from RxList: (2010). Mitoxantrone (Intravenous Route). Retrieved on September 9, 2010 from