mitoxantrone hydrochloride at a glance
Medicine class
Cytotoxic anthracenedione anticancer treatment
Administration
Diluted and given slowly into a vein by a specialist cancer team
Important monitoring
Blood counts, heart function and relevant biochemical tests
Expected colour change
Urine may temporarily become blue-green; the whites of the eyes, skin or nails may also become bluish
What is mitoxantrone hydrochloride used for?
The selected product is licensed for:
Metastatic breast cancer
Non-Hodgkin lymphoma
Acute myeloid leukaemia in adults
Remission induction for blast crisis in chronic myeloid leukaemia, as part of combination treatment
Palliation, such as pain relief, in advanced castration-resistant prostate cancer when combined with corticosteroids
How does mitoxantrone hydrochloride work?
Mitoxantrone inserts between DNA strands, causes DNA damage and inhibits topoisomerase II, an enzyme involved in unwinding and repairing DNA. This disrupts cell division and can kill both rapidly dividing and slower-growing cancer cells.
mitoxantrone hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 2 mg/mL
How to take mitoxantrone hydrochloride
Mitoxantrone is not taken at home. Trained staff dilute the concentrate and give it slowly through a freely flowing intravenous infusion under specialist supervision.
Tell staff immediately if the infusion site burns, hurts, itches, swells or changes colour.
It must not be injected under the skin, into muscle, into an artery or into the spinal canal.
Food does not affect administration because the medicine is given intravenously.
mitoxantrone hydrochloride side effects
Common or expected effects
- Reduced red or white blood cells
- Infections
- Nausea or vomiting
- Hair loss
- Reduced platelets, with easier bleeding or bruising
- Loss of appetite
- Tiredness or weakness
- Constipation or diarrhoea
- Sore or inflamed mouth
- Fever
Get urgent medical advice
- Severe infection or sepsis associated with bone-marrow suppression
- Heart damage or heart failure, which can appear during treatment or months to years later
- Severe bleeding or profound reduction in blood cells
- Severe allergic reaction
- Tissue injury if the infusion leaks outside the vein
- Tumour lysis syndrome
- Rare secondary acute leukaemia or myelodysplastic syndrome
mitoxantrone hydrochloride in pregnancy
Mitoxantrone can damage an unborn baby and should generally be avoided during pregnancy, particularly during the first trimester, unless a specialist judges that the potential benefit outweighs the risk. Pregnancy testing is required before administration. Effective contraception is advised during treatment and after stopping—at least nine months for women and six months for men. Fertility-preservation options should be discussed before treatment where relevant.
mitoxantrone hydrochloride while breastfeeding
Breastfeeding is contraindicated because mitoxantrone enters breast milk and could cause serious effects in an infant. It must be stopped before treatment; the medicine has been detected in milk for up to one month after the last administration. Specialist advice is needed before breastfeeding is resumed.
mitoxantrone hydrochloride interactions
The treatment team should review all medicines and vaccinations before mitoxantrone is given.
Anthracyclines and other cardiotoxic treatments
Using these together can increase the risk of heart damage.
Other myelosuppressive anticancer treatments
Combined treatment can cause more severe suppression of blood-cell production.
Other immunosuppressants
The combination may produce excessive immune suppression and increase infection-related risks.
Common questions about mitoxantrone hydrochloride
Answers are fully visible for fast scanning and source review.
Why does mitoxantrone hydrochloride turn urine blue-green?
The medicine is strongly coloured and may temporarily discolour urine after administration. Bluish changes can also affect the whites of the eyes, skin or nails.
How is mitoxantrone hydrochloride given?
It is diluted and given slowly into a vein by trained staff under specialist supervision.
What blood tests are needed with mitoxantrone hydrochloride?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.