pixantrone dimaleate at a glance
Medicine class
A cytotoxic aza-anthracenedione related to anthracyclines.
How it is given
A healthcare professional gives it as an intravenous infusion after preparing and diluting the powder.
Important monitoring
Blood counts, liver and kidney markers, and heart function require assessment.
Colour changes
Urine, skin or the whites of the eyes may temporarily appear blue because the medicine itself is blue.
What is pixantrone dimaleate used for?
The product is licensed as monotherapy for adults with multiply relapsed or refractory aggressive non-Hodgkin B-cell lymphoma.
Benefit has not been established in later-line treatment when the lymphoma was refractory to the most recent therapy.
Safety and effectiveness have not been established in people younger than 18 years.
How does pixantrone dimaleate work?
Pixantrone enters dividing cells and damages their DNA by forming stable DNA adducts and cross-strand breaks. It also targets topoisomerase IIα, an enzyme involved in DNA management during cell division. This can prevent lymphoma cells multiplying and lead to cell death.
How to take pixantrone dimaleate
Pixantrone is prepared and given into a vein by an experienced cancer-treatment team; it is not taken at home. Tell staff immediately if the infusion site becomes painful or red. No routine dietary change is required, but mention a sodium-restricted diet and use sun-protective clothing and broad UVA protection because photosensitivity is possible.
Tell the team about infections, heart disease, liver or kidney problems, and all medicines or vaccines before treatment.
Blue urine or temporary blue discolouration of the skin or eyes can occur and is usually caused by the colour of pixantrone.
pixantrone dimaleate side effects
Common or expected effects
- Reduced white cells, red cells or platelets
- Nausea or vomiting
- Weakness or tiredness
- Hair thinning or loss
- Temporary blue discolouration of urine or skin
- Mouth inflammation, diarrhoea or constipation
- Headache, altered taste or tingling sensations
Get urgent medical advice
- Serious infection or sepsis, particularly when white-cell counts are low
- Reduced heart pumping function, heart failure or abnormal heart rhythm
- Severe bone-marrow suppression or bleeding related to low platelets
- Tumour lysis syndrome with metabolic disturbances and possible kidney injury
- Rare secondary blood or bone-marrow cancers, including acute myeloid leukaemia or myelodysplastic syndrome
- Hypersensitivity or significant infusion-site leakage
pixantrone dimaleate in pregnancy
Human pregnancy data are unavailable, and animal studies found reproductive toxicity. Pixantrone is not recommended during pregnancy or when effective contraception is not being used. Women and men should use effective contraception during treatment and for six months afterwards; discuss fertility preservation before treatment where relevant.
pixantrone dimaleate while breastfeeding
It is unknown whether pixantrone or its metabolites enter human milk, and risk to a breastfed child cannot be excluded. Breastfeeding should be stopped during treatment, with specialist advice used to plan feeding.
pixantrone dimaleate interactions
Human interaction studies are limited, so several interactions are theoretical or based on laboratory findings. The cancer team should review all medicines, supplements and vaccines.
Live-virus vaccines
Live vaccines are contraindicated because treatment suppresses immunity; other vaccines may also be less effective.
Warfarin
Pixantrone may alter warfarin metabolism, so closer INR monitoring is advised when concurrent treatment begins.
Theophylline
Theophylline concentrations could rise and cause toxicity, requiring level and adverse-effect monitoring.
Amitriptyline, clozapine, haloperidol, ondansetron or propranolol
Common questions about pixantrone dimaleate
Answers are fully visible for fast scanning and source review.
Why is pixantrone dimaleate used for lymphoma that has returned?
Its licensed role is for adults with aggressive non-Hodgkin B-cell lymphoma that has relapsed repeatedly or has not responded to previous chemotherapy.
Can pixantrone dimaleate turn urine blue?
Yes. Blue urine, skin or eye discolouration can occur because pixantrone is deep blue; skin changes generally fade as it clears.
Does pixantrone dimaleate cause hair loss?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.