Uses

Indicated for reducing neurologic disability and relapse frequency in secondary progressive, progressive relapsing, or worsening relapsing-remitting multiple sclerosis. Also used in combination chemotherapy for acute nonlymphocytic leukemia and advanced hormone-refractory prostate cancer.

Do not use if

Contraindicated in patients with prior hypersensitivity to mitoxantrone. Should not be used in patients with baseline LVEF below normal range or prior cumulative anthracenedione/anthracycline dose exceeding safe limits.

Side effects

Major adverse effects include cardiotoxicity (dose-dependent cardiomyopathy and decreased LVEF), myelosuppression (leukopenia, thrombocytopenia), nausea, alopecia, and secondary acute myeloid leukemia. Urine and sclera may turn blue-green transiently.

Warnings

Administer under supervision of a physician experienced in cytotoxic chemotherapy. Never give by subcutaneous, intramuscular, or intrathecal injection. Monitor cardiac function (LVEF) before each dose; do not exceed lifetime cumulative dose of 140 mg/m². Monitor for secondary AML. Avoid in pregnancy.

How it works

Mitoxantrone is a DNA-reactive anthracenedione that intercalates into DNA, causing crosslinks and strand breaks. It is a potent inhibitor of topoisomerase II and interferes with both DNA and RNA synthesis, exerting cytocidal effects on proliferating and non-proliferating cells.

Storage

Store at room temperature between 20°C and 25°C. Do not freeze. Store upright.