Drug reference

Mitoxantrone

Anthracycline · Antineoplastic

Also known as Mitozantrone

AnthracyclineAntineoplastic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Avoid.

FDA category + note

Top interactionssee all 12 →

AdalimumabSevereDatabaseDDInter
BaricitinibSevereDatabaseDDInter
CertolizumabSevereDatabaseDDInter
CladribineSevereDatabaseDDInter

Mechanism

Mitoxantrone is an anthracenedione that intercalates into DNA and inhibits topoisomerase II by stabilizing the enzyme-DNA cleavable complex, preventing religation of double-strand DNA breaks. Unlike the structurally related anthracycline doxorubicin, mitoxantrone lacks the aminosugar moiety and generates fewer free radicals, resulting in significantly less cardiotoxicity while retaining potent antitumor activity. It is used in acute myeloid leukemia, prostate cancer, and as an immunosuppressant in progressive multiple sclerosis.

Indications

Metastatic breast cancerNon-Hodgkin’s lymphomaAdult acute non-lymphocytic leukaemiaNon-resectable primary hepatocellular carcinomaSymptomatic stage III and IV follicular lymphoma in previously untreated patients (in combination with rituximab, chlorambucil, and prednisolone)reducing relapse rates of msslowing progression of msAcute myeloid leukemia (AML)Prostate cancerLate-stage, secondary progressive multiple sclerosisAcute myeloid leukaemiaAdvanced hormone refractory prostate cancerBreast carcinomaHepatic carcinomaNon-Hodgkin lymphomaLate stage multiple sclerosis

Dosing

Adult: (consult local protocol)
Hepatic adjustment: Manufacturer advises caution (limited information available). Consider dose reduction.

Contraindications

Active severe infection
Risk factors for severe infection
Active cardiovascular disease
Cardiac risk factors
Concurrent radiotherapy to the mediastinal area
History of cardiovascular disease
Previous radiotherapy to the mediastinum

Side effects

Common

Abdominal painAlopeciaAmenorrhoeaAnxietyAppetite decreasedAstheniaConfusionConstipationDiarrhoeaDrowsinessDyspnoeaFeverGastrointestinal haemorrhageMucositisNail discolourationNail dystrophyNauseaNeurological effectsParaesthesiaScleral discolourationSkin discolourationStomatitisUrine blueVomitingAcute myelosuppressionMarrow depressionMucosal inflammationDiscolouration of nails and eye

Serious