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Overview: Mitoxantrone is used to treat certain types of multiple sclerosis, prostate cancer, or leukemia. Common side effects include infections, nausea, and constipation or diarrhea. Keep all appointments to have your blood or heart checked. Call your health care provider right away if you get a fever, swelling, shortness of breath, or unusual bleeding or bruising.

Uses

What is mitoxantrone used for?

Mitoxantrone is commonly used to reduce disability and relapses in people with certain types of multiple sclerosis. It may also be used as chemotherapy to treat some types of leukemia or prostate cancer.

Mitoxantrone may also be used for other conditions as determined by your health care provider.

How does mitoxantrone work (mechanism of action)?

Mitoxantrone works for multiple sclerosis because it lowers the activity of the immune system to help ease inflammation in the brain and spinal cord. For treatment of cancer, mitoxantrone stops cells from dividing, which prevents them from multiplying. This means it can slow or stop cancer tumors from growing.

How is mitoxantrone supplied (dosage forms)?

Brands and other names

  • Novantrone

Dosage forms and strengths

Mitoxantrone is available in an injectable form that is given by a health care provider.

How should I store mitoxantrone?

Mitoxantrone is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of mitoxantrone?

The most common side effects of mitoxantrone are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Blue-green urine or blue tint to whites of the eyes for about a day after a dose
  • Nausea
  • Constipation or diarrhea
  • Belly pain
  • Hair loss
  • Infection that causes fever, chills, sore throat, or cough
  • Mouth sores
  • Your period stopping

There may be other side effects of mitoxantrone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of mitoxantrone?

While less common, the most serious side effects of mitoxantrone are described below, along with what to do if they happen.

Severe Allergic Reactions. Mitoxantrone may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Failure. Mitoxantrone may increase your risk of heart failure that can be life-threatening. This can even happen for months to years after you are treated with mitoxantrone. Keep all appointments to have testing on your heart. Tell your health care provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness
  • Fast heartbeat or a pounding feeling in your chest

Bone Marrow Suppression. Mitoxantrone may cause your bone marrow to not make enough cells. This can lead to low blood levels of important cells, such as red blood cells, white blood cells, platelets, and neutrophils. Bone marrow suppression can lead to infections or bleeding. This can be serious or even life-threatening. Keep all appointments to have your blood checked. Tell your health care provider right away if you have any of the following symptoms of bone marrow suppression.

  • Fever, chills, or sweats
  • Sore throat, cough, or shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat
  • Mouth or throat sores
  • Swollen lymph nodes

New Cancer. Mitoxantrone can increase the risk of developing leukemia. This has been reported by a small number of people who used mitoxantrone and can happen months to years later. Keep all appointments to have your blood counts checked during and after treatment with mitoxantrone. Tell your health care provider if you have symptoms such as bleeding and bruising easily, infections that keep coming back, bone pain, unusual weight loss, or night sweats.

Tissue Damage. Mitoxantrone is given as an infusion into a vein. If the medicine does not go into your vein, it could damage nearby tissue. Tell your health care provider right away if you have pain, swelling, warmth, burning, or skin color changes where the medicine is being or was given.

Warnings & Precautions

Who should not use mitoxantrone?

Allergies to Ingredients. People who are allergic to any of the following should not use mitoxantrone.

  • Mitoxantrone
  • Novantrone
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific mitoxantrone products they stock.

What should I know about mitoxantrone before using it?

Mitoxantrone is usually given by a health care provider in a clinic or hospital.

Your pee is likely going to look blue or green for about 24 hours after you get a dose of this medicine. The whites of your eyes may also look blue for about 24 hours after you get a dose of this medicine. These color changes are harmless.

If you can get pregnant, use effective birth control. Talk with your health care provider about the best birth control for you.

What should I tell my health care provider before using mitoxantrone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if mitoxantrone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • A history of treatment with mitoxantrone
  • Radiation treatment to your chest
  • Heart problems, including heart failure
  • Kidney or liver problems
  • Low blood counts
  • An infection

Sulfite Sensitivity. Mitoxantrone contains sodium metabisulfite. This is a sulfite that may cause you to have an allergic reaction, especially if you have asthma. Tell your health care provider if you have allergies to any foods, drinks, or medicines.

Pregnancy. Mitoxantrone may cause harm to an unborn baby. Your health care provider will make sure you are not pregnant before you start using mitoxantrone and before you get each dose of mitoxantrone. If you can become pregnant, you should use effective birth control while using mitoxantrone. Tell your health care provider right away if you are pregnant or plan to become pregnant.

Breastfeeding. Do not use mitoxantrone while you are breastfeeding. Mitoxantrone can pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does mitoxantrone interact with foods or drinks?

There are no known interactions between mitoxantrone and foods or drinks.

It is unknown if drinking alcohol will affect mitoxantrone, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does mitoxantrone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure that you discuss if you are using any of the following before taking mitoxantrone.

  • Daunorubicin, doxorubicin (Adriamycin, Doxil), epirubicin (Ellence), idarubicin (Idamycin), or valrubicin (Valstar), which is a medicine used to treat certain types of cancer
  • Any medicine that may affect your heart

This may not be a complete list of medicines that can interact with mitoxantrone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much mitoxantrone?

If you or someone else has received too much mitoxantrone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of mitoxantrone?

Mitoxantrone is usually given by a health care provider in a clinic or hospital. Your health care provider will make sure you are receiving mitoxantrone as scheduled.

If you miss an appointment to get your mitoxantrone dose, call to make another appointment as soon as possible.