Dangerous Drug: Mitoxantrone Hydrochloride(mye toe zan’ trone)
PREGNANCY CATEGORY D
Drug Classes
Antineoplastic
MS drug
Therapeutic Actions
Cytotoxic; cell-cycle nonspecific, appears to be DNA reactive, RNA reactive, and potent inhibitor of topoisomerase II, causing the death of both proliferating and nonproliferating cells.
Indications
As part of combination therapy in the treatment of acute nonlymphocytic leukemia in adults, including myelogenous, promyelocytic, monocytic, and erythroid acute leukemias
Treatment of pain in patients with advanced prostatic cancer, in combination with steroids
Treatment of chronic progressive, progressive relapsing, or worsening relapsing-remitting MS
Unlabeled uses: Treatment of breast cancer, refractory lymphomas, autologous bone marrow transplantation, solid tumors in children
Contraindications and Cautions
Contraindicated with hypersensitivity to mitoxantrone, pregnancy.
Use cautiously with bone marrow suppression, HF, lactation.
Available Forms
Injection—2 mg/mL
Dosages
Adults
Combination therapy: For induction, 12 mg/m2 IV per day on days 1–3, with 100 mg/m2 of cytarabine for 7 days given as a continuous infusion on days 1–7. If remission does not occur, a second series can be used, with mitoxantrone given for 2 days and cytarabine for 5 days.
Consolidation therapy: Mitoxantrone 12 mg/m2 IV for days 1 and 2, and cytarabine 100 mg/m2 given as a continuous 24-hr infusion on days 1–5; first course given 6 wk after induction therapy if needed. Second course is generally administered 4 wk after first course. Severe myelosuppression may occur.
Hormone-refractory prostate cancer: 12–14 mg/m2 as short IV infusion every 21 days.
MS: 12 mg/m2 IV over 5–15 min every 3 mo; do not exceed cumulative lifetime dose of 140 mg/m2.
Pediatric patients
Safety and efficacy not established.
Pharmacokinetics
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