Mitoxantrone HCL (Generic Name)

Other Names: Novantrone

About This Drug

Mitoxantrone is used to treat cancer. This drug is given intravenously (IV).

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs eight to 10 days after the drug is given and may increase your risk of infection, fatigue, and bleeding.
  • Effects on the heart.  High doses of this drug may cause chest pain or rapid or irregular heart beat (palpitations).  Your heart may weaken. Your heart function will be checked as needed.
  • Nausea and vomiting. These symptoms may occur within hours after you receive the drug and may last up to 24 hours.
  • Changes in liver enzymes. Liver enzymes will be monitored as needed.
  • Skin and tissue irritation.  You may have redness, pain, warmth, or swelling at the IV site.  This irritation occurs if the drug leaks out of the vein and into the surrounding tissue. 
  • Change in the color of urine to blue or green and change in the color of  your sclera (the usually white part of your eye) to blue. This color change will go away in 24 hours after receiving this drug.
  • Swelling (fluid retention) in the legs, ankles, and/or feet.
  • Fever
  • Fatigue
  • Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Changes in your nails.
  • You may develop high blood sugars.  Your blood work will be monitored as needed.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Lack of appetite
  • Abdominal pain
  • Weakness.
  • Changes in kidney function.  Yur kidney function will be monitored as needed.

Possible Side Effects (Less Common)

  • Seizure
  • Changes in your electrolytes.  Your electrolytes will be monitored by blood work as needed.
  • Development of another cancer such as leukemia.
  • Joint and muscle aches and pains.
  • Irritation, pain and eye infections
  • Blurred vision
  • Changes in the way your kidneys function.  Your kidney function will be monitored as needed.

Sexual Problems and Reproduction Concerns

In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.

Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking. 

Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 

Pregnancy Warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.

Breast Feeding Warning :Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously.

Women may experience signs of menopause like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Ask your doctor or nurse about medication that is available to help prevent or lessen nausea and vomiting, pain, and/or irritated eyes.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Speak with your nurse about obtaining a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345  to find out information  about the “ Look Good, Feel Better” program close to where you live. It is a free program where women undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.

Food and Drug Interactions

There are no known interactions of mitoxzntrone with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions

  • While you are receiving this drug by IV,  tell your nurse immediately if you have any of the following symptoms of an allergic reaction:
    - Shortness of breath 
    - Rash or itching 
    - Dizziness or lightheadedness 
    - Feeling your heart beat rapidly (palpitations)

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Redness, pain, warmth, or swelling at the IV site while you are receiving this drug
  • Chest pain or symptoms of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. Or the discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Seizure
  • Uncontrolled nausea that prevents you from eating or drinking
  • Rapid or irregular heart beat
  • Difficulty catching your breath
  • Difficulty breathing when lying flat
  • Blurred vision

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Nausea unrelieved by prescribed medication
  • Yellowing of the skin or eyes
  • Swelling of the legs, ankles, and/or feet.
  • Nausea, vomiting, pain, and eye discomfort unrelieved by prescribed medication
  • Painful mouth or throat that makes it difficult to eat or drink  
  • Extreme fatigue or weakness that interferes with daily activities
  • Persistent loss of appetite of fast weight loss (such as 5 pounds in 1 week)

Revised January 2012

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