Mitoxantrone review

The drug mitoxantrone is classified as an anthracenedione, which is an antineoplastic agent. This drug is a type II topoisomerase inhibitor, which impairs DNA synthesis and repair in both healthy and cancer cells.

Mitoxantrone is marketed under the name Norvantrone. It is indicated for the treatment of patients with certain types of cancer, mostly they are metastatic breast cancer, non-Hodgkin’s lymphoma and acute myeloid leukemia. Mitoxantrone is also used for the treatment of multiple sclerosis. This drug does not cure the disease, but is effective in the slowing down of the disease.

The recommended dosage of mitoxantrone for the treatment of multiple sclerosis is at 12 mg/m2 given as a short intravenous infusion once every 3 months.

As part of combination therapy, the recommended dosage is 12 mg/m2 daily on the first until the third day as an intravenous infusion. Succeeding dosages are individualized to meet the reactions of the drug to the body’s resistance and reactions.

General side effects of the use of the drug include allergic reactions: rashes, hives, and allergies in the injection sites. Other commonly reported side effects include hypotension, urticaria, swelling, pain, burning and even discoloration of the skin.

Mitoxantrone, as with other topoisomerase II inhibitors have been found out to cause acute leukemia in most patients. Other side effects include less serious conditions such as dehydration, nausea, and vomiting and more serious conditions such as tachycardia, congestive heart failure, chest pains and interstitial pneumonia.

Mitoxantrone is contraindicated in patients with known hypersensitivity to the drug or its known components. It also is contraindicated in patients with hypersensitivity to the drug’s family.

The administration of the drug is to be done only by experienced physicians. Patients who will undergo mitoxantrone therapy should first get consulted by their physicians, with a complete report on medical history and blood and chemistry analysis. Patients with known blood, liver and heart conditions should be given caution when using the drug.

The drug is not recommended for intramuscular/subcutaneous injection, as there are reports of regional neuropathy, which may be irreversible following such injection routes.

Mitoxantrone does not cure multiple sclerosis, rather is a secondary agent in treating the disease. The drug only suppresses the disease. Prior to the use of the drug, patients with multiple sclerosis should have their cardiac signs and history assessed by physicians.

Reports have shown that mitoxantrone causes harm to the unborn baby. Women under the drug therapy should avoid pregnancy as the drug is considered a potential teratogen. The drug has also been found out to be excreted in breast milk. Breastfeeding should be stopped if a patient is under medication of mitoxantrone.

No known studies were reported in pediatric and geriatric patients. However, the use of the drug has to be given caution for children and the elderly, as their reactions may be different from the normal adult population.

Mitoxantrone has the following structural formula:

Chemical structure of mitoxantrone

• Molecular formula of mitoxantrone is C22H28N4O6
• Chemical IUPAC Name is 1,4-dihydroxy-5,8-bis[2-(2-hydroxyethylamino)ethylamino]-anthracene-9,10-dione
• Molecular weight is 444.481 g/mol

Brand name(s): Dihydroxyanthraquinone, Immunex, Mitox, Mitoxanthrone, Mitoxantron, Mitoxantrona, Mitoxantronum, Mitozantrone, Novantron, Novantrone

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