Mitoxantrone – Uses, Dosage, Side Effects, Interaction Mitoxantrone is an antineoplastic antibiotic that is used in the treatment of acute leukemia, lymphoma, and prostate and breast cancer, but also for late-stage, severe multiple sclerosis. Mitoxantrone therapy is often accompanied by mild to moderate elevations in serum aminotransferase levels, but in typical doses, it rarely causes clinically apparent, acute liver injury. Mitoxantrone is an anthracenedione antibiotic with antineoplastic activity. Mitoxantrone intercalates into and crosslinks DNA, thereby disrupting DNA and RNA replication. This agent also binds to topoisomerase II, resulting in DNA strand breaks and inhibition of DNA repair. Mitoxantrone is less cardiotoxic compared to doxorubicin. Mitoxantrone is a dihydroxyanthraquinone that is 1,4-dihydroxy-9,10-anthraquinone which is substituted by 6-hydroxy-1,4-diazahexyl groups at positions 5 and 8. It has a role as an antineoplastic agent and an analgesic. Mitoxantrone Hydrochloride is the hydrochloride salt of an anthracene-dione antibiotic with antineoplastic activity. Mitoxantrone intercalates into and crosslinks DNA, thereby disrupting DNA and RNA replication. This agent also binds to topoisomerase II, resulting in DNA strand breaks and inhibition of DNA repair. Mitoxantrone is less cardiotoxic compared to doxorubicin. Mechanism of Action Mitoxantrone, a DNA-reactive agent that intercalates into deoxyribonucleic acid (DNA) through hydrogen bonding, causes crosslinks and strand breaks. Mitoxantrone also interferes with ribonucleic acid (RNA) and is a potent inhibitor of topoisomerase II, an enzyme responsible for uncoiling and repairing damaged DNA. It has a cytocidal effect on both proliferating and nonproliferating cultured human cells, suggesting a lack of cell cycle phase specificity. Mitoxantrone has a limited ability to produce quinone-type free radicals & causes less cardiac toxicity than doxorubicin. Mitoxantrone exerts its antitumor action by stimulating the formation of strand breaks in DNA; this is mediated by topoisomerase II; it also intercalates with DNA. or The mechanisms of the inotropic effect of mitoxantrone (MTO), a synthetic dihydroxyanthracenedione derivative with antineoplastic activity, were investigated in guinea pig ventricular myocytes using whole-cell patch-clamp methods combined with fura-2 fluorescence and cell-edge tracking techniques. In the right ventricular papillary muscles, 30 microM MTO increased the isometric force of contraction as well as action potential duration (APD) in a time-dependent manner. The force of contraction was increased approximately 3-fold within 4 h. This positive inotropic effect was accompanied by a prolongation of time to peak force and relaxation time. In current-clamped single myocytes treated with 30 microM MTO for 30 min, an increase of cell shortening by 77% and a prolongation of APD by 19% was observed. The peak amplitude of the intracellular Ca(2+) transients were also increased by 10%. The contribution of APD prolongation to the enhancement of cell shortening induced by MTO was assessed by clamping control myocytes with action potentials of various duration. Prolongation of APD(90) (ADP measured at 90% of repolarization) by 24% led to an increase in cell shortening by 13%. When the cells were clamped by an action potential with constant APD, MTO still caused an increase of cell shortening by 59% within 30 min. No increase of the peak intracellular Ca(2+) transients, however, was observed under this condition. We conclude that both the APD prolongation and direct interaction with the contractile proteins contributed to the positive inotropic effect of MTO. Indications For the treatment of secondary (chronic) progressive, progressive relapsing, or worsening relapsing-remitting multiple sclerosis Mitoxantrone is an antineoplastic antibiotic that is used in the treatment of acute leukemia, lymphoma, and prostate and breast cancer, but also for late-stage, severe multiple sclerosis. Mitoxantrone (NOVANTRONE) is supplied for iv infusion. To induce remission in acute nonlymphocytic leukemia in adults, the drug is given in a daily dose … for 3 days as a component of a regimen that also includes cytosine arabinoside. Mitoxantrone also is used in advanced hormone-resistant prostate cancer. In 2000, mitoxantrone was approved by the FDA for the treatment of late-stage secondary progressive multiple sclerosis. To reduce neurologic disability and/or the frequency of clinical relapses in patients with secondary (chronic) progressive, progressive relapsing, or worsening relapsing-remitting multiple sclerosis (i.e., patients whose neurologic status is significantly abnormal between relapses) The combination of mitoxantrone and prednisone is approved as a second-line treatment for metastatic hormone-refractory prostate cancer. Until recently this combination was the first line of treatment; however, a combination of docetaxel and prednisone improves survival rates and lengthens the disease-free period.[rx] Mitoxantrone is also used to treat multiple sclerosis (MS), most notably the subset of the disease known as secondary-progressive MS. In the absence of a cure, mitoxantrone is effective in slowing the progression of secondary-progressive MS and extending the time between relapses in both relapsing-remitting MS and progressive-relapsing MS.[rx] Acute Lymphoblastic Leukemia (ALL) Acute Myeloid Leukemia Acute Promyelocytic Leukemia Hodgkin’s Lymphoma Metastatic Breast Cancer Non-Hodgkin’s Lymphoma (NHL) Progressive Relapsing Multiple Sclerosis Relapsed Leukemia Relapsed Lymphomas Relapsing-Remitting Multiple Sclerosis (RRMS) Secondary Progressive Multiple Sclerosis (SPMS) Hormone refractory, advanced Prostate cancer Relapsed Hepatocellular carcinoma Use in Cancer Mitoxantrone hydrochloride is approved to be used with other drugs to treat: Acute non-lymphocytic leukemia in adults. Prostate cancer. It is used as palliative treatment in patients with advanced disease that is hormone-refractory (does not respond to hormone treatment). Mitoxantrone hydrochloride is also being studied in the treatment of other types of cancer. Contraindications a bacterial infection. an infection due to a fungus. a bad infection. decreased function of bone marrow. anemia. decreased blood platelets. low levels of white blood cells. low levels of a type of white blood cell called neutrophils. Dosage Strengths: 2 mg/mL Acute Nonlymphocytic Leukemia INDUCTION THERAPY: 12 mg/m2 IV daily on days 1 to 3 (in combination with cytarabine at 100 mg/m2 given as a continuous 24-hour IV infusion on days 1 to 7) SECOND INDUCTION THERAPY (if needed in the event of an incomplete antileukemic response to the first induction): 12 mg/m2 IV daily on days 1 and 2 (in combination with cytarabine given as a continuous 24-hour IV infusion on days 1 to 5) CONSOLIDATION THERAPY: 12 mg/m2 given IV daily on days 1 and 2 (in combination with cytarabine given as a continuous 24-hour IV infusion on days 1 to 5). The first course is given approximately 6 weeks after the final induction course and the second is generally administered 4 weeks after the first. The IV infusion should be given over 5 to 15 minutes. Most complete remissions from ANLL occur during initial induction therapy. In the event of an incomplete antileukemic response, a second induction course may be administered. Second inductions should be withheld until severe or life-threatening nonhematologic toxicity associated with the first induction dose is cleared. For the initial therapy of acute nonlymphocytic leukemia (ANLL) in adults (includes myelogenous, promyelocytic, monocytic, and erythroid acute leukemias) in combination with other approved drug(s) Multiple Sclerosis 12 mg/m2 given as a short (approximately 5 to 15 minute) IV infusion every 3 months The IV infusion should be given over 5 to 15 minutes. Evaluation of left ventricular ejection fraction (LVEF) by echocardiogram or multiple gated acquisition (MUGA) scan is recommended prior to all doses. LVEF evaluations are recommended if signs of congestive heart failure develop. This drug should not be administered to MS patients who have received a cumulative lifetime dose of 140 mg/m2 or more, or those with either an LVEF less than 50% or a clinically significant reduction in LVEF. Complete blood counts, including platelets, should be monitored prior to each dose and if signs of infection develop. This drug should not be administered to MS patients with neutrophil counts less than 1500 cells/mm3. Liver function tests should also be monitored prior to each dose. Use of this drug in MS abnormal liver function tests is not recommended. Women who are capable of becoming pregnant (even if they are using birth control) should have a pregnancy test before each dose. Prostate Cancer 12 to 14 mg/m2 given as a short IV infusion every 21 days (in combination with corticosteroids) The IV infusion should be given over 5 to 15 minutes. US BOXED WARNINGS: This drug should be administered under the supervision of a physician experienced in the use of cytotoxic chemotherapy agents. This drug should be given slowly into a freely flowing IV infusion. It should never be given subcutaneously, IM, or intra-arterially. Severe local tissue damage may occur if there is extravasation during administration. NOT FOR INTRATHECAL USE. Severe injury with permanent sequelae can result from intrathecal administration. Except for the treatment of acute nonlymphocytic leukemia, this drug generally should not be given to patients with baseline neutrophil counts of less than 1,500 cells/mm3. In order to monitor the occurrence of bone marrow suppression, primarily neutropenia, which may be severe and result in infection, it is recommended that frequent peripheral blood cell counts be performed on all patients receiving this drug. Cardiotoxicity: Congestive heart failure (CHF), potentially fatal, may occur either during therapy or months to years after termination of therapy. The risk increases with cumulative dose and may occur whether or not cardiac risk factors are present. Presence or history of cardiovascular disease, radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracene diones, or use of other cardiotoxic drugs may increase this risk. In cancer patients, the risk of symptomatic CHF was estimated to be 2.6% for patients receiving up to a cumulative dose of 140 mg/m2. To mitigate the cardiotoxicity risk, prescribers should consider the following: ALL PATIENTS: All patients should be assessed for cardiac signs and symptoms by history, physical examination, and ECG prior to starting therapy. All patients should have baseline quantitative evaluation of left ventricular ejection fraction (LVEF) using appropriate methodology (e.g., echocardiogram, multi-gated radionuclide angiography (MUGA), MRI). MULTIPLE SCLEROSIS PATIENTS: MS patients with a baseline LVEF below the lower limit of normal should not be treated with this drug. MS patients should be assessed for cardiac signs and symptoms by history, physical examination, and ECG prior to each dose. MS patients should undergo quantitative reevaluation of LVEF prior to each dose using the same methodology that was used to assess baseline LVEF. Additional doses of mitoxantrone should not be administered to multiple sclerosis patients who have experienced either a drop in LVEF to below the lower limit of normal or a clinically significant reduction in LVEF during therapy. MS patients should not receive a cumulative mitoxantrone dose greater than 140 mg/m2. MS patients should undergo yearly quantitative LVEF evaluation after stopping therapy to monitor for late-occurring cardiotoxicity. SECONDARY LEUKEMIA: Therapy in patients with MS and in patients with cancer increases the risk of developing secondary acute myeloid leukemia. Patient advice: Patients should be informed of the availability of a Medication Guide and instructed to read it prior to initiating treatment and prior to each infusion. Patients should be advised that this drug can cause myelosuppression and be informed of signs of myelosuppression. Patients should be advised that this drug can cause congestive heart failure that may lead to death, even in people who have never had heart problems before. Patients with MS should be advised that they should receive cardiac monitoring prior to each dose and yearly after stopping therapy. Patients should be advised that this drug may impart a blue-green color to the urine and/or sclera for 24 hours after administration. Side Effects The Most Common nausea vomiting diarrhea constipation heartburn loss of appetite sores on the mouth and tongue runny or stuffed nose thinning or loss of hair changes in the area around or under fingernails and toenails missed or irregular menstrual periods extreme tiredness weakness headache back pain unusual bleeding or bruising small red or purple dots on the skin hives itching rash difficulty swallowing shortness of breath fainting dizziness pale skin yellowing of the skin or eyes seizures redness, pain, swelling, burning, or blue discoloration at the site where the injection was given More common Black, tarry stools bladder pain bloody or cloudy urine cough or shortness of breath difficult, burning, or painful urination dizziness fainting fast, slow, or irregular heartbeat frequent urge to urinate lower back or side pain pale skin stomach pain swelling or inflammation of the mouth troubled breathing with exertion ulcers, sores, or white spots in the mouth unusual bleeding or bruising unusual tiredness or weakness Absent, missed, or irregular menstrual periods back pain body aches or pains congestion constipation diarrhea dryness or soreness of the throat hair loss headache longer or heavier menstrual periods nausea or vomiting oral bleeding pain or tenderness around the eyes and cheekbones runny nose sneezing stopping of menstrual bleeding stuffy nose tender, swollen glands in the neck thinning of the hair Rare Blood in the urine or stools decrease in urination fever or chills pinpoint red spots on the skin seizures sore, red eyes swelling of the feet and lower legs yellow eyes or skin Blue skin at the place of injection pain or redness at the place of injection skin rash Drug Interactions DRUG INTERACTION Abatacept The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Abatacept. Abciximab The risk or severity of bleeding can be increased when Abciximab is combined with Mitoxantrone. Abemaciclib Abemaciclib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Mitoxantrone. Acetaminophen The metabolism of Acetaminophen can be increased when combined with Mitoxantrone. Acetyldigitoxin Acetyldigitoxin may decrease the cardiotoxic activities of Mitoxantrone. Acetylsalicylic acid The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Mitoxantrone. Adalimumab The risk or severity of adverse effects can be increased when Adalimumab is combined with Mitoxantrone. Adenovirus type 7 vac The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Mitoxantrone. Afatinib Afatinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Aldesleukin The risk or severity of adverse effects can be increased when Aldesleukin is combined with Mitoxantrone. Alectinib Alectinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Mitoxantrone. Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mitoxantrone. Allogeneic processed The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Mitoxantrone. Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Mitoxantrone. Alteplase The risk or severity of bleeding can be increased when Alteplase is combined with Mitoxantrone. Altretamine The risk or severity of adverse effects can be increased when Altretamine is combined with Mitoxantrone. Ambroxol The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Ambroxol. Aminophylline The metabolism of Aminophylline can be increased when combined with Mitoxantrone. Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Mitoxantrone. Anagrelide The risk or severity of bleeding can be increased when Anagrelide is combined with Mitoxantrone. Anakinra The risk or severity of adverse effects can be increased when Anakinra is combined with Mitoxantrone. Anastrozole The risk or severity of cardiotoxicity can be increased when Mitoxantrone is combined with Anastrozole. Ancrod The risk or severity of bleeding can be increased when Ancrod is combined with Mitoxantrone. Anifrolumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Anifrolumab. Anistreplase The risk or severity of bleeding can be increased when Anistreplase is combined with Mitoxantrone. Anthrax immune The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Mitoxantrone. Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Mitoxantrone. Antilymphocyte i The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Antilymphocyte immunoglobulin (horse). Antithrombin Alfa The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Mitoxantrone. Antithrombin III human The risk or severity of bleeding can be increased when Antithrombin III human is combined with Mitoxantrone. Antithymocyte immun The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Mitoxantrone. Apalutamide The serum concentration of Mitoxantrone can be decreased when it is combined with Apalutamide. Apixaban The risk or severity of bleeding can be increased when Apixaban is combined with Mitoxantrone. Apremilast The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Apremilast. Ardeparin The risk or severity of bleeding can be increased when Ardeparin is combined with Mitoxantrone. Argatroban The risk or severity of bleeding can be increased when Argatroban is combined with Mitoxantrone. Arsenic trioxide The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Mitoxantrone. Articaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Articaine. AstraZeneca COVID-19 Vaccine The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Mitoxantrone. Avacopan The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Avacopan. Avanafil Avanafil may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Avatrombopag Avatrombopag may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Azacitidine The risk or severity of adverse effects can be increased when Azacitidine is combined with Mitoxantrone. Azathioprine The risk or severity of adverse effects can be increased when Azathioprine is combined with Mitoxantrone. Bacillus calmette-guerin The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Mitoxantrone. Bacillus calmette- The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Mitoxantrone. Bacillus calmette-gu The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Mitoxantrone. Baricitinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Baricitinib. Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Mitoxantrone. BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Mitoxantrone. Beclomethasone dipropionate The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Mitoxantrone. Belatacept The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Belatacept. Belimumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Belimumab. Belinostat The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Belinostat. Belumosudil The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Belumosudil. Bemiparin The risk or severity of bleeding can be increased when Bemiparin is combined with Mitoxantrone. Bendamustine The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Bendamustine. Bendroflumethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Mitoxantrone. Benzocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Benzocaine. Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Mitoxantrone. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Benzyl alcohol. Betamethasone The risk or severity of adverse effects can be increased when Betamethasone is combined with Mitoxantrone. Betrixaban The risk or severity of bleeding can be increased when Betrixaban is combined with Mitoxantrone. Bevacizumab The risk or severity of cardiotoxicity can be increased when Bevacizumab is combined with Mitoxantrone. Bexarotene The risk or severity of adverse effects can be increased when Bexarotene is combined with Mitoxantrone. Bimekizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Bimekizumab. Bivalirudin The risk or severity of bleeding can be increased when Bivalirudin is combined with Mitoxantrone. Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Mitoxantrone. Blinatumomab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Blinatumomab. Bordetella pertussis The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Bortezomib The risk or severity of adverse effects can be increased when Bortezomib is combined with Mitoxantrone. Bosutinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Bosutinib. Brentuximab vedotin The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Brentuximab vedotin. Brigatinib Brigatinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Brodalumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Brodalumab. Budesonide The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Budesonide. Bupivacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Bupivacaine. Buprenorphine Buprenorphine may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Busulfan The risk or severity of adverse effects can be increased when Busulfan is combined with Mitoxantrone. Butacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Butacaine. Butamben The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Butamben. Cabazitaxel The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Cabazitaxel. Caffeine Caffeine may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Canakinumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Canakinumab. Cangrelor The risk or severity of bleeding can be increased when Cangrelor is combined with Mitoxantrone. Cannabidiol Cannabidiol may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Capecitabine The risk or severity of adverse effects can be increased when Capecitabine is combined with Mitoxantrone. Caplacizumab The risk or severity of bleeding can be increased when Caplacizumab is combined with Mitoxantrone. Capmatinib The serum concentration of Mitoxantrone can be increased when it is combined with Capmatinib. Capsaicin The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Capsaicin. Carbamazepine The risk or severity of adverse effects can be increased when Carbamazepine is combined with Mitoxantrone. Carboplatin The risk or severity of adverse effects can be increased when Carboplatin is combined with Mitoxantrone. Carfilzomib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Carfilzomib. Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Mitoxantrone. Carvedilol The metabolism of Carvedilol can be increased when combined with Mitoxantrone. Cenobamate The metabolism of Cenobamate can be increased when combined with Mitoxantrone. Certolizumab pegol The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Certolizumab pegol. Chlorambucil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mitoxantrone. You Might Also Read Pamidronate; Uses, Dosage, Side Effects, Interactions Chloramphenicol The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Mitoxantrone. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Chloroprocaine. Chlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Mitoxantrone. Chlorzoxazone The metabolism of Chlorzoxazone can be increased when combined with Mitoxantrone. Cholesterol Cholesterol may increase the excretion rate of Mitoxantrone which could result in a lower serum level and potentially a reduction in efficacy. Ciclesonide The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ciclesonide. Cilostazol The risk or severity of bleeding can be increased when Cilostazol is combined with Mitoxantrone. Cinchocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Cinchocaine. Cisplatin The risk or severity of adverse effects can be increased when Cisplatin is combined with Mitoxantrone. Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Mitoxantrone. Clobetasol propionate The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Mitoxantrone. Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Mitoxantrone. Clofazimine Clofazimine may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Clopidogrel The risk or severity of bleeding can be increased when Clopidogrel is combined with Mitoxantrone. Clostridium tetani t The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Clozapine The risk or severity of neutropenia can be increased when Mitoxantrone is combined with Clozapine. Cobicistat Cobicistat may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Cocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Cocaine. Corticotropin The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Corticotropin. Cortisone acetate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Cortisone acetate. Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Mitoxantrone. Cyclopenthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Mitoxantrone. Cyclophosphamide The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Mitoxantrone. Cyclosporine The serum concentration of Mitoxantrone can be increased when it is combined with Cyclosporine. Cyclothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Mitoxantrone. Cytarabine The risk or severity of adverse effects can be increased when Cytarabine is combined with Mitoxantrone. Dabigatran The risk or severity of bleeding can be increased when Dabigatran is combined with Mitoxantrone. Dabigatran etexilate The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Mitoxantrone. Dabrafenib Dabrafenib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Dacarbazine The risk or severity of adverse effects can be increased when Dacarbazine is combined with Mitoxantrone. Daclatasvir Daclatasvir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Dacomitinib Dacomitinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Dactinomycin The risk or severity of adverse effects can be increased when Dactinomycin is combined with Mitoxantrone. Dalteparin The risk or severity of bleeding can be increased when Dalteparin is combined with Mitoxantrone. Danaparoid The risk or severity of bleeding can be increased when Danaparoid is combined with Mitoxantrone. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Mitoxantrone. Darolutamide Darolutamide may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Dasabuvir Dasabuvir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Dasatinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Dasatinib. Daunorubicin The risk or severity of adverse effects can be increased when Daunorubicin is combined with Mitoxantrone. Decitabine The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Decitabine. Defibrotide The risk or severity of bleeding can be increased when Defibrotide is combined with Mitoxantrone. Deflazacort The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Deflazacort. Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Mitoxantrone. Desirudin The risk or severity of bleeding can be increased when Desirudin is combined with Mitoxantrone. Deslanoside Deslanoside may decrease the cardiotoxic activities of Mitoxantrone. Desoximetasone The risk or severity of adverse effects can be increased when Desoximetasone is combined with Mitoxantrone. Deucravacitinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Deucravacitinib. Dexamethasone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Dexamethasone. Dexamethasone acetate Dexamethasone acetate may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Dexrazoxane The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Mitoxantrone. Dextran The risk or severity of bleeding can be increased when Dextran is combined with Mitoxantrone. Dicoumarol The risk or severity of bleeding can be increased when Dicoumarol is combined with Mitoxantrone. Diethylstilbestrol Diethylstilbestrol may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Difluocortolone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Difluocortolone. Digitoxin Digitoxin may decrease the cardiotoxic activities of Mitoxantrone. Digoxin Digoxin may decrease the cardiotoxic activities of Mitoxantrone. Dimethyl fumarate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Dimethyl fumarate. Dinutuximab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Dinutuximab. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Diphenhydramine. Dipyridamole The risk or severity of bleeding can be increased when Dipyridamole is combined with Mitoxantrone. Diroximel fumarate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Diroximel fumarate. Docetaxel The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Docetaxel. Doxorubicin The risk or severity of adverse effects can be increased when Doxorubicin is combined with Mitoxantrone. Drotrecogin alfa The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Mitoxantrone. Dyclonine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Dyclonine. Ebola Zaire vaccine The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Mitoxantrone. Eculizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Eculizumab. Edetic acid The risk or severity of bleeding can be increased when Edetic acid is combined with Mitoxantrone. Edoxaban The risk or severity of bleeding can be increased when Edoxaban is combined with Mitoxantrone. Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Mitoxantrone. Efgartigimod alfa The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Efgartigimod alfa. Elacestrant The serum concentration of Mitoxantrone can be increased when it is combined with Elacestrant. Elbasvir Elbasvir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Eltrombopag Eltrombopag may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Emapalumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Emapalumab. Enasidenib Enasidenib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Enflurane The metabolism of Enflurane can be increased when combined with Mitoxantrone. Enoxaparin The risk or severity of bleeding can be increased when Enoxaparin is combined with Mitoxantrone. Epirubicin The risk or severity of adverse effects can be increased when Epirubicin is combined with Mitoxantrone. Epoprostenol The risk or severity of bleeding can be increased when Epoprostenol is combined with Mitoxantrone. Eptifibatide The risk or severity of bleeding can be increased when Eptifibatide is combined with Mitoxantrone. Eribulin The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Eribulin. Erlotinib Erlotinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Mitoxantrone. Estradiol Estradiol may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Estradiol acetate Estradiol acetate may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Estradiol benzoate Estradiol benzoate may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Estradiol cypionate Estradiol cypionate may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Estradiol dienanthate Estradiol dienanthate may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Estradiol valerate Estradiol valerate may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Estramustine The risk or severity of adverse effects can be increased when Estramustine is combined with Mitoxantrone. Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Mitoxantrone. Ethanol The metabolism of Ethanol can be increased when combined with Mitoxantrone. Ethosuximide The metabolism of Ethosuximide can be increased when combined with Mitoxantrone. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Etidocaine. Etoposide The risk or severity of adverse effects can be increased when Etoposide is combined with Mitoxantrone. Everolimus The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Everolimus. Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Mitoxantrone. Febuxostat The excretion of Mitoxantrone can be decreased when combined with Febuxostat. Fedratinib Fedratinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Felbamate The metabolism of Felbamate can be increased when combined with Mitoxantrone. Filgotinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Filgotinib. Fingolimod Mitoxantrone may increase the immunosuppressive activities of Fingolimod. Floxuridine The risk or severity of adverse effects can be increased when Floxuridine is combined with Mitoxantrone. Flucytosine The risk or severity of adverse effects can be increased when Flucytosine is combined with Mitoxantrone. Fludarabine The risk or severity of adverse effects can be increased when Fludarabine is combined with Mitoxantrone. Fludrocortisone The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Mitoxantrone. Fluindione The risk or severity of bleeding can be increased when Fluindione is combined with Mitoxantrone. Flunisolide The risk or severity of adverse effects can be increased when Flunisolide is combined with Mitoxantrone. Fluocinolone acetonide The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Mitoxantrone. Fluocinonide The risk or severity of adverse effects can be increased when Fluocinonide is combined with Mitoxantrone. Fluocortolone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Fluocortolone. Fluorometholone The risk or severity of adverse effects can be increased when Fluorometholone is combined with Mitoxantrone. Fluorouracil The risk or severity of adverse effects can be increased when Fluorouracil is combined with Mitoxantrone. Flupentixol The risk or severity of myelosuppression can be increased when Flupentixol is combined with Mitoxantrone. Fluprednisolone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Fluprednisolone. Fluticasone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Fluticasone. Fluticasone furoate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Fluticasone furoate. Fluticasone propionate The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Mitoxantrone. Fondaparinux The risk or severity of bleeding can be increased when Fondaparinux is combined with Mitoxantrone. Fostamatinib Fostamatinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Fostemsavir Fostemsavir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Fusidic acid Fusidic acid may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Gallium nitrate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Gallium nitrate. Gefitinib Gefitinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Gemcitabine The risk or severity of adverse effects can be increased when Gemcitabine is combined with Mitoxantrone. Gemtuzumab ozogamicin The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Mitoxantrone. Gilteritinib Gilteritinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Glasdegib Glasdegib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Glatiramer The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Glatiramer. Glecaprevir Glecaprevir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Golimumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Golimumab. Grazoprevir Grazoprevir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Guselkumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Guselkumab. Haemophilus influenzae The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Mitoxantrone. Halothane The metabolism of Halothane can be increased when combined with Mitoxantrone. Heparin The risk or severity of bleeding can be increased when Heparin is combined with Mitoxantrone. Hepatitis A Vaccine The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Mitoxantrone. Hepatitis B Vaccine The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Mitoxantrone. Human adenovirus The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Mitoxantrone. Hydrochlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Mitoxantrone. Hydrocortisone acetate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Hydrocortisone acetate. Hydrocortisone butyrate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Hydrocortisone butyrate. Hydrocortisone succinate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Hydrocortisone succinate. Hydroflumethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Mitoxantrone. Hydroxychloroquine The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Hydroxychloroquine. Hydroxyurea The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mitoxantrone. Ibritumomab tiuxetan The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Mitoxantrone. Ibrutinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ibrutinib. Icosapent ethyl The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Mitoxantrone. Idarubicin The risk or severity of adverse effects can be increased when Idarubicin is combined with Mitoxantrone. Idelalisib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Idelalisib. Ifosfamide The risk or severity of adverse effects can be increased when Ifosfamide is combined with Mitoxantrone. Iloprost The risk or severity of bleeding can be increased when Iloprost is combined with Mitoxantrone. Imatinib The risk or severity of adverse effects can be increased when Imatinib is combined with Mitoxantrone. Indomethacin The risk or severity of adverse effects can be increased when Indomethacin is combined with Mitoxantrone. Inebilizumab The risk or severity of infection can be increased when Mitoxantrone is combined with Inebilizumab. Infliximab The risk or severity of adverse effects can be increased when Infliximab is combined with Mitoxantrone. Influenza A virus A The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Influenza A virus A The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Influenza A virus A The therapeutic efficacy of Influenza A virus A/California/7/2009 (H1N1) live (attenuated) antigen can be decreased when used in combination with Mitoxantrone. Influenza A virus A The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Influenza A virus A The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Influenza A virus The therapeutic efficacy of Influenza A virus A/Perth/16/2009 (H3N2) live (attenuated) antigen can be decreased when used in combination with Mitoxantrone. Influenza A vi The therapeutic efficacy of Influenza A virus A/Uruguay/716/2007(H3N2) antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Influenza A virus A The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Influenza A virus A/Vi The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Influenza B virus The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Influenza The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Influenza B virus The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Influenza B virus B/B The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Mitoxantrone. Interferon alfa-2a The risk or severity of adverse effects can be increased when Interferon alfa-2a is combined with Mitoxantrone. Interferon alfa-2b The risk or severity of adverse effects can be increased when Interferon alfa-2b is combined with Mitoxantrone. Interferon alfa-n1 The risk or severity of adverse effects can be increased when Interferon alfa-n1 is combined with Mitoxantrone. Interferon alfa-n3 The risk or severity of adverse effects can be increased when Interferon alfa-n3 is combined with Mitoxantrone. Interferon alfacon-1 The risk or severity of adverse effects can be increased when Interferon alfacon-1 is combined with Mitoxantrone. Interferon beta-1b The risk or severity of adverse effects can be increased when Interferon beta-1b is combined with Mitoxantrone. Interferon gamma-1b The risk or severity of adverse effects can be increased when Interferon gamma-1b is combined with Mitoxantrone. Irinotecan The risk or severity of adverse effects can be increased when Irinotecan is combined with Mitoxantrone. Isavuconazole Isavuconazole may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Isoflurane The metabolism of Isoflurane can be increased when combined with Mitoxantrone. Istradefylline Istradefylline may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Itraconazole Itraconazole may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Ixabepilone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ixabepilone. Ixekizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ixekizumab. Janssen COVID-19 Vaccine The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Mitoxantrone. Japanese encephalitis The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Mitoxantrone. Lansoprazole Lansoprazole may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Lasmiditan The serum concentration of Mitoxantrone can be increased when it is combined with Lasmiditan. Ledipasvir Ledipasvir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Leflunomide The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Leflunomide. Lenalidomide The risk or severity of adverse effects can be increased when Lenalidomide is combined with Mitoxantrone. Leniolisib The excretion of Mitoxantrone can be decreased when combined with Leniolisib. Lepirudin The risk or severity of bleeding can be increased when Lepirudin is combined with Mitoxantrone. Letermovir Letermovir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Levobupivacaine. Lidocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Lidocaine. You Might Also Read Infliximab; Uses, Dosage, Side Effects, Drug Interactions Linezolid The risk or severity of adverse effects can be increased when Linezolid is combined with Mitoxantrone. Lipegfilgrastim Mitoxantrone may increase the myelosuppressive activities of Lipegfilgrastim. Lomustine The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Lomustine. Lopinavir The serum concentration of Mitoxantrone can be increased when it is combined with Lopinavir. Magnesium The serum concentration of Magnesium can be decreased when it is combined with Mitoxantrone. Maribavir Maribavir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Measles virus vaccine The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Mitoxantrone. Mechlorethamine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Mitoxantrone. Meloxicam The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Meloxicam. Melphalan The risk or severity of adverse effects can be increased when Melphalan is combined with Mitoxantrone. Meningococcal The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Mitoxantrone. Mepivacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Mepivacaine. Mepolizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Mepolizumab. Meprednisone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Meprednisone. Mercaptopurine The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Mitoxantrone. Methimazole The risk or severity of adverse effects can be increased when Methimazole is combined with Mitoxantrone. Methotrexate The risk or severity of adverse effects can be increased when Methotrexate is combined with Mitoxantrone. Methoxy polyethylen The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Mitoxantrone. Methoxyflurane The metabolism of Methoxyflurane can be increased when combined with Mitoxantrone. Methylprednisolone The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Mitoxantrone. Mitomycin The risk or severity of adverse effects can be increased when Mitomycin is combined with Mitoxantrone. Moderna COVID-19 Vaccine The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Mitoxantrone. Modified vaccinia ankara The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Mitoxantrone. Mometasone furoate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Mometasone furoate. Monomethyl fumarate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Monomethyl fumarate. Mosunetuzumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Mosunetuzumab. Mumps virus strain The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Mitoxantrone. Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Mitoxantrone. Mycophenolate mofetil The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Mitoxantrone. Mycophenolic acid The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Mitoxantrone. Nadroparin The risk or severity of bleeding can be increased when Nadroparin is combined with Mitoxantrone. Natalizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Natalizumab. Nelarabine The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Nelarabine. Nelfinavir Nelfinavir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Nilotinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Nilotinib. Nilvadipine The metabolism of Nilvadipine can be increased when combined with Mitoxantrone. Nimesulide The risk or severity of bleeding can be increased when Nimesulide is combined with Mitoxantrone. Novobiocin Novobiocin may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Mitoxantrone. Obinutuzumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Obinutuzumab. Ocrelizumab Ocrelizumab may increase the immunosuppressive activities of Mitoxantrone. Ofatumumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ofatumumab. Olaparib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Olaparib. Osimertinib Osimertinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Oteseconazole The serum concentration of Mitoxantrone can be increased when it is combined with Oteseconazole. Ouabain Ouabain may decrease the cardiotoxic activities of Mitoxantrone. Oxaliplatin The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Mitoxantrone. Oxetacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Oxybuprocaine. Ozanimod The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ozanimod. Paclitaxel The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Paclitaxel. Pacritinib The serum concentration of Mitoxantrone can be increased when it is combined with Pacritinib. Palbociclib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Palbociclib. Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Mitoxantrone. Panobinostat The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Panobinostat. Pantoprazole Pantoprazole may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Paritaprevir Paritaprevir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Parnaparin The risk or severity of bleeding can be increased when Parnaparin is combined with Mitoxantrone. Pazopanib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pazopanib. Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Mitoxantrone. Pegcetacoplan The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pegcetacoplan. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Mitoxantrone. Peginterferon alfa-2a The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Mitoxantrone. Peginterferon alfa-2b The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Mitoxantrone. Peginterferon beta-1a The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Peginterferon beta-1a. Pemetrexed The risk or severity of adverse effects can be increased when Pemetrexed is combined with Mitoxantrone. Penicillamine The risk or severity of adverse effects can be increased when Penicillamine is combined with Mitoxantrone. Pentosan polysulfate The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Mitoxantrone. Pentostatin The risk or severity of adverse effects can be increased when Pentostatin is combined with Mitoxantrone. Pentoxifylline The risk or severity of bleeding can be increased when Pentoxifylline is combined with Mitoxantrone. Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Mitoxantrone. Pertuzumab The risk or severity of cardiotoxicity can be increased when Mitoxantrone is combined with Pertuzumab. Phenindione The risk or severity of bleeding can be increased when Phenindione is combined with Mitoxantrone. Phenobarbital The metabolism of Phenobarbital can be increased when combined with Mitoxantrone. Phenol The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Phenol. Phenprocoumon The risk or severity of bleeding can be increased when Phenprocoumon is combined with Mitoxantrone. Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Mitoxantrone. Phenytoin The metabolism of Phenytoin can be increased when combined with Mitoxantrone. Pibrentasvir Pibrentasvir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Mitoxantrone. Pirfenidone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pirfenidone. Pirtobrutinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pirtobrutinib. Polythiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Mitoxantrone. Pomalidomide The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pomalidomide. Ponatinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ponatinib. Ponesimod The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ponesimod. Pralatrexate The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Pralatrexate. Pralsetinib Pralsetinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Pramocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Pramocaine. Prasugrel The risk or severity of bleeding can be increased when Prasugrel is combined with Mitoxantrone. Pravastatin Pravastatin may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Prednisolone The risk or severity of adverse effects can be increased when Prednisolone is combined with Mitoxantrone. Prednisone The risk or severity of adverse effects can be increased when Prednisone is combined with Mitoxantrone. Pretomanid The serum concentration of Mitoxantrone can be increased when it is combined with Pretomanid. Prilocaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Prilocaine. Primidone The metabolism of Primidone can be increased when combined with Mitoxantrone. Procaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Procaine. Procarbazine The risk or severity of adverse effects can be increased when Procarbazine is combined with Mitoxantrone. Progesterone Progesterone may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Proparacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Proparacaine. Propoxycaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Propoxycaine. Propylthiouracil The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Mitoxantrone. Protein C The risk or severity of bleeding can be increased when Protein C is combined with Mitoxantrone. Protein S human The risk or severity of bleeding can be increased when Protein S human is combined with Mitoxantrone. Rabeprazole Rabeprazole may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Rabies immune globulin The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Mitoxantrone. Rabies v antigen, A The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Mitoxantrone. Rabies vi antigen, B The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Mitoxantrone. Raltitrexed The risk or severity of adverse effects can be increased when Raltitrexed is combined with Mitoxantrone. Ravulizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ravulizumab. Regorafenib Regorafenib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Reteplase The risk or severity of bleeding can be increased when Reteplase is combined with Mitoxantrone. Reviparin The risk or severity of bleeding can be increased when Reviparin is combined with Mitoxantrone. Rilonacept The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Rilonacept. Rilpivirine Rilpivirine may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Ripretinib Ripretinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Risankizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Risankizumab. Ritonavir Ritonavir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Mitoxantrone. Rivaroxaban The risk or severity of bleeding can be increased when Rivaroxaban is combined with Mitoxantrone. Roflumilast Roflumilast may increase the immunosuppressive activities of Mitoxantrone. Rolapitant Rolapitant may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Ropeginterferon alfa-2b The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ropeginterferon alfa-2b. Ropivacaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Ropivacaine. Rosiglitazone The metabolism of Rosiglitazone can be increased when combined with Mitoxantrone. Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Mitoxantrone. Roxadustat The serum concentration of Mitoxantrone can be increased when it is combined with Roxadustat. Rubella virus vaccine The risk or severity of infection can be increased when Rubella virus vaccine is combined with Mitoxantrone. Rucaparib Rucaparib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Ruxolitinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ruxolitinib. Safinamide Safinamide may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Saquinavir Saquinavir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Sarilumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Sarilumab. Satralizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Satralizumab. Secukinumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Secukinumab. Selumetinib The metabolism of Selumetinib can be increased when combined with Mitoxantrone. Sevoflurane The metabolism of Sevoflurane can be increased when combined with Mitoxantrone. Siltuximab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Siltuximab. Simeprevir Simeprevir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Siponimod The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Siponimod. Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Mitoxantrone. Sirolimus The risk or severity of adverse effects can be increased when Sirolimus is combined with Mitoxantrone. Smallpox (Vaccinia) The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Mitoxantrone. Sodium citrate The risk or severity of bleeding can be increased when Sodium citrate is combined with Mitoxantrone. Sorafenib The risk or severity of adverse effects can be increased when Sorafenib is combined with Mitoxantrone. Sotagliflozin Sotagliflozin may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Sotorasib The serum concentration of Mitoxantrone can be increased when it is combined with Sotorasib. Sparsentan Sparsentan may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Spesolimab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Spesolimab. Stiripentol The excretion of Mitoxantrone can be decreased when combined with Stiripentol. Streptokinase The risk or severity of bleeding can be increased when Streptokinase is combined with Mitoxantrone. Streptozocin The risk or severity of adverse effects can be increased when Streptozocin is combined with Mitoxantrone. Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Mitoxantrone. Sulfasalazine The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Mitoxantrone. Sulfinpyrazone The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Mitoxantrone. Sulodexide The risk or severity of bleeding can be increased when Sulodexide is combined with Mitoxantrone. Sunitinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Sunitinib. Sutimlimab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Sutimlimab. Tacrolimus Tacrolimus may increase the immunosuppressive activities of Mitoxantrone. Tafamidis The serum concentration of Mitoxantrone can be increased when it is combined with Tafamidis. Tamoxifen The metabolism of Tamoxifen can be increased when combined with Mitoxantrone. Taurocholic acid Taurocholic acid may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Tedizolid phosphate The risk or severity of myelosuppression can be increased when Mitoxantrone is combined with Tedizolid phosphate. Telmisartan Telmisartan may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Temozolomide The risk or severity of adverse effects can be increased when Temozolomide is combined with Mitoxantrone. Temsirolimus The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Temsirolimus. Tenecteplase The risk or severity of bleeding can be increased when Tenecteplase is combined with Mitoxantrone. Teniposide The risk or severity of adverse effects can be increased when Teniposide is combined with Mitoxantrone. Tepotinib Tepotinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Teprotumumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Teprotumumab. Teriflunomide The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Teriflunomide. Tetracaine The risk or severity of methemoglobinemia can be increased when Mitoxantrone is combined with Tetracaine. Thalidomide The risk or severity of adverse effects can be increased when Thalidomide is combined with Mitoxantrone. Theophylline The metabolism of Theophylline can be increased when combined with Mitoxantrone. Thiotepa The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Thiotepa. Ticagrelor The risk or severity of bleeding can be increased when Ticagrelor is combined with Mitoxantrone. Tick-borne encephalitis The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Mitoxantrone. Ticlopidine The risk or severity of bleeding can be increased when Ticlopidine is combined with Mitoxantrone. Tinzaparin The risk or severity of bleeding can be increased when Tinzaparin is combined with Mitoxantrone. Tioguanine The risk or severity of adverse effects can be increased when Tioguanine is combined with Mitoxantrone. Tirofiban The risk or severity of bleeding can be increased when Tirofiban is combined with Mitoxantrone. Tivozanib Tivozanib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Tixocortol The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Tixocortol. Tocilizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Tocilizumab. Tofacitinib Mitoxantrone may increase the immunosuppressive activities of Tofacitinib. Topotecan The risk or severity of adverse effects can be increased when Topotecan is combined with Mitoxantrone. Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Mitoxantrone. Trabectedin The metabolism of Trabectedin can be increased when combined with Mitoxantrone. Trastuzumab The risk or severity of neutropenia can be increased when Trastuzumab is combined with Mitoxantrone. Trastuzumab emtansine The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Trastuzumab emtansine. Tretinoin The risk or severity of cardiotoxicity can be increased when Tretinoin is combined with Mitoxantrone. Triamcinolone The risk or severity of adverse effects can be increased when Triamcinolone is combined with Mitoxantrone. Trichlormethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Mitoxantrone. Trifluridine The risk or severity of adverse effects can be increased when Trifluridine is combined with Mitoxantrone. Triflusal The risk or severity of bleeding can be increased when Triflusal is combined with Mitoxantrone. Trilostane The risk or severity of adverse effects can be increased when Trilostane is combined with Mitoxantrone. Trimethadione The metabolism of Trimethadione can be increased when combined with Mitoxantrone. Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Mitoxantrone. Typhoid Vaccine Live The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Mitoxantrone. Typhoid Vi polysacch The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Mitoxantrone. You Might Also Read Uses Indications of Eluxadoline Tablet Ublituximab The risk or severity of infection can be increased when Ublituximab is combined with Mitoxantrone. Upadacitinib The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Upadacitinib. Urokinase The risk or severity of bleeding can be increased when Urokinase is combined with Mitoxantrone. Vandetanib Vandetanib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Varicella zoster vaccine The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Mitoxantrone. Varicella zoster vaccine The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Mitoxantrone. Vedolizumab The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Vedolizumab. Velpatasvir Velpatasvir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Vemurafenib Vemurafenib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Venetoclax Venetoclax may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Venlafaxine Venlafaxine may increase the excretion rate of Mitoxantrone which could result in a lower serum level and potentially a reduction in efficacy. Vibrio cholerae CVD The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Mitoxantrone. Vilanterol The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Vilanterol. Vinblastine The risk or severity of adverse effects can be increased when Vinblastine is combined with Mitoxantrone. Vincristine The risk or severity of adverse effects can be increased when Vincristine is combined with Mitoxantrone. Vindesine The risk or severity of adverse effects can be increased when Vindesine is combined with Mitoxantrone. Vinorelbine The risk or severity of adverse effects can be increased when Vinorelbine is combined with Mitoxantrone. Vismodegib Vismodegib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Voclosporin The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Voclosporin. Vorapaxar The risk or severity of bleeding can be increased when Vorapaxar is combined with Mitoxantrone. Vorinostat The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Vorinostat. Voxilaprevir Voxilaprevir may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Warfarin The risk or severity of bleeding can be increased when Warfarin is combined with Mitoxantrone. Ximelagatran The risk or severity of bleeding can be increased when Ximelagatran is combined with Mitoxantrone. Yellow fever vaccine The risk or severity of infection can be increased when Yellow fever vaccine is combined with Mitoxantrone. Zidovudine The risk or severity of adverse effects can be increased when Zidovudine is combined with Mitoxantrone. Pregnancy and Lactation AU TGA pregnancy category: D US FDA pregnancy category: D Pregnancy This drug can cause fetal harm when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Women with who are capable of becoming pregnant, even if they are using birth control, should have a pregnancy test, before receiving each dose of this drug. Women of childbearing potential should be advised to avoid becoming pregnant. During therapy and for at least 6 months after termination of therapy, effective contraception should be practiced by patients of reproductive age, of either sex Lactation Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone. It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration of abstinence is not clear. In one patient, mitoxantrone was still detectable in milk 28 days after a dose of 6 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breast milk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant. One mother received 3 daily doses of 6 mg/sq. m. of mitoxantrone intravenously along with 5 daily doses of etoposide 80 mg/sq. m. and cytarabine 170 mg/sq. m. intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age. One mother received 3 daily doses of 6 mg/sq. m. of mitoxantrone intravenously along with 5 daily doses of etoposide 80 mg/sq. m. and cytarabine 170 mg/sq. m. intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age. Why is this medication prescribed? Mitoxantrone injection is used to adults with various forms of multiple sclerosis (MS; a disease in which the nerves do not function properly and people may experience weakness, numbness, loss of muscle coordination, and problems with vision, speech, and bladder control) including the following: relapsing-remitting forms (course of disease where symptoms flare up from time to time), or progressive relapsing (course of disease with occasional relapses), or secondary progressive forms (course of disease where relapses occur more often). Mitoxantrone injection is also used together with steroid medications to relieve pain in people with advanced prostate cancer who did not respond to other medications. Mitoxantrone injection is also used with other medications to treat certain types of leukemia. Mitoxantrone injection is in a class of medications called anthracene diones. Mitoxantrone treats MS by stopping certain cells of the immune system from reaching the brain and spinal cord and causing damage. Mitoxantrone treats cancer by stopping the growth and spread of cancer cells. How should this medicine be used? Mitoxantrone injection comes as a liquid to be given intravenously (into a vein) by a doctor or nurse in a hospital or clinic. When mitoxantrone injection is used to treat MS, it is usually given once every 3 months for about 2 to 3 years (for a total of 8 to 12 doses). When mitoxantrone injection is used to treat prostate cancer, it is usually given once every 21 days. When mitoxantrone injection is used to treat leukemia, you will continue to receive this medication based on your condition and how you respond to the treatment. If you are using mitoxantrone injection for MS, you should know that it controls MS but does not cure it. Continue to receive treatments even if you feel well. Talk to your doctor if you no longer want to receive treatment with mitoxantrone injection. If you are using mitoxantrone injection for MS, ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. Other uses for this medicine Mitoxantrone injection is also sometimes used to treat non-Hodgkin’s lymphoma (NHL; cancer that begins in a type of white blood cell that normally fights infection). Talk to your doctor about the risks of using this medication for your condition. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? Before using mitoxantrone injection, tell your doctor and pharmacist if you are allergic to mitoxantrone injection, any other medications, sulfites, or any of the other ingredients in mitoxantrone injection. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had any blood-clotting problems, anemia (decreased amount of red blood cells in the blood), or liver disease. tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are using mitoxantrone injection. Talk to your doctor about effective birth control methods that you can use during your treatment. If you become pregnant while using mitoxantrone injection, call your doctor immediately. Mitoxantrone injection may harm the fetus. If you are using mitoxantrone injection to treat MS, even if you are using birth control, your doctor should give you a pregnancy test before each treatment. You must have a negative pregnancy test before the start of each treatment. tell your doctor if you are breastfeeding. Do not breastfeed while you are using mitoxantrone injection. if you are having surgery, including dental surgery, tell the doctor or dentist that you are using mitoxantrone injection. you should know that mitoxantrone injection is dark blue in color and may cause the white parts of your eyes to have a slight blue color for a few days after you receive each dose. It may also change the color of your urine to a blue-green color for about 24 hours after you receive a dose. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019297s030s031lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019297s035lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/nda/2000/21120_Novantrone.cfm https://www.accessdata.fda.gov/drugsatfda_docs/nda/2000/21120.pdf_Novantrone_Pharmr_P1.pdf https://pubchem.ncbi.nlm.nih.gov/compound/Mitoxantrone https://pubchem.ncbi.nlm.nih.gov/compound/Mitoxantrone-hydrochloride https://www.cancer.gov/about-cancer/treatment/drugs/mitoxantronehydrochloride https://www.drugs.com/pregnancy/mitoxantrone.html https://go.drugbank.com/drugs/DB01204 https://en.wikipedia.org/wiki/Mitoxantrone https://www.mayoclinic.org/drugs-supplements/mitoxantrone-intravenous-route/side-effects/drg-20064849 https://medlineplus.gov/druginfo/meds/a608019.html CAS Common Chemistry https://creativecommons.org/licenses/by-nc/4.0/ 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