Mitoxantrone HCL (Generic Name)

Other Names: Novantrone

About This Drug

Mitoxantrone is used to treat cancer. This drug is given in the vein(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. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Effects on the heart: This drug can weaken the heart and lower heart function. Your heart function will be checked as needed. You may have trouble catching your breath, mainly during activities. You may also have trouble breathing while lying down, and have swelling in your ankles.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 hours. Medicines are available to stop or lessen these side effects.
  • Changes in your liver function. Your doctor will check your liver function as needed.
  • Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
  • Change in the color of urine to blue or green and change in the color the white part of your eye to blue. This color change should go away within 24 hours of getting this drug.
  • Swelling of your legs, ankles and/or feet
  • Fever
  • Tiredness
  • Hair loss. Most often hair loss is temporary; your hair should grow back when treatment is done.
  • Darkening of the skin or nails
  • You may develop high blood sugars.  Your blood work will be checked as needed.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Decreased appetite (decreased hunger)
  • Abdominal pain
  • Weakness that interferes with your daily activities
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed.

Possible Side Effects (Less Common)

  • Seizure. Common symptoms of a seizure can include confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures. If you or your family member suspects you are having a seizure, call 911 right away.
  • Electrolyte changes.  Your blood will be checked for electrolyte changes as needed.
  • This drug may raise your risk of getting a second cancer
  • Generalized weakness and discomfort (aches or pains)
  • Eye irritation. Your eyes may water.  Your eyes and eye lids may hurt and become red.
  • Blurred vision

Allergic Reactions

While you are getting this drug in your vein (IV), you may have a reaction to the drug. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen for 24 hours after your infusion. If this happens, call 911 for emergency care.

Treating Side Effects

  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).
  • While you are getting this drug in your IV, please tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion.
  • Mouth care is very important. Your mouth care should consist of routine, 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 baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • Talk with your nurse about getting 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 getting chemotherapy can 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 mitoxantrone with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might 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 help.

 

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Easy bleeding or bruising
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Feeling confused or agitated
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Symptoms of a seizure, such as confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures. If you or your family member suspects you are having a seizure, call 911 right away.
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin

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

  • Change in hearing, ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Reproduction Concerns

  • 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.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and badly harm a breast feeding baby.

Revised November 2014

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