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What should I discuss with my healthcare provider before receiving mitoxantrone (Novantrone)?

You should not use this medication if you are allergic to mitoxantrone.

To make sure you can safely use mitoxantrone, tell your doctor if you have any of these other conditions:

• prior treatment with mitoxantrone;
• heart disease, congestive heart failure;
• a weak immune system (bone marrow depression);
• any type of infection;
• a bleeding or blood-clotting disorder;
• a blood cell disorder, such as anemia (decreased red blood cells) or decreased platelets;
• liver disease; or
• if you have ever been treated with daunorubicin (Cerubidine, Daunoxome) or doxorubicin (Adriamycin, Doxil).

FDA pregnancy category D. Do not use mitoxantrone if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Your doctor may want you to have a pregnancy test to make sure you are not pregnant before you receive each injection of mitoxantrone.

Mitoxantrone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using mitoxantrone.

Using mitoxantrone can sometimes increase your risk of developing secondary types of leukemia. Talk to your doctor about your individual risk.

How is mitoxantrone given (Novantrone)?

Mitoxantrone is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Mitoxantrone injections are usually given once every 3 months for up to 3 years. Your dose of this medication will depend on why you are receiving it and whether it causes any harmful side effects.

Tell your caregivers if you have any burning, stinging, pain, itching, redness, bruising, or swelling around the IV needle when the medicine is injected.

Mitoxantrone may cause your urine to turn a blue-green color. You may also notice a bluish discoloration of the whites of your eyes. This side effect should last only a few days and is not harmful.

Mitoxantrone can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often. You must remain under the care of a doctor while receiving mitoxantrone.

Contact your doctor at once if you develop signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual weakness.

Mitoxantrone can also cause serious heart damage. Your heart rate will need to be checked using an electrocardiograph or ECG (sometimes called an EKG) before and during your treatment with mitoxantrone. This machine measures electrical activity of the heart. This will help your doctor determine how long you can safely receive mitoxantrone.

The effects of mitoxantrone on your heart could be long-lasting. Your doctor may want to keep checking your heart function at yearly visits even after your mitoxantrone treatment ends. Do not miss any scheduled appointments.

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