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mitoxantrone
generic
Black Box Warnings .
Appropriate Use
admin. only under supervision of physician experienced in cancer chemotherapy; give slowly into freely flowing IV infusion, never give SC, IM, or intra-arterially, severe local tissue damage may occur if extravasation; not for intrathecal use as severe injury w/ permanent sequelae can result
Neutropenia
except for tx of acute nonlymphocytic leukemia, do not use if baseline ANC <1500 cells/mm^3; neutropenia may be severe and result in infection, monitor peripheral blood count frequently
Cardiotoxicity
potentially fatal CHF may occur during tx or months to years after D/C; risk incr. w/ cumulative dose and may occur w/ or w/o cardiac risk factors; risk also incr. w/ active cardiovascular dz or hx, prior or concomitant radiotx to mediastinal/pericardial area, prior anthracycline or anthracenedione tx, or concomitant cardiotoxic drugs; 2.6% symptomatic CHF risk in cancer pts w/ cumulative dose up to 140 mg/m^2; assess baseline cardiac status in all pts incl. hx, physical exam, ECG, and LVEF, repeat in MS pts prior to each dose; do not use in MS pts w/ LVEF below lower limit of normal or if clinically significant reduction in LVEF; max 140 mg/m^2 cumulative dose in MS pts; test LVEF in MS pts yearly after D/C to monitor for late occurring cardiotoxicity
Secondary AML
incr. risk in MS and cancer pts
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
AML
- [induction tx]
- Dose: 12 mg/m^2/dose IV x1 on days 1-3 of cycle; Max: cumulative dose 140 mg/m^2; Info: use w/ cytarabine; if incomplete response, may give 2nd course 12 mg/m^2/dose IV x1 on days 1-2 of cycle
- [consolidation tx]
- Dose: 12 mg/m^2/dose IV x1 on days 1-2 of 28-day cycle; Max: cumulative dose 140 mg/m^2; Info: give 6wk after induction tx; use w/ cytarabine
prostate CA, metastatic castration-resistant
- [12-14 mg/m^2/dose IV x1 on day 1 of 21-day cycle for up to 10 cycles]
- Max: cumulative dose 140 mg/m^2; Info: for palliation in symptomatic pts w/ visceral metastases; use w/ prednisone
multiple sclerosis, relapsing forms
- [12 mg/m^2/dose IV x1 q3mo]
- Max: cumulative dose 140 mg/m^2; Info: for pts w/ relapsing-remitting dz and active secondary progressive dz
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [multiple sclerosis]
- hepatic impairment: avoid use
- [all other indications]
- hepatic impairment: consider dose adjustment
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.