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Mitoxantrone use while Breastfeeding

Drugs containing Mitoxantrone: Novantrone

Mitoxantrone Levels and Effects while Breastfeeding

Summary of Use during Lactation

Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.[1][2] 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.

Drug Levels

Maternal Levels. A woman treated with mitoxantrone, etoposide and cytarabine for promyelocytic leukemia received 3 daily mitoxantrone doses of 6 mg per square meter intravenously. A mitoxantrone milk level of 120 mcg/L occurred immediately after the third dose. Milk mitoxantrone level dropped to a plateau value of about 20 mcg/L by 7 days after the third dose and remained at 18 mcg/L at 28 days after the last dose.[3]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

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.[3]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

(Multiple Sclerosis) Glatiramer, Immune Globulin, Interferon Beta, Methylprednisolone

References

1. Pistilli B, Bellettini G, Giovannetti E et al. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013;39:207-11. PMID: 23199900

2. Almas S, Vance J, Baker T et al. Management of multiple sclerosis in the breastfeeding mother. Mult Scler Int. 2016;2016:6527458. PMID: 26966579

3. Azuno Y, Kaku K, Fujita N et al. Mitoxantrone and etoposide in breast milk. Am J Hematol. 1995;48:131-2. Letter. PMID: 7847330

Mitoxantrone Identification

Substance Name

Mitoxantrone

CAS Registry Number

65271-80-9

Drug Class

Antineoplastic Agents

Administrative Information

LactMed Record Number

185

Last Revision Date

20160602

Disclaimer

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Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.

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