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Novantrone (mitoxantrone) Disease Interactions

There are 5 disease interactions with Novantrone (mitoxantrone):


Antineoplastics (Includes Novantrone) ↔ Infections

Severe Potential Hazard, High plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.


  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  4. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  6. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  7. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  8. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  9. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  10. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  11. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  12. "Product Information. Tabloid (thioguanine)." Glaxo Wellcome, Research Triangle Park, NC.
  13. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  14. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  15. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  16. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  17. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  18. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  19. "Product Information. Nipent (pentostatin)." Parke-Davis, Morris Plains, NJ.
  20. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  21. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  22. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  23. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  24. "Product Information. Thiotepa (thiotepa)." Lederle Laboratories, Wayne, NJ.
  25. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  26. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  27. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  28. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  29. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  30. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  31. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
View all 31 references

Mitoxantrone (Includes Novantrone) ↔ Heart Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Heart Disease

Mitoxantrone can cause myocardial toxicity leading to congestive heart failure (CHF). Patients with preexisting heart disease, prior irradiation, previous therapy with related compounds such as daunorubicin, idarubicin or doxorubicin, or of advanced age are at increased risk of cardiotoxicity at a lower cumulative dose. The incidence of drug-induced congestive heart failure in adults is increased when the total cumulative dose of mitoxantrone exceeds 140 mg/m2. Close clinical monitoring of cardiac function, such as determination of left ventricular ejection fraction, prior to each course of therapy is recommended.


  1. Fountzilas G, Afthonidis D, Geleris P, Salem N, Kottas G, Halkidis C, Apostolidis P, Beer M, Tourkantonis A "Cardiotoxicity evaluation in patients treated with a mitoxantrone combination as adjuvant chemotherapy for breast cancer." Anticancer Res 12 (1992): 231-4
  2. Janmohammed R, Milligan DW "Mitoxantrone induced congestive heart failure in patients previously treated with anthracyclines." Br J Haematol 71 (1989): 292-3
  3. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  4. Benekli M, Kars A, Guler N "Mitoxamtrone-induced bradycardia." Ann Intern Med 126 (1997): 409
  5. Cassidy J, Merrick MV, Smyth JF, Leonard RC "Cardiotoxicity of mitozantrone assessed by stress and resting nuclear ventriculography." Eur J Cancer Clin Oncol 24 (1988): 935-8
  6. Benjamin RS "Rationale for the use of mitoxantrone in the older patient: cardiac toxicity." Semin Oncol 22 (1 Suppl) (1995): 11-3
  7. Mather FJ, Simon RM, Clark GM, Von Hoff DD "Cardiotoxicity in patients treated with mitoxantrone: Southwest Oncology Group phase II studies." Cancer Treat Rep 71 (1987): 609-13
  8. LeMaistre CF, Herzig R "Mitoxantrone: potential for use in intensive therapy." Semin Oncol 17 (1 Suppl) (1990): 43-8
  9. Schell FC, Yap HY, Blumenschein G, Valdivieso M, Bodey G "Potential cardiotoxicity with mitoxantrone." Cancer Treat Rep 66 (1982): 1641-3
  10. de Leonardis V, Bartalucci S, Cinelli P, De Scalzi M, Becucci A, Lottini G, Neri B "Ventricular late potentials in the assessment of mitoxantrone cardiotoxicity." Cardiology 79 (1991): 110-5
  11. Lewkow LM, Hooker JL, Movahed A "Cardiac complications of intensive dose mitoxantrone and cyclophosphamide with autologous bone marrow transplantation in metastatic breast cancer." Int J Cardiol 34 (1992): 273-6
  12. Villani F, Galimberti M, Crippa F "Evaluation of ventricular function by echocardiography and radionuclide angiography in patients treated with mitoxantrone." Drugs Exp Clin Res 15 (1989): 501-6
  13. Pai GR, Reed NS, Ruddell WS "A case of mitozantrone-associated cardiomyopathy without prior anthracycline therapy." Br J Radiol 60 (1987): 1125-6
View all 13 references

Mitoxantrone (Includes Novantrone) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Hepatic impairment reduces mitoxantrone clearance. Patients with severe hepatic dysfunction (bilirubin > 3.4 mg/dL) have an AUC more than three times greater than that of patients with normal hepatic function receiving the same dose. Therapy with mitoxantrone should be administered cautiously to patients with significantly compromised hepatic function.


  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. Keller JW, Omura GA, Gams RA, Bartolucci AA "Weekly mitoxantrone therapy of Hodgkin's disease, non-Hodgkin's lymphoma, and chronic lymphocytic leukemia. A Southeastern Cancer Study Group Trial." Am J Clin Oncol 10 (1987): 194-5
  3. Paciucci PA, Sklarin NT "Mitoxantrone and hepatic toxicity." Ann Intern Med 105 (1986): 805-6

Mitoxantrone (Includes Novantrone) ↔ Myelosuppression

Severe Potential Hazard, High plausibility

Applies to: Fever, Bone Marrow Depression/Low Blood Counts, Bleeding, Infection - Bacterial/Fungal/Protozoal/Viral

Mitoxantrone induces myelosuppression when administered at therapeutic doses indicated for treatment of leukemia. Leukopenia is the most profound hematologic side-effect. Thrombocytopenia is rare, but can be severe and erythrocytes do not appear to be significantly affected. Therapy with mitoxantrone should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering mitoxantrone. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended.


  1. Muhonen TT, Wiklund TA, Blomqvist CP, Pyrhonen SO "Unexpected prolonged myelosuppression after mitomycin, mitoxantrone and methotrexate." Eur J Cancer 28a (1992): 1974-6
  2. Neijt JP, Lacave AJ, Splinter TA, Taal BG, Veenhof CH, Sahmoud T, Lips CJ "Mitoxantrone in metastatic apudomas: a phase II study of the EORTC Gastro-Intestinal Cancer Cooperative Group." Br J Cancer 71 (1995): 106-8
  3. Larson RA, Daly KM, Choi KE, Han DS, Sinkule JA "A clinical and pharmacokinetic study of mitoxantrone in acute nonlymphocytic leukemia." J Clin Oncol 5 (1987): 391-7
  4. Dugan M, Choy D, Ngai A, Sham J, Choi P, Shiu W, Leung T, Teo P, Prasad U, Lee S, et al "Multicenter phase II trial of mitoxantrone in patients with advanced nasopharyngeal carcinoma in Southeast Asia: an Asian-Oceanian Clinical Oncology Association Group study." J Clin Oncol 11 (1993): 70-6
  5. Harris AL, Cantwell BM, Carmichael J, Wilson R, Farndon J, Dawes P, Ghani S, Evans RG "Comparison of short-term and continuous chemotherapy (mitozantrone) for advanced breast cancer." Lancet 335 (1990): 186-90
  6. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  7. Jodrell DI, Iveson TJ, Smith IE "Myelosuppression after methotrexate, mitoxantrone, and mitomycin C." Lancet 1 (1987): 1211
  8. Bajetta E, Buzzoni R, Valagussa P, Bonadonna G "Mitoxantrone: an active agent in refractory non-Hodgkin's lymphomas." Am J Clin Oncol 11 (1988): 100-3
  9. Saletan S "Mitoxantrone: an active, new antitumor agent with an improved therapeutic index." Cancer Treat Rev 14 (1987): 297-303
  10. Keller JW, Omura GA, Gams RA, Bartolucci AA "Weekly mitoxantrone therapy of Hodgkin's disease, non-Hodgkin's lymphoma, and chronic lymphocytic leukemia. A Southeastern Cancer Study Group Trial." Am J Clin Oncol 10 (1987): 194-5
  11. Faulds D, Balfour JA, Chrisp P, Langtry HD "Mitoxantrone: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in the chemotherapy of cancer." Drugs 41 (1991): 400-49
  12. LeMaistre CF, Herzig R "Mitoxantrone: potential for use in intensive therapy." Semin Oncol 17 (1 Suppl) (1990): 43-8
  13. Morton AR, Anderson H, Howell A "Myelotoxicity of methotrexate, mitozantrone, and mitomycin C." Lancet 1 (1987): 1494
  14. Henderson IC, Allegra JC, Woodcock T, Wolff S, Bryan S, Cartwright K, Dukart G, Henry D "Randomized clinical trial comparing mitoxantrone with doxorubicin in previously treated patients with metastatic breast cancer." J Clin Oncol 7 (1989): 560-71
  15. Powles TI, Ashley S "Myelosuppression after methotrexate, mitozantrone, and mitomycin C combination chemotherapy." Lancet 2 (1987): 853
  16. Markman M, Hakes T, Reichman B, Lewis JL Jr, Rubin S, Jones W, Almadrones L, Hoskins W "Phase II trial of weekly or biweekly intraperitoneal mitoxantrone in epithelial ovarian cancer." J Clin Oncol 9 (1991): 978-82
View all 16 references

Mitoxantrone (Includes Novantrone) ↔ Hyperuricemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperuricemia Secondary to Chemotherapy

Treatment with mitoxantrone may cause hyperuricemia as a result of rapid lysis of tumor cells. Levels of serum uric acid should be monitored and appropriate therapy should be initiated before starting therapy.

Novantrone (mitoxantrone) drug Interactions

There are 260 drug interactions with Novantrone (mitoxantrone)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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