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Mitoxantrone Disease Interactions

There are 5 disease interactions with mitoxantrone:

Major

Antineoplastics (Includes Mitoxantrone) ↔ 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.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
View all 31 references
Major

Mitoxantrone (Includes Mitoxantrone) ↔ Heart Disease

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, 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.

References

  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. 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
View all 13 references
Major

Mitoxantrone (Includes Mitoxantrone) ↔ 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.

References

  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
Major

Mitoxantrone (Includes Mitoxantrone) ↔ 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.

References

  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. 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
  3. 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
View all 16 references
Moderate

Mitoxantrone (Includes Mitoxantrone) ↔ 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.

mitoxantrone drug Interactions

There are 246 drug interactions with 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.

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

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