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Mitoxantrone Side Effects

In Summary

Commonly reported side effects of mitoxantrone include: urinary tract infection, upper respiratory tract infection, fungal skin infection, fungal infection, sepsis, infection, ecg abnormality, gastrointestinal hemorrhage, increased gamma-glutamyl transferase, nausea, amenorrhea, urine abnormality, stomatitis, constipation, alopecia, leukopenia, cardiac arrhythmia, menstrual disease, diarrhea, pharyngitis, abdominal pain, hypocalcemia, increased serum glucose, aphthous stomatitis, epigastric pain, decreased hemoglobin, vomiting, hematuria, rhinitis, burning sensation of gastrointestinal tract, stomach pain, hypokalemia, mucositis, lymphocytopenia, decreased white blood cell count, weight gain, fever, dyspnea, weakness, thrombocytopenia, fatigue, cough, hyperglycemia, edema, abnormal absolute neutrophil count, nail bed changes, anorexia, and malaise. Other side effects include: pneumonia, skin infection, seizure, renal failure, back pain, sinusitis, granulocytopenia, headache, anemia, increased serum aspartate aminotransferase, increased serum alanine aminotransferase, ischemic heart disease, conjunctivitis, petechia, hypermenorrhea, hemorrhage, sterility, dyspepsia, myalgia, arthralgia, anxiety, depression, pain, hyponatremia, impotence, proteinuria, hypertension, chills, ecchymoses, bruise, and diaphoresis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to mitoxantrone: intravenous solution

In addition to its needed effects, some unwanted effects may be caused by mitoxantrone. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking mitoxantrone, check with your doctor or nurse immediately:

More common:
  • Black, tarry stools
  • bladder pain
  • bloody or cloudy urine
  • cough or shortness of breath
  • difficult, burning, or painful urination
  • dizziness
  • fainting
  • fast, slow, or irregular heartbeat
  • frequent urge to urinate
  • lower back or side pain
  • pale skin
  • stomach pain
  • swelling or inflammation of the mouth
  • troubled breathing with exertion
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Less common:
  • Blood in the urine or stools
  • decrease in urination
  • fever or chills
  • pinpoint red spots on the skin
  • seizures
  • sore, red eyes
  • swelling of the feet and lower legs
  • yellow eyes or skin
  • Blue skin at the place of injection
  • pain or redness at the place of injection
  • skin rash

Minor Side Effects

Some of the side effects that can occur with mitoxantrone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Absent, missed, or irregular menstrual periods
  • back pain
  • body aches or pains
  • congestion
  • constipation
  • diarrhea
  • dryness or soreness of the throat
  • hair loss
  • headache
  • longer or heavier menstrual periods
  • nausea or vomiting
  • oral bleeding
  • pain or tenderness around the eyes and cheekbones
  • runny nose
  • sneezing
  • stopping of menstrual bleeding
  • stuffy nose
  • tender, swollen glands in the neck
  • thinning of the hair

For Healthcare Professionals

Applies to mitoxantrone: intravenous solution


Very common (10% or more): Platelets low (up to 33%), leukopenia (up to 19%), white blood cells low (up to 100%)
Common (1% to 10%): Myelosuppression (especially leucopenia)
Uncommon (0.1% to 1%): Thrombocytopenia, anemia
Frequency not reported: Bone marrow depression[Ref]


Frequency not reported: Acute myeloid leukemia (AML), acute myelodysplastic syndrome (AMS)[Ref]


Very common (10% or more): Nausea (up to 76%), stomatitis (up to 19%), diarrhea (up to 16%), gastralgia/stomach burn/epigastric pain (up to 14%), constipation (up to 10%), aphthosis (up to 10%)
Common (1% to 10%): Vomiting
Uncommon (0.1% to 1%): Anorexia, GI bleeding, abdominal pain, altered taste
Frequency not reported: Mucositis, vomiting[Ref]


Very common (10% or more): Arrhythmia (up to 18%), ECG abnormal (up to 11%)
Uncommon (0.1% to 1%): Hypotension
Frequency not reported: Acute arrhythmias, transient ECG alterations, reduced left ventricular output, cardiac insufficiency, congestive heart failure (CHF)[Ref]


Uncommon (0.1% to 1%): Phlebitis, erythema, swelling, pain, burning and/or blue discoloration of the skin
Rare (less than 0.1%): Tissue necrosis (following extravasation)[Ref]

Nervous system

Common (1% to 10%): Headache
Uncommon (0.1% to 1%): Somnolence, mild paresthesia[Ref]


Uncommon (0.1% to 1%): Anaphylaxis[Ref]


Very common (10% or more): Reversible alopecia (up to 61%)
Uncommon (0.1% to 1%): Urticaria, rash, nail pigmentation, onycholysis[Ref]


Uncommon (0.1% to 1%): Elevated serum creatinine, elevated blood urea nitrogen
Frequency not reported: Renal failure[Ref]


Very common (10% or more): Gamma-glutamyl transpeptidase increased (up to 15%)
Common (1% to 10%): Alanine aminotransferase (ALT or SGPT) increased, aspartate aminotransferase (AST or SGOT) increased, granulocytopenia, anemia
Uncommon (0.1% to 1%): Increased liver enzyme levels, elevated bilirubin levels[Ref]


Very common (10% or more): Asthenia (up to 24%)
Uncommon (0.1% to 1%): Fever, fatigue, weakness[Ref]


Very common (10% or more): Menstrual disorder (including amenorrhea) (up to 61%), urinary tract infection (up to 32%), abnormal urine (up to 11%)
Common (1% to 10%): Menorrhagia
Frequency not reported: Blue-green coloration of the urine 1 to 2 days after administration[Ref]


Frequency not reported: Amenorrhea[Ref]


Very common (10% or more): Infection (e.g., tonsillitis, enteritis, urinary tract infection, viral infection, endometritis) (up to 85%), cutaneous mycosis (up to 10%)[Ref]


Very common (10% or more): Glucose high (up to 10%), potassium low (up to 10%)
Common (1% to 10%): Back pain
Rare (less than 0.1%): Tumor lysis syndrome (characterized by hyperuricemia, hypercalcemia, hyperphosphatasemia, hypocalcemia)[Ref]


Uncommon (0.1% to 1%): Reversible blue coloration of the sclera
Frequency not reported: Lethargy, fatigue, seizures[Ref]


Frequency not reported: Depression[Ref]


Very common (10% or more): Upper respiratory tract infection (up to 53%), pharyngitis/throat infection (up to 19%), rhinitis (up to 10%)
Common (1% to 10%): Sinusitis
Uncommon (0.1% to 1%): Dyspnea, pneumonitis[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. Available from: URL:" ([2006]):

3. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.

Not all side effects for mitoxantrone may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.