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| Clinical data | |
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| Trade names | Novantrone |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a608019 |
| Routes of administration | Mainlyintravenous |
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| Pharmacokinetic data | |
| Bioavailability | n/a |
| Protein binding | 78% |
| Metabolism | Hepatic (CYP2E1) |
| Eliminationhalf-life | 75 hours |
| Excretion | Renal |
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| PDB ligand | |
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| Chemical and physical data | |
| Formula | C22H28N4O6 |
| Molar mass | 444.488 g·mol−1 |
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Mitoxantrone (INN, BAN, USAN; also known asMitozantrone in Australia; trade nameNovantrone) is ananthracenedioneantineoplastic agent.
Mitoxantrone is used to treat certain types of cancer, mostlyacute myeloid leukemia. It improves the survival rate of children suffering fromacute lymphoblastic leukemia relapse.[1]
The combination of mitoxantrone andprednisone is approved as a second-line treatment for metastatic hormone-refractoryprostate cancer. This combination was once the first line of treatment; however, a combination ofdocetaxel and prednisone improves survival rates and lengthens the disease-free period.[2]
Mitoxantrone is also used to treatmultiple sclerosis (MS), most notably thesubset of the disease known as secondary-progressive MS. In the absence of a cure, mitoxantrone is effective in slowing the progression of secondary-progressive MS and extending the time between relapses in both relapsing-remitting MS and progressive-relapsing MS.[3]
Mitoxantrone, as with other drugs in its class, may causeadverse reactions of varying severity, includingnausea,vomiting,hair loss, heart damage andimmunosuppression, possibly with delayed onset.Cardiomyopathy is a particularly concerning effect as it is irreversible; thus regular monitoring withechocardiograms orMUGA scans is recommended for patients.
Because of the risk of cardiomyopathy, mitoxantrone carries a limit on the cumulative lifetime dose (based on body surface area) in MS patients.[4]
Mitoxantrone is atype II topoisomeraseinhibitor; it disruptsDNA synthesis andDNA repair in both healthy cells and cancer cells byintercalation[5][6] between DNA bases. It is also classified as an antibiotic.[7]
