MUHC /CUSM, 2004
Mitoxantrone is a drug used to treat certain types of worsening MS. Mitoxantrone is not a cure, but it may help slow progression of the disease. It may also decrease the number of relapses that you have.
Mitoxantrone was first developed over 10 years ago as a drug to treat cancer. It is a drug that suppresses the immune system (an immunosuppressive drug). Suppressing the immune system can be beneficial in the treatment of MS because, in MS, certain cells in your immune system attack your brain and spinal cord. By suppressing the immune system, Mitoxantrone can help control the cells that attack myelin and cause lesions. This may help reduce the symptoms of MS in some patients.
You and your doctor will need to talk about the risks and benefits of this medicine. For you and your doctor to decide if this medication is right for you, your doctor will need to know the following: Tell your doctor about all the medicines you are taking, including non-prescription medicines and nutritional supplements. Tell your doctor if you have now or had in the past:
Generally the medication is well tolerated. You may experience some nausea and loss of appetite in the days following your treatment. You will be given medication to help control nausea, if needed. Some patients find they are very tired (fatigued) for a number of days following their Mitoxantrone dose. Speak to your doctor or nurse about ways to manage fatigue if this is a problem for you.
You will need to have regular testing of your heart and blood to help avoid side effects.
Blood samples will be taken before each dose of Mitoxantrone to make sure your blood counts are normal and to monitor your liver function. Your doctor may also request a blood sample if you have signs of infection.
If you are a woman who is capable of becoming pregnant, you should use an effective means of birth control since Mitoxantrone may be harmful to the fetus. If you suspect you are pregnant, you must have a pregnancy test and should know the results before you receive your next Mitoxantrone dose.
There is a lifetime limit of Mitoxantrone treatment because high doses may damage your heart. For most patients, the limit is approximately 9 doses given over 2 to 3 years. After you reach your limit, you should not receive any additional Mitoxantrone. You and your doctor should both keep track of how much Mitoxantrone you get.
What is a MUGA scan? In the MUGA scan a small amount of radioactive dye will be injected into your bloodstream. The dye attaches to red cells in the blood and then a special camera traces the cells as they pass through your heart and circulation system.
What is an electrocardiogram (ECG or EKG)? An ECG is a recording of the electrical activity of the heart. For this test small disks will be placed on your chest, using sticky patches or suction cups. Wires leading from these disks connect to a machine that records electrical impulses of the heart.
You will be tested before the first dose of Mitoxantrone is given. The total amount of Mitoxantrone you receive will be carefully tracked. Your doctor will also test your heart if you show signs of heart problems. Your doctor may stop Mitoxantrone if your tests show that your heart’s ability to pump blood has decreased.
The most common side effects of Mitoxantrone in clinical studies in people with MS, have been:
Most side effects of Mitoxantrone are not severe and can generally be treated.
Bladder and other infections can be treated with antibiotics. You can also take the steps below to help reduce your chances of getting an infection:
Mitoxantrone is dark blue in color, so it may turn your urine a bluegreen color. The white part of your eyes may also have a slight blue color. This effect should only last for a few days.
Mitoxantrone can lower your number of platelets, a type of blood cell necessary for blood clotting. If you notice any unusual bleeding or bruising, call your doctor immediately.
Other side effects may also occur. Be sure to tell your doctor about any side effects, whether or not they are listed in this brochure.
Rare side effects:
Leukemia is a possible side effect which is serious, but rare.
Women should not become pregnant or breastfeed while taking Mitoxantrone because it may harm the fetus. If you wish to become pregnant, or are concerned that you may be already, discuss this matter with your doctor. While taking Mitoxantrone, women who might become pregnant should use effective birth control and should be sure, before each dose, that they are not pregnant by taking a pregnancy test. If you do become pregnant, contact your doctor immediately.
Information about InfoNEURO
This information is for educational purposes only, and is not intended to replace the advice of a professional healthcare practitioner, or to substitute for medical care.
Collaborators: D. Lowden Clinical Nurse Specialist, Multiple Sclerosis Clinic, B. Taugher, G. Leduc, S. DeMelo, Nurse Clinician Educators, Neurology Day Centre.