Mitoxantrone

Mitoxantrone

Clinical data
Trade names	Novantrone
AHFS/Drugs.com	Monograph
MedlinePlus	a608019
Pregnancy category	US: D (Evidence of risk)
Routes of administration	Mainly intravenous
ATC code	L01DB07 (WHO)
Legal status
Legal status	In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability	n/a
Protein binding	78%
Metabolism	Hepatic (CYP2E1)
Biological half-life	75 hours
Excretion	Renal
Identifiers
IUPAC name 1,4-dihydroxy-5,8-bis[2-(2-hydroxyethylamino) ethylamino]-anthracene-9,10-dione
CAS Number	65271-80-9 Y
PubChem CID	4212
IUPHAR/BPS	7242
DrugBank	DB01204 Y
ChemSpider	4067 Y
UNII	BZ114NVM5P
KEGG	D08224 Y
ChEBI	CHEBI:50729 Y
ChEMBL	CHEMBL58 Y
PDB ligand	MIX (PDBe, RCSB PDB)
Chemical and physical data
Formula	C22H28N4O6
Molar mass	444.481 g/mol
3D model (Jmol)	Interactive image
SMILES O=C2c1c(c(NCCNCCO)ccc1NCCNCCO)C(=O)c3c2c(O)ccc3O
InChI InChI=1S/C22H28N4O6/c27-11-9-23-5-7-25-13-1-2-14(26-8-6-24-10-12-28)18-17(13)21(31)19-15(29)3-4-16(30)20(19)22(18)32/h1-4,23-30H,5-12H2 Y Key:KKZJGLLVHKMTCM-UHFFFAOYSA-N Y

Mitoxantrone (INN, BAN, USAN; also known as Mitozantrone in Australia; trade name Novantrone) is an anthracenedione antineoplastic agent.

Mitoxantrone is used to treat certain types of cancer, mostly metastatic breast cancer, acute myeloid leukemia, and non-Hodgkin's lymphoma. It improves the survival rate of children suffering from acute lymphoblastic leukemia relapse.

The combination of mitoxantrone and prednisone is approved as a second-line treatment for metastatic hormone-refractory prostate cancer. Until recently this combination was the first line of treatment; however, a combination of docetaxel and prednisone improves survival rates and lengthens the disease-free period.

Mitoxantrone is also used to treat multiple sclerosis (MS), most notably the subset of the disease known as secondary-progressive MS. Absent 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.

Mitoxantrone, as with other drugs in its class, may cause adverse reactions of varying severity, including nausea, vomiting, hair loss, heart damage and immunosuppression, possibly with delayed onset. Cardiomyopathy is a particularly concerning effect as it is irreversible; thus regular monitoring with echocardiograms or MUGA scans is recommended for patients.