Introduction

Name

• Mitoxantrone.

Class of drug

• Antineoplastic. 
• Anthracycline analogue. 

Description

Chemical name

• 1,4-dihydroxy-5,8-bis[2-(2-hydroxyethylamino)ethylamino]anthracene-9,10-dione. 

Molecular formula

• C₂₂H₂₈N₄O₆ 

Molecular weight

• 444.5 

Physical properties

• Available as a concentrate for dilution before infusion, authorized for use in humans. 

Uses

Indications

• Treatment of canine and feline lymphoma Lymphoma, squamous cell carcinoma Squmaous cell carcinoma and transitional cell carcinoma Bladder: neoplasia.  
• Has also been used in other neoplastic diseases in cats and dogs, including renal adenocarcinoma, fibroid sarcoma, anal gland adenocarcinoma, thyroid carcinoma, prostate carcinoma, mammary gland adenocarcinoma, feline injection site sarcoma, hemangiopericytoma and as a radiosensitizer in cats with oral squamous cell carcinoma.

Administration

Pharmacokinetics

Precautions

Interactions

With other drugs

• May interact with ciclosporin Ciclosporin, daunorubicin, doxorubicin Doxorubicin, other immunosuppressive drugs, bone marrow suppressants and vaccines. Mitoxantrone is a substrate for ABCB1 (P-glycoprotein) and ABCG2.  

With diagnostic tests

• Mitoxantrone may raise serum uric acid levels. Drugs such as allopurinol Allopurinol may be required to control hyperuricemia. 
• Liver function tests may become abnormal, indicating hepatotoxicity. 
• Mitoxantrone may discolor urine to a green-blue color. 

Adverse Reactions

Further Reading

Publications

Refereed Papers

• Recent references from PubMed and VetMedResource.
• Tagawa M et al (2021) Cardiomyopathy in a dog with multicentric lymphoma following treatment with several anthracyclines. Open Vet J 11(1), 6-10 PubMed. 
• Marquardt T M et al (2019) Substitution of mitoxantrone for doxorubicin in a multidrug chemotherapeutic protocol for first-line treatment of dogs with multicentric intermediate- to large-cell lymphoma. JAVMA 254(2), 236-242 PubMed.  
• Richardson D et al (2018) Correlation between body weight and mitoxantrone-associated neutropenia in dogs. J Am Animal Hosp Assoc 54(3), 144-149 PubMed.  
• Allstadt S D et al (2015) Randomized phase III trial of piroxicam in combination with mitoxantrone or carboplatin for first-line treatment of urogenital tract transitional cell carcinoma in dogs. J Vet Intern Med 29(1), 261-267 PubMed. 
• Cunha S C S et al (2015) Adjuvant chemotherapy with mitoxantrone for cats with mammary carcinomas treated with radical mastectomy. J Feline Med Surg 17(12), 1000-1004 PubMed. 

Organisation(s)

• Electronic Medicines Compendium (eMC): https://www.medicines.org.uk/