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Anthracenedione cytotoxic

Mitoxantrone (Specialist drug)

Brand names: Onkotrone

Mitoxantrone is an anthracenedione cytotoxic used, under specialist supervision, in certain leukaemias, lymphomas, breast and prostate cancer, and occasionally in highly active multiple sclerosis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It intercalates DNA and inhibits topoisomerase II, causing DNA strand breaks and blocking DNA and RNA synthesis.

Prescribing in practice

  • It is cardiotoxic with a cumulative dose-related risk of heart failure, so left ventricular function is assessed before and during treatment and a lifetime cumulative limit is observed.
  • It causes myelosuppression and carries a risk of secondary leukaemia, and is a vesicant requiring careful intravenous administration.
  • It characteristically turns urine and sometimes the sclerae blue-green, and patients should be forewarned.

Monitoring

Monitor full blood count before each course and cardiac (left ventricular ejection fraction) function before and during treatment against the cumulative dose.

Counselling the patient

  • Expect a temporary blue-green discolouration of urine, and sometimes a bluish tinge to the whites of the eyes.
  • Report breathlessness, ankle swelling or palpitations, which may indicate heart strain.
  • Report fever, bruising or bleeding promptly.

Evidence & guidelines

Long-established cytotoxic used per the SPC; cumulative cardiac dose limits are standard oncology and MS-treatment practice.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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