WARNING

Only a physician with training in the administration of chemotherapeutic drugs should provide mitoxantrone.

White blood cell counts in the blood may drop as a result of mitoxantrone. To monitor whether your body’s white blood cell count has dropped, your doctor will periodically order laboratory tests before and during your therapy. Call your doctor right away if you have any of the following signs of infection: fever, chills, sore throat, cough, frequent or painful urination.

Any time throughout your therapy or months to years after it has completed, mitoxantrone injection could harm your heart. Even among those who are not at risk for heart disease, major cardiac damage that could result in death can nonetheless happen. Before starting mitoxantrone medication and if you exhibit any heart-related symptoms, your doctor will evaluate you and do a number of tests to determine how well your heart is functioning. Your doctor will also conduct specific tests before each dose of mitoxantrone injection and once a year after you have finished treatment if you are using it to treat multiple sclerosis (MS), a condition in which the nerves do not function properly and cause symptoms like weakness, numbness, loss of muscle coordination, and issues with vision, speech, and bladder control). A heart electrocardiogram (ECG) and an echocardiogram, which employs sound waves to gauge the heart’s blood-pump efficiency, may be performed as part of these tests.If the tests reveal a decline in your heart’s capacity to pump blood, your doctor may advise against using this drug. Inform your doctor if you have or have previously had a cardiac condition, as well as any radiation (x-ray) therapy for the chest. Inform your doctor and pharmacist if you are now taking or have previously taken any of the following cancer chemotherapy drugs: daunorubicin (Cerubidine), doxorubicin (Doxil), epirubicin (Ellence), or idarubicin (Idamycin), as well as if you have ever received mitoxantrone treatment. Your doctor will likely restrict the total number of doses you take if you use mitoxantrone for MS because the risk of heart damage may depend on the total amount of the drug given to a person over the course of a lifetime. Make a quick call to your doctor if you encounter any of the following signs: breathing difficulties, chest pain, ankle or leg swelling, or an irregular or erratic heartbeat.

When given in large dosages or in combination with some other chemotherapy drugs, mitoxantrone has the potential to raise your risk of developing leukemia (cancer of the white blood cells).

Discuss the dangers of using injections of mitoxantrone with your doctor.

Why is this medication prescribed?

Adults with a variety of kinds of multiple sclerosis (MS; a condition in which the nerves do not function properly and patients may experience weakness, numbness, loss of muscular coordination, and issues with vision, speech, and bladder control) may benefit from mitoxantrone injection, including the following:

• Relapsing-remitting types (a disease course where symptoms periodically flare up), or
• Relapses that occur occasionally during a disease’s progression, or
• (Disease progression with increasingly frequent relapses) Secondary progressive types.

When various painkillers have failed to control the symptoms of advanced prostate cancer, mitoxantrone injection is frequently used in combination with steroid medicines. Certain kinds of leukemia are also treated with mitoxantrone injection in combination with other drugs. Anthracenediones are a class of drugs that includes mitoxantrone injection. By preventing specific immune system cells from harming the brain and spinal cord upon contact, mitoxantrone heals MS. Mitoxantrone cures cancer by halting the development and division of cancerous cells.

How should this medicine be used?

In a hospital or clinic, a doctor or nurse administers mitoxantrone injection intravenously (into a vein). When mitoxantrone injection is used to treat MS, it is typically administered once every three months for roughly two to three years (for a total of 8 to 12 doses). Prostate cancer patients typically receive a mitoxantrone injection once every 21 days. You will continue to take mitoxantrone injection for the duration of your leukemia treatment depending on how well you respond to the drug and how your condition is.

You should be aware that when taking mitoxantrone injection to treat your MS, the disease cannot be cured. Even if you are feeling better, keep getting treatments. If you no longer desire to receive mitoxantrone injectable therapy, speak with your doctor.

Get a copy of the manufacturer’s information for the patient if you are using mitoxantrone injection for multiple sclerosis by asking your pharmacist or doctor.

Other uses for this medicine

Injections of mitoxantrone are also occasionally used to treat non-Hodgkin’s lymphoma (NHL), a malignancy that starts in a category of white blood cell that often fights infection. Discuss the dangers of using this drug for your illness with your doctor.

Ask your doctor or pharmacist for more details if you think this drug may be recommended for other conditions.

What special precautions should I follow?

Regarding precautions, there are several important considerations when using posaconazole:

• If you have any allergies, especially to sulfites or other substances in mitoxantrone injection, tell your doctor and pharmacist right away. For a list of the ingredients, ask your pharmacist.
• Inform your doctor and pharmacist about any additional prescription and over-the-counter medications, vitamins, herbal items, nutritional supplements, and any drugs you are now taking or intend to take. Include the drugs that are listed in the IMPORTANT WARNING section. Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects.
• Inform your physician about any liver illness, anemia (lower-than-normal levels of red blood cells in the blood), or blood coagulation issues you currently have or have ever had.
• If you are pregnant or plan to become pregnant, notify your doctor. While taking mitoxantrone injection, you shouldn’t get pregnant. Consult your physician about reliable birth control options you can use while undergoing therapy. Call your doctor right away if you find out you’re pregnant while taking mitoxantrone injection. The fetus could suffer from the infusion of mitoxantrone. Even if you are on birth control, your doctor should do a pregnancy test on you prior to each mitoxantrone injectable treatment if you are using it to treat MS. Before beginning each treatment, you must have a pregnancy test that is negative.
• If you are nursing a child, notify your doctor. While using the mitoxantrone injection, avoid breastfeeding.
• Inform your surgeon or dentist that you are using mitoxantrone injection if you are having surgery, including dental surgery.
• You should be aware that each dose of mitoxantrone injection is a dark blue color, and that this coloration may last for a few days and affect the whites of your eyes. Approximately 24 hours after receiving a dose, it may also cause your urine to turn blue-green in color.

Always follow your healthcare provider’s instructions, including dosage, frequency, and duration of treatment. If you have any specific concerns or questions about using posaconazole, consult with your healthcare provider or pharmacist for personalized advice based on your individual situation.

What special dietary instructions should I follow?

Maintain your regular diet unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you need a dosage of mitoxantrone injection but are unable to keep a scheduled appointment, call your doctor right once.

What side effects can this medication cause?

The injection of mitoxantrone may have negative effects. If any of these symptoms are severe or do not go away, consult your doctor:

• Nnausea
• Vomiting
• Diarrhea
• Constipation
• Heartburn
• Loss of appetite
• Sores on the mouth and tongue
• Runny or stuffed nose
• Thinning or loss of hair
• Changes in the area around or under fingernails and toenails
• Missed or irregular menstrual periods
• Extreme tiredness
• Weakness
• Headache
• Back pain

Some adverse effects may be severe. Call your doctor right away if you have any of the following symptoms or any of the ones detailed in the IMPORTANT WARNING section:

• Unusual bleeding or bruising
• Small red or purple dots on the skin
• Hives
• Itching
• Rash
• Difficulty swallowing
• Shortness of breath
• Fainting
• Dizziness
• Pale skin
• Yellowing of the skin or eyes
• Seizures
• Redness, pain, swelling, burning, or blue discoloration at the site where the injection was given

A mitoxantrone injection may result in additional adverse effects. If you experience any strange issues while taking this medicine, contact your doctor right away.

The Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program can be contacted by phone at 1-800-332-1088 or online if you suffer a major side effect.

What should I know about storage and disposal of this medication?

• Storage: Store mitoxantrone injection, at room temperature, away from excessive heat, moisture, and direct light. Keep the medication out of reach of children and pets.
• Disposal: Dispose of any unused or expired mitoxantrone injection properly according to local regulations or guidelines. Do not dispose of medications in household trash or flush them down the toilet unless specifically instructed to do so.

In case of emergency/overdose

Call 1-800-222-1222 to reach the poison control hotline in the event of an overdose. Call emergency services at 911 right away if the sufferer has fallen, experienced a seizure, is having problems breathing, or cannot be roused.

What other information should I know?

Maintain all scheduled times with your physician and the lab. To monitor your body’s reaction to mitoxantrone injection, your doctor will request a few lab tests.

Inquire about mitoxantrone injection with your pharmacist.

You should keep a written record of every drug you take, including prescription and nonprescription (over-the-counter) medications, vitamins, minerals, and other dietary supplements. Every time you see a doctor or are admitted to the hospital, you should carry this list with you. Additionally, it is crucial to have this knowledge on hand in case of emergency.

Remember to always consult your healthcare provider or pharmacist for specific instructions and guidance regarding the storage, disposal, and emergency procedures related to posaconazole. They can provide you with the most accurate and up-to-date information based on your individual circumstances.