Your child needs to take the medicine called mitoxantrone (say: mye-toe-ZAN-trone). This information sheet explains what mitoxantrone does, when it is given, and what side effects or problems your child may have when they take this medicine.
What is mitoxantrone?
Mitoxantrone is a medicine used to kill cancer cells. You may hear mitoxantrone called DHAD, or by its brand name, Novantrone. Mitoxantrone comes in an injection form.
Before giving mitoxantrone to your child?
Tell your doctor if your child has ever reacted badly to mitoxantrone or any other medication.
Talk with your child's doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- infection or recent exposure to infection (for example chickenpox)
- liver or kidney problems
- low blood counts
- heart problems or is taking heart medications
- had previous treatment with any cancer drugs including doxorubicin, daunorubicin, and idarubicin
How will your child get mitoxantrone?
Mitoxantrone is a dark blue liquid that is usually injected into your child's vein (intravenously or IV). Usually your child will get this medicine in the hospital clinic or on a nursing unit.
If mitoxantrone leaks out of the vein through which it is being given, it can cause severe damage. Tell the nurse right away if you or your child notice redness, pain, or swelling at the place of injection.
What are the possible side effects of mitoxantrone?
Your child may have some of these side effects while they take mitoxantrone. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:
- nausea and vomiting (throwing up)
- diarrhea (loose, watery stools)
- constipation
- irregular menstrual periods (in females)
- hair loss or thinning of the hair
- discolouration of urine to blue or green
Call your child's doctor during office hours if your child has any of these side effects:
- sores in the mouth and on the lips
- stomach pain
- cough
- yellowing of eyes or skin
- skin rash
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- pain or redness at the site of injection
- black tarry stools
- blood in urine or stools
- unusual bleeding and bruising
- shortness of breath or trouble breathing
- swelling of feet and lower legs
- fast or uneven heartbeat
- fever or chills
- lower back or side pain
- seizures
After your child stops receiving mitoxantrone it may still cause side effects. These delayed effects may include certain types of cancer. Check with your doctor immediately if any of the following signs occur:
- yellow eyes or skin
- black tarry bowel movements
- blood in urine or bowel movements
- lower back or side pain
- stomach pain
- cough or a hoarse voice
- unusual bleeding or bruising
- diarrhea
What safety measures should you take when your child is using mitoxantrone?
Your child will receive medicine to prevent upset stomach and throwing up caused by mitoxantrone.
Your child may lose their hair. It will grow back once your child is no longer receiving mitoxantrone. Its colour and texture may change. Use a gentle shampoo and a soft brush.
Mitoxantrone may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can review this with you. Avoid store bought mouthwash as it may sting and cause dry mouth.
Mitoxantrone can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are very crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
- You or your child should make sure hands are clean before touching his eyes or inside his nose.
- Your child's nurse will review with you what to do in case of fever.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) and chickenpox vaccine.
Mitoxantrone can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using fingernail scissors or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking mitoxantrone.
- Your child should not receive a permanent tattoo or any kind of body piercing.
Mitoxantrone may cause heart damage. Your child will have heart function tests done as needed while receiving this medicine. Contact your child's doctor immediately if your child has a fast or irregular heartbeat, shortness of breath, trouble breathing, or swelling of feet and lower legs.
There is a chance that mitoxantrone may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active it is best that they use some kind of birth control while receiving this medicine. Tell the doctor right away if your child may be pregnant.
After receiving mitoxantrone your child may not be able to have children or have difficulty having children. Your child's doctor will discuss this in more detail with you or your child.
What other important information should you know about mitoxantrone?
- Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).
- Keep a list of all medications your child is on to show the doctor or pharmacist.
- Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
- Keep mitoxantrone out of your child's sight and reach and locked up in a safe place.
Keep mitoxantrone out of your child’s sight and reach and locked up in a safe place. If your child takes too much mitoxantrone, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.