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Novantrone (Mitoxantrone Hydrochloride) - Drug Interactions, Contraindications, Overdosage, etc




Mitoxantrone and its metabolites are excreted in bile and urine, but it is not known whether the metabolic or excretory pathways are saturable, may be inhibited or induced, or if mitoxantrone and its metabolites undergo enterohepatic circulation.  To date, post-marketing experience has not revealed any significant drug interactions in patients who have received NOVANTRONE® for treatment of cancer.  Information on drug interactions in patients with multiple sclerosis is limited.

Following concurrent administration of NOVANTRONE® with corticosteroids, no evidence of drug interactions has been observed.


There is no known specific antidote for NOVANTRONE®.  Accidental overdoses have been reported.  Four patients receiving 140-180 mg/m2 as a single bolus injection died as a result of severe leukopenia with infection.  Hematologic support and antimicrobial therapy may be required during prolonged periods of severe myelosuppression.

Although patients with severe renal failure have not been studied, NOVANTRONE® is extensively tissue bound and it is unlikely that the therapeutic effect or toxicity would be mitigated by peritoneal or hemodialysis.


NOVANTRONE® is contraindicated in patients who have demonstrated prior hypersensitivity to it.


  1. NIOSH Alert: Preventing occupational exposures to antineoplastic and other hazardous drugs in healthcare settings.  2004. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2004-165.

  2. OSHA Technical Manual, TED 1-0.15A, Section VI: Chapter 2.  Controlling Occupational Exposure to Hazardous Drugs.  OSHA, 1999. http://www.osha.gov/dts/osta/otm_vi_2.html.

  3. NIH [2002].  1999 recommendations for the safe handling of cytotoxic drugs.  U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, NIH Publication No. 92-2621.

  4. American Society of Health-System Pharmacists.  (2002) ASHP Guidelines on Handling Hazardous Drugs.

  5. Polovich, M., White, J.M., & Kelleher, L.O. (eds.) 2005.  Chemotherapy and biotherapy guidelines and recommendations for practice (2nd. ed.) Pittsburgh, PA: Oncology Nursing Society.

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