Your neurologist has ordered Novantrone® (generic
name: mitoxantrone) to treat your multiple sclerosis. Novantrone is a
chemotherapy drug that works by suppressing the immune system. It can slow the
worsening of neurologic disability and reduce the relapse rate in patients with
clinically worsening forms of relapsing-remitting and secondary progressive MS.
How is the medication given?
The medication is administered directly into a vein through an
intravenous (I.V.) drip. The treatment may take place at your treatment center
every three months. Occasionally, the dosage timing will be once a month.
Before treatment
Before your treatment begins you will need the following pretreatment tests:
- Blood tests (CBC, liver function)
- Electrocardiogram (EKG)
- Echocardiogram heart test to determine strength of heart muscle. This
test will be done again after one year of treatment.
- Height and weight
What should my doctor know before I start Novantrone treatments?
Your doctor needs to know if any of the following applies to you:
- Dental disease
- Gout
- Heart disease
- Infection (especially a viral infection such as chicken pox or herpes)
- Liver disease
- Recent radiation therapy
- Allergies
- Pregnant or trying to get pregnant
- Breastfeeding
- Unusual or unexpected bleeding
- Received chemotherapy
Your neurologist will discuss the potential benefits and risks
of Novantrone with you and your family. If you have any concerns or questions,
discuss them with your health care provider.
What can I expect during treatment?
- Plan to be at your treatment center for 2 hours. During this time you
will be given Novantrone, IV Solu-Medrol® (methylprednisolone),
Zofran® (ondansetron, an anti-nausea drug), and IV fluids through
an IV drip.
- Wear comfortable, warm clothes.
- Your nurse will check your blood pressure, pulse, and weight before
treatment. Your nurse will also check your pretreatment test results.
- Bring something to occupy your time, such as a book.
- Bring a drink container.
What can I expect during my recovery?
Because Novantrone suppresses your immune system (the body's
system for fighting illness), you will have an increased risk of infection after
treatment. It is important to avoid contact with people who are sick. You may
experience fatigue for a few days after each treatment. Some people experience
nausea for a few days after each treatment. This may require a change in anti
nausea medication.
Call your doctor immediately if you have any of the following symptoms:
- Fever
- Chills
- Sore throat
- Shortness of breath
- Vomiting
- Diarrhea
- Uneven or rapid heartbeat
- Swollen feet or ankles
Common side effects of Novantrone:
- A blue-green color of the urine for 24 hours after receiving Novantrone
- Dark yellow or brown urine
- A temporary bluish color of the whites of the eyes
- Mild or moderate nausea and vomiting
- Fever, chills, sore throat or cough (flu symptoms)
- Stomach pain or discomfort
- Sore mouth
- Headache
- Diarrhea
- Pain, swelling, redness, or irritation at the injection site
- Unusual bleeding or bruising
- Chest pain or discomfort
- Difficulty breathing, wheezing
- Irregular heartbeat
- Swollen feet or ankles
- Hair loss may be mild to moderate (hair will usually grow back after
treatment is discontinued)
More serious side effects of Novantrone
Novantrone has been linked to cases of reduced heart muscle
function. This is usually more common with a longer course of treatment and we
limit the number of treatments used for MS to try to avoid this. Reduced heart
muscle function is checked with heart scanning before and over the course of
Novantrone treatment. Reduced heart muscle function may cause shortness of
breath, swelling of the ankles, and fatigue. If this occurs, Novantrone has to
be stopped, and the heart function has to be monitored.
There have been published cases of leukemia occurring during
Novantrone treatment. This is an uncommon but serious side effect. Blood testing
during Novantrone therapy will monitor for this possibility.
Infections are more likely any type of chemotherapy, including
Novantrone. If you develop an infection, it should be treated with antibiotics
early (if it is a bacterial infection). Let your health care practitioner know
if you develop symptoms of an infection.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
Ask a Health Educator, Live!
Know someone who could use this information?...send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/23/2009...#8671
