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Mitoxantrone (Mitoxantrone) instruction manual
Common name: Mitoxantrone
Trade name: NOVANTRON INJECTION
Full names: Mitoxantrone, dihydroxyanthracenedione, Mitoxantrone, NOVANTRON INJECTION, Mitoxantrone Injection
Indications:
1. Breast cancer and malignant lymphoma.
2. Gastrointestinal cancer.
3. Leukemia.
4. Bladder cancer, ovarian cancer, primary liver cancer, multiple myeloma and diffuse pleural mesothelioma (malignant mesothelioma).
Dosage:
Acute leukemia (including acute conversion of chronic myeloid leukemia): Typically, adults are treated with mitoxantrone 2 to 5 mg/m2 (1 to 2.5 mL/m2 of this drug) once daily for 5 days for 3 to 4 weeks, administered slowly intravenously across the diaphragm.
Malignant Lymphoma, Breast Cancer: Typically adults are treated with mitoxantrone at a dose of 2 to 4 mg/㎡ (1 to 2 mL/㎡ of the drug) once daily for 5 consecutive days or 8 to 14 mg/㎡ (4 to 7 mL/㎡) administered slowly intravenously at 3-4 week intervals.
Hepatocellular Carcinoma: In adults, 6 to 12 mg/m2 (3 to 6 mL/m2 of this drug) administered slowly intravenously once daily at 3 to 4 week intervals in adults.
In either case, it will increase or decrease depending on your age and symptoms.
Adverse reactions:
Myelosuppression: decrease in white blood cells and platelets. Generally, the leukocyte count occurs 10 to 14 days after treatment and begins to recover in about 3 weeks.
Digestive tract reactions: nausea, vomiting, oral mucositis, diarrhea. Liver damage is rare. The plasma half-life of patients with poor liver function is significantly prolonged and the dosage should be reduced. Use with caution in patients with liver and kidney insufficiency.
Cardiotoxicity is milder than that of doxorubicin, with 3% of 2,500 cases experiencing cardiotoxicity. Manifestations include reduced cardiac ejection fraction, arrhythmia, abnormal electrocardiogram, and myocardial infarction. Heart failure mainly occurs in patients who have previously used doxorubicin. The incidence rate of cardiotoxicity in children is 6%. Its prevention and treatment methods are: it is contraindicated in those with cardiac insufficiency and those who have received doxorubicin in excess of cumulative amounts. Because there is a significant correlation between the cardiotoxicity of MA and previous use of doxorubicin, caution should be exercised especially when treating children with MA, and cardiac monitoring should be performed in patients who have not received MA treatment. For patients whose dosage of doxorubicin exceeds 350 mg/m and requires MA treatment, echocardiography or multi-gated blood flow cardiac scanning should be used for monitoring.
The medicinal solution leaks out of the blood vessels and can cause severe subcutaneous tissue necrosis. It may appear as local redness, swelling, and burning sensation immediately. On the second day, the ulcer becomes dark red, swollen, and painful. On the third day, ulceration begins and the pain is severe. Later, the ulcer can reach as deep as the periosteum and is difficult to heal. When injecting, the drug solution should not leak out of the blood vessel. To do this, first use 5% glucose injection for intravenous infusion. After confirming that the infusion tube is unobstructed, slowly push the drug in from the side tube.
Others: hair loss, hematuria, elevated creatinine, decreased kidney function, fatigue, headache, etc., can be treated symptomatically. Others: hair loss, hematuria, elevated creatinine, decreased kidney function, fatigue, headache, etc., which can be treated symptomatically.
Contraindications:
Contraindicated for those allergic to this product.
Contraindicated in patients with bone marrow suppression or liver insufficiency.
Patients with poor general conditions, complications, and heart and lung insufficiency should use it with caution.
Storage:
Shade, airtight, and store in a cool place (not exceeding 20℃).
Mechanism of action:
Mitoxantrone cross-links with DNA chains and inhibits nucleic acid synthesis in tumor cells.
Through the action of mitoxantrone (L1210) on the DNA strands of leukemia cells, a rise in temperature was observed necessary for melting the DNA strands, and mitoxantrone has been proposed to form cross-links with the DNA strands. Cross-linked mitoxantrone effect, 50% uptake inhibition rate of 0.17 μmol/L (respectively 75 ng/mL) in leukemia cells with thymidine and uridine (L1210), mitoxantrone (IC 50 value), respectively 0.34 μmol/L (150ng/mL).
In addition, mitoxantrone, which inhibits DNA cleavage activity by topoisomerase-II, has been confirmed.