Mitoxantrone for multiple sclerosis
Provided by: Healthwise
Last Updated: March 23, 2004
Examples
Brand Name Chemical Name
Novantrone mitoxantrone
How It Works
Mitoxantrone (Novantrone) is an immunosuppressant, a type of medication that reduces the activity of the immune system. It has been used to treat leukemia and some advanced prostate cancer. Since multiple sclerosis (MS) appears to be a disease in which the immune system attacks the covering of the nerves (myelin sheath) within the brain and spinal cord, immunosuppressants may slow the progression of the disease. Immunosuppressants other than mitoxantrone, however, have not been shown to significantly reduce the progression of MS or the frequency of relapses.
Mitoxantrone may be injected once every 3 months for up to 3 years. A higher total dose increases the risk of serious heart damage and is not recommended by the U.S. Food and Drug Administration (FDA).
Why It Is Used
The FDA approved mitoxantrone for treatment of several forms of advancing MS, including secondary progressive MS, progressive relapsing MS, and advanced relapsing-remitting MS.
Mitoxantrone (Novantrone) is one of only two medications that have been shown to benefit people with secondary progressive MS; the interferon beta medication Betaseron is the other. Betaseron will likely remain the first choice for treating secondary progressive MS because it does not carry the risk of heart damage associated with Novantrone. Novantrone may be tried if you develop severe side effects from Betaseron, cannot take the medication for some other reason, or continue to have active disease.
How Well It Works
Mitoxantrone reduces the frequency of relapses, the number of new MS lesions on the brain and spinal cord, and helps slow the development of disability in people with secondary progressive, progressive relapsing, or advanced relapsing-remitting MS. 1, 2
Side Effects
Use of mitoxantrone may cause serious, even fatal, heart damage in some people. It also can cause bone marrow problems. Frequent tests are needed to monitor heart function while taking this medication. To reduce the risk of heart damage associated with the medication, you should receive only a limited number of doses—the FDA recommends up to 12 total doses. Typically, the medication is injected once every 3 months for 2 to 3 years.
Common but less serious side effects of mitoxantrone include:
* Nausea.
* Hair loss.
* Increased risk of infections, especially urinary tract infections.
* Changes in a woman's menstrual cycle.
* Mouth sores.
* Diarrhea or constipation.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Due to safety concerns and the limitations on its use, mitoxantrone is for the most part being used only in specialized MS clinics or centers staffed by neurologists and other health professionals who specialize in treating people with MS.
As with interferon beta, people who are taking mitoxantrone need to have regular blood tests to monitor white and red blood cell counts and liver function. These are in addition to the regular testing needed to monitor heart function. Mitoxantrone is not recommended for people who already have heart disease, liver problems, or certain blood disorders because it may make these problems worse.
Mitoxantrone should not be used during pregnancy. If you become pregnant while you are taking this medication, contact your doctor immediately.
Complete the new medication information form (PDF) Click here to view a form. (What is a PDF document?) to help you understand this medication.
References
Citations
1.
Halmi KA (2003). Eating disorders: Anorexia nervosa, bulimia nervosa, and obesity. In RE Hales, SC Yudofsky, eds., Texbook of Clinical Psychiatry, 4th ed., chap. 22, pp. 1001–1021. Washington, DC: American Psychiatric Publishing.
2.
Bogglid M, Ford H (2003). Multiple sclerosis. Clinical Evidence (9): 1459–1473.
Credits
Author Dana L. Rowett
Editor Renée Spengler, RN, BSN
Associate Editor Lila Havens
Associate Editor Tracy Landauer
Primary Medical Reviewer Jesse Sandoval, DO
- Internal Medicine
Specialist Medical Reviewer Barrie J. Hurwitz, MD
- Neurology
Last Updated March 23, 2004
Author: Dana L. Rowett
Medical Review: Jesse Sandoval, DO - Internal Medicine
Barrie J. Hurwitz, MD - Neurology
Last Updated: March 23, 2004
© 1995-2006, Healthwise, Incorporated, P.O. Box 1989, Boise, ID 83701. ALL RIGHTS RESERVED.
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. For more information, click here. Privacy Policy. How this information was developed.
http://health.yahoo.com/topic/ms/medications/article/healthwise/tf4627
Provided by: Healthwise
Last Updated: March 23, 2004
Examples
Brand Name Chemical Name
Novantrone mitoxantrone
How It Works
Mitoxantrone (Novantrone) is an immunosuppressant, a type of medication that reduces the activity of the immune system. It has been used to treat leukemia and some advanced prostate cancer. Since multiple sclerosis (MS) appears to be a disease in which the immune system attacks the covering of the nerves (myelin sheath) within the brain and spinal cord, immunosuppressants may slow the progression of the disease. Immunosuppressants other than mitoxantrone, however, have not been shown to significantly reduce the progression of MS or the frequency of relapses.
Mitoxantrone may be injected once every 3 months for up to 3 years. A higher total dose increases the risk of serious heart damage and is not recommended by the U.S. Food and Drug Administration (FDA).
Why It Is Used
The FDA approved mitoxantrone for treatment of several forms of advancing MS, including secondary progressive MS, progressive relapsing MS, and advanced relapsing-remitting MS.
Mitoxantrone (Novantrone) is one of only two medications that have been shown to benefit people with secondary progressive MS; the interferon beta medication Betaseron is the other. Betaseron will likely remain the first choice for treating secondary progressive MS because it does not carry the risk of heart damage associated with Novantrone. Novantrone may be tried if you develop severe side effects from Betaseron, cannot take the medication for some other reason, or continue to have active disease.
How Well It Works
Mitoxantrone reduces the frequency of relapses, the number of new MS lesions on the brain and spinal cord, and helps slow the development of disability in people with secondary progressive, progressive relapsing, or advanced relapsing-remitting MS. 1, 2
Side Effects
Use of mitoxantrone may cause serious, even fatal, heart damage in some people. It also can cause bone marrow problems. Frequent tests are needed to monitor heart function while taking this medication. To reduce the risk of heart damage associated with the medication, you should receive only a limited number of doses—the FDA recommends up to 12 total doses. Typically, the medication is injected once every 3 months for 2 to 3 years.
Common but less serious side effects of mitoxantrone include:
* Nausea.
* Hair loss.
* Increased risk of infections, especially urinary tract infections.
* Changes in a woman's menstrual cycle.
* Mouth sores.
* Diarrhea or constipation.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Due to safety concerns and the limitations on its use, mitoxantrone is for the most part being used only in specialized MS clinics or centers staffed by neurologists and other health professionals who specialize in treating people with MS.
As with interferon beta, people who are taking mitoxantrone need to have regular blood tests to monitor white and red blood cell counts and liver function. These are in addition to the regular testing needed to monitor heart function. Mitoxantrone is not recommended for people who already have heart disease, liver problems, or certain blood disorders because it may make these problems worse.
Mitoxantrone should not be used during pregnancy. If you become pregnant while you are taking this medication, contact your doctor immediately.
Complete the new medication information form (PDF) Click here to view a form. (What is a PDF document?) to help you understand this medication.
References
Citations
1.
Halmi KA (2003). Eating disorders: Anorexia nervosa, bulimia nervosa, and obesity. In RE Hales, SC Yudofsky, eds., Texbook of Clinical Psychiatry, 4th ed., chap. 22, pp. 1001–1021. Washington, DC: American Psychiatric Publishing.
2.
Bogglid M, Ford H (2003). Multiple sclerosis. Clinical Evidence (9): 1459–1473.
Credits
Author Dana L. Rowett
Editor Renée Spengler, RN, BSN
Associate Editor Lila Havens
Associate Editor Tracy Landauer
Primary Medical Reviewer Jesse Sandoval, DO
- Internal Medicine
Specialist Medical Reviewer Barrie J. Hurwitz, MD
- Neurology
Last Updated March 23, 2004
Author: Dana L. Rowett
Medical Review: Jesse Sandoval, DO - Internal Medicine
Barrie J. Hurwitz, MD - Neurology
Last Updated: March 23, 2004
© 1995-2006, Healthwise, Incorporated, P.O. Box 1989, Boise, ID 83701. ALL RIGHTS RESERVED.
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. For more information, click here. Privacy Policy. How this information was developed.
http://health.yahoo.com/topic/ms/medications/article/healthwise/tf4627
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