Mitoxantrone: what it treats, how it's given, side effects
Last updated September 7, 2026.
**Mitoxantrone is an intravenous chemotherapy medicine in the anthracenedione class.** It interferes with DNA and suppresses immune cells. Your main safety concern is heart damage, which can develop during treatment or years afterward.
What does it treat?
You may receive it for secondary progressive, progressive relapsing, or worsening relapsing-remitting multiple sclerosis (MS), with accumulating disability or persistent problems between attacks. It is not indicated for primary progressive MS. It also treats pain from advanced prostate cancer resistant to hormone treatment, alongside corticosteroids, and acute nonlymphocytic leukemia, alongside drugs such as cytarabine.
How do you take it?
Your specialist gives diluted liquid through an IV. Adult label doses are 12 mg/m² every 3 months for MS, 12 to 14 mg/m² every 21 days with corticosteroids for prostate cancer, or 12 mg/m² daily on days 1 through 3 with cytarabine for leukemia induction. These doses use your body surface area; there is no universal daily ceiling. For MS, your lifetime limit is 140 mg/m². Eat normally unless instructed otherwise. Call to reschedule a missed infusion. Report fever or new swelling before another dose; report IV burning immediately so staff can stop the infusion.
Side effects to know
- Common: You may have nausea, mouth sores, fatigue, hair thinning, menstrual changes, or temporarily blue-green urine.
- Serious: Pause further treatment and get immediate medical advice for fever, unusual bleeding, or new ankle swelling, which can signal blood cell suppression or heart failure. Treatment also increases your risk of developing acute myeloid leukemia.
Who should not take it?
Do not receive it after an allergy to mitoxantrone or its ingredients; report sulfite sensitivity. Discuss heart disease, liver disease, infection, low blood counts, previous chest radiation, and chemotherapy. For MS, reduced heart pumping function can rule out treatment. Tell your doctor about pregnancy or breastfeeding before treatment, and discuss alcohol and all medicines.
When is it an emergency?
Call 911 for collapse, breathing trouble, or throat swelling suggesting anaphylaxis. Suspected overdose needs immediate help even without symptoms: call Poison Control at 1-800-222-1222 and your treatment team. Fever, chills, or unusual bleeding can indicate severe blood cell suppression. Report painful or swollen IV skin immediately because leakage can damage tissue.
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Common questions
What is the maximum dose?
For MS, your lifetime total must not exceed 140 mg/m². Your clinician tracks every dose. Heart changes can require stopping sooner.
Can I drink alcohol?
The label gives no specific alcohol allowance. Ask your treatment team before drinking. Your liver tests and other medicines guide that advice.
What about pregnancy and breastfeeding?
Mitoxantrone can harm your unborn baby, so use effective birth control. For MS, you need a pregnancy test before every dose even with contraception. Stop breastfeeding before treatment and ask when you can safely restart.
Do I need to fast?
You can usually eat normally. Food does not control absorption because you receive it intravenously. Follow any separate instructions from your infusion center.
What are overdose signs?
You may develop fever, infection, or unusual bleeding from severely reduced blood counts. Symptoms can be delayed. Call Poison Control at 1-800-222-1222 immediately for suspected overdose.
Which interactions matter?
Tell your specialist about previous doxorubicin or daunorubicin. Other medicines that damage the heart can increase your risk. Check with your team before vaccinations.