ミトキサントロン

使用用途

• Soft-tissue sarcomas
• Effective dose (general)
• Single rescue agent for lymphoma
• Transitional cell carcinoma
• Lymphoma, squamous cell carcinoma, transitional cell carcinoma, mammary gland tumors, etc.
• Single rescue agent for lymphoma
• Rescue agent for canine lymphoma
• Transitional cell carcinoma after laser ablation of the primary tumor

投与方法

考えられる副作用

• Dose-dependent GI distress (vomiting, anorexia, diarrhea)
• Bone marrow depression (neutropenia, sepsis; nadir typically around day 10)
• Non-regenerative anemia
• Lethargy
• Seizures (specifically noted in cats)
• Blue-green discoloration of urine and sclera (benign)
• Tissue necrosis or phlebitis (if extravasated, though less severe than doxorubicin)
• Rarely: conjunctivitis, jaundice, renal failure, allergic reactions, thrombocytopenia
• Gastrointestinal signs (vomiting, anorexia, diarrhoea)
• Bone marrow depression (WBC nadir generally at 10 days)
• Seizure activity (reported in cats)
• Blue discoloration of urine and sclera (very rare)

注意事項と禁忌

• Severe pre-existing myelosuppression
• Concurrent active infection
• Significantly impaired cardiac function
• Patients with prior extensive cytotoxic drug or radiation exposure (relative)
• Pregnancy (FDA Category D) and nursing mothers
• Pre-existing myelosuppression
• Concurrent infection
• Hepatic disease
• Impaired cardiac function
• **Handling Precautions:** Mitoxantrone is a cytotoxic agent. Strict adherence to safe handling, administration, and disposal protocols for chemotherapeutic agents is mandatory to protect veterinary personnel. **Extravasation Risk:** While generally considered an irritant rather than a severe vesicant like doxorubicin, extravasation can still cause tissue necrosis. Ensure a perfectly placed, clean IV catheter before administration. **Organ Function:** Use with caution in patients with impaired hepatic function or hyperuricemia/hyperuricuria.

薬物相互作用

• Doxorubicin, Daunorubicin, or Radiation Therapy: Cardiotoxicity risks may be enhanced in patients that have previously received these therapies to the mediastinum.
• Immunosuppressant Drugs (e.g., azathioprine, cyclophosphamide, corticosteroids): Concurrent use may significantly increase the risk of severe infection.
• Myelosuppressive Drugs (e.g., chloramphenicol, flucytosine, amphotericin B, colchicine): Additive bone marrow depression; use with extreme caution.
• Live Vaccines: Increased risk of vaccine-induced infection; should be used with extreme caution or avoided during therapy.
• Myelosuppressive agents: Increased risk of severe bone marrow depression
• Immunosuppressive agents: Increased risk of severe immunosuppression and infection
• Heparin: Chemically incompatible

よくある質問