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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Mitoxantrone - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Mitoxantrone">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2024/07/15">
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<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK501033/">
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<meta name="citation_keywords" content="mitoxantrone">
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<meta name="citation_keywords" content="Mitoxanthrone">
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<meta name="citation_keywords" content="Mitozantrone">
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<meta name="citation_keywords" content="Mitoxantron">
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<meta name="citation_keywords" content="Novantron">
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<meta name="citation_keywords" content="DHAQ">
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<meta name="citation_keywords" content="Dihydroxyanthraquinone">
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<meta name="citation_keywords" content="Mitoxantrona">
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<meta name="citation_keywords" content="Mitoxantronum">
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<meta name="citation_keywords" content="1,4-dihydroxy-5,8-bis[2-(2-hydroxyethylamino)ethylamino]anthracene-9,10-dione">
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<meta name="description" content="Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.[1,2] It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration of abstinence is not clear. In one patient, mitoxantrone was still detectable in milk 28 days after a dose of 6 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[3] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.[4]">
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<meta name="og:description" content="Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.[1,2] It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration of abstinence is not clear. In one patient, mitoxantrone was still detectable in milk 28 days after a dose of 6 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[3] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.[4]">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501033_"><span class="title" itemprop="name">Mitoxantrone</span></h1><p class="fm-aai"><a href="#_NBK501033_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 1 minute</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 65271-80-9</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/135007017" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135007017" alt="image 135007017 in the ncbi pubchem database" /></a><div id="LM185.Drug_Levels_and_Effects"><h2 id="_LM185_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM185.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.[<a class="bibr" href="#LM185.REF.1" rid="LM185.REF.1">1</a>,<a class="bibr" href="#LM185.REF.2" rid="LM185.REF.2">2</a>] It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration of abstinence is not clear. In one patient, mitoxantrone was still detectable in milk 28 days after a dose of 6 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[<a class="bibr" href="#LM185.REF.3" rid="LM185.REF.3">3</a>] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.[<a class="bibr" href="#LM185.REF.4" rid="LM185.REF.4">4</a>]</p></div><div id="LM185.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> A woman treated with mitoxantrone, etoposide and cytarabine for promyelocytic leukemia received 3 daily mitoxantrone doses of 6 mg per square meter intravenously. A mitoxantrone milk level of 120 mcg/L occurred immediately after the third dose. Milk mitoxantrone level dropped to a plateau value of about 20 mcg/L by 7 days after the third dose and remained at 18 mcg/L at 28 days after the last dose.[<a class="bibr" href="#LM185.REF.5" rid="LM185.REF.5">5</a>]</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM185.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>One mother received 3 daily doses of 6 mg/sq. m. of mitoxantrone intravenously along with 5 daily doses of etoposide 80 mg/sq. m. and cytarabine 170 mg/sq. m. intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age.[<a class="bibr" href="#LM185.REF.5" rid="LM185.REF.5">5</a>]</p></div><div id="LM185.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM185.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p>(Multiple Sclerosis) <a href="/books/n/lactmed/LM306/?report=reader">Glatiramer</a>, <a href="/books/n/lactmed/LM555/?report=reader">Immune Globulin</a>, <a href="/books/n/lactmed/LM307/?report=reader">Interferon Beta</a></p></div><div id="LM185.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM185.REF.1">Pistilli
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B, Bellettini
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G, Giovannetti
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E, et al.
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Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding?
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Cancer Treat Rev
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2013;39:207-11
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[<a href="https://pubmed.ncbi.nlm.nih.gov/23199900" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23199900</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM185.REF.2">Almas
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S, Vance
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J, Baker
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T, et al.
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Management of multiple sclerosis in the breastfeeding mother.
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Mult Scler Int
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2016;2016:6527458
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[<a href="/pmc/articles/PMC4757692/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4757692</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26966579" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26966579</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM185.REF.3">Urbaniak
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C, McMillan
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A, Angelini
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M, et al.
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Effect of chemotherapy on the microbiota and metabolome of human milk, a case report.
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Microbiome
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2014;2:24
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[<a href="/pmc/articles/PMC4109383/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4109383</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25061513" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25061513</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM185.REF.4">Stopenski
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S, Aslam
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A, Zhang
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X, et al.
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After chemotherapy treatment for maternal cancer during pregnancy, is breastfeeding possible?
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Breastfeed Med
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2017;12:91-7
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[<a href="https://pubmed.ncbi.nlm.nih.gov/28170295" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28170295</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM185.REF.5">Azuno
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Y, Kaku
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K, Fujita
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N, et al.
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Mitoxantrone and etoposide in breast milk.
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Am J Hematol
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1995;48:131-2
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[<a href="https://pubmed.ncbi.nlm.nih.gov/7847330" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7847330</span></a>]</div></dd></dl></dl></div></div><div id="LM185.Substance_Identification"><h2 id="_LM185_Substance_Identification_">Substance Identification</h2><div id="LM185.Substance_Name"><h3>Substance Name</h3><p>Mitoxantrone</p></div><div id="LM185.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>65271-80-9</p></div><div id="LM185.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Antineoplastic Agents</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501033_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">July 15, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Mitoxantrone. [Updated 2024 Jul 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM554/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM857/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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