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Mitoxantrone (Mitozantrone)

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This page tells you about the chemotherapy drug mitoxantrone (mitozantrone) and its possible side effects. There is information about


What mitoxantrone is

Mitoxantrone has the brand name mitozantrone. It is a treatment for 

  • Breast cancer that has spread
  • Non Hodgkin lymphoma
  • Leukaemia

Mitoxantrone may also be used to reduce symptoms in people with liver cancer. 

Some people have it for other types of cancer as part of clinical trials.


How mitoxantrone works

Mitoxantrone blocks an enzyme called topoisomerase 2 so the cancer cell's DNA gets tangled up and the cell can't divide. DNA is the genetic code that is in the nucleus of all animal and plant cells. It controls everything that cells do.


How you have mitoxantrone

Mitoxantrone is a dark blue liquid. You have it by drip (infusion) into a vein through a fine tube put into the vein (cannula). Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. The tube can stay in throughout your treatment.

You usually have mitoxantrone chemotherapy as a course of several cycles of treatment. The treatment plan depends on which type of cancer you have. We have detailed information about planning chemotherapy

The side effects associated with mitoxantrone are listed below. You can use the links to find out more about each side effect. Or you can go to our section about cancer drug side effects.


Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
  • Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
  • Hair thinning and loss of body hair
  • Urine may become a blue or green colour for a day or so after treatment – this won't harm you
  • Feeling or being sick may happen but is generally well controlled with anti sickness injections and tablets – if you are still being sick, tell your doctor or nurse as you can try other anti sickness medicines

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Changes in heart muscle, which are usually temporary but for a small number of people may be permanent. Your doctor will check your heart before and after your treatment
  • A sore mouth and ulcers
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising or bleeding more easily due to a drop in platelets – you may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia)
  • Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your liver is working
  • Diarrhoea – if you have diarrhoea, drink plenty of fluids and tell your doctor or nurse if it is severe or lasts more than a couple of days
  • Constipationtell your doctor or nurse if you are constipated for more than 3 days
  • Weight loss
  • Stomach pains
  • Taste changes
  • Loss of appetite
  • High uric acid levels in your blood due to cancer cells being broken down in the body. You will have regular blood tests and will need to drink plenty of fluids to flush out the uric acid
  • A feeling of the heart beating fast (palpitations)
  • Skin rashes
  • Loosening of your nails
  • Inflamed and sore eyes – your nurse can give you eye drops
  • Women may stop having periods (amenorrhoea) but this may be temporary
  • Confusion, sleepiness and anxiety
  • Inflammation around the drip siteif you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse straight away
  • Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks. It usually goes within a few months of finishing treatment

Rare side effects

Fewer than 1 in 100 people have these.

  • The whites of the eyes go slightly blue, but this is temporary – if it happens to you, you will need to stop wearing contact lenses for a while
  • Your nails may go slightly blue
  • Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
  • An increased risk of developing acute myeloid leukaemia some time after mitoxantrone treatment
  • Blood in your urine or stool – tell your doctor or nurse straight away if you have this
  • Changes in levels of substances in the blood, such as calcium, potassium and phosphate – you will have regular blood tests to check the levels
  • An allergic reaction – tell your nurse straight away if you have a sudden skin rash, breathlessness, or swelling of the eyelids, face or lips

Important points to remember

You may have a few of the side effects mentioned on this page. They may be mild or more severe. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

  • How many times you've had a drug before
  • Your general health
  • How much of the drug you have (the dose)
  • Other drugs you are having

Coping with side effects

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


Do not breastfeed during this treatment and for a month afterwards because the drug may come through in the breast milk.


Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.


Related information


More information about mitoxantrone

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at

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Updated: 2 January 2015