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How does Novantrone help treat multiple sclerosis (MS)?

Novantrone (mitoxantrone) is a chemotherapy drug used to treat worsening relapsing-remitting (characterized by clearly defined acute attacks), progressive relapsing or secondary progressive multiple sclerosis (MS)—progression of disability from the onset. Novantrone, like other chemotherapy drugs, suppresses the division and reproduction of many cells in the immune system. This drug is administered four times a year by intravenous (IV) infusion until a maximum cumulative lifetime dosage is reached. Chemotherapy for MS is administered at a lower dosage than chemotherapy for cancer, so side effects are usually less severe. During Novantrone therapy, a prior disease-modifying therapy may or may not be continued.

Those treating their multiple sclerosis (MS) with Novantrone should be aware of recommendations regarding heart health issued from the Food and Drug Administration (FDA).

Since 2005, the agency has recommended that people taking Novantrone (mitoxantrone) be evaluated for a heart condition called left ventricular ejection fraction (LVEF) both before their first treatment and prior to each subsequent infusion.

LVEF and congestive heart failure have been associated with people whose cumulative dose of Novantrone was less than 100 mg/m2. The maximum lifetime cumulative dose for Novantrone for people with MS is 140 mg/m2, or 8 to 12 doses in two to three years.

Those people who have finished treatment with Novantrone also should be evaluated yearly to detect cardiac problems.

Most side effects are temporary. In clinical trials, the most common side effects were nausea, hair thinning, ceasing of menstrual periods, bladder infections, temporary changes in Pap smear results, and mouth sores. The urine and whites of the eyes may turn a blue-green color for 24 hours after administration.

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