When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to mitoxantrone, or if you are pregnant or breastfeeding.

How to Use This Medicine:
Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• If this medicine gets on your skin, rinse the area well with warm water and tell your doctor. If the medicine gets in your eyes, rinse your eyes with large amounts of water, and tell your doctor.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Tell your doctor about all other medicines you are using, radiation treatment, and all other cancer medicines you have received in the past.
• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. Your doctor may require you to have a pregnancy test before you receive each dose of this medicine, to make sure you are not pregnant.
• Make sure your doctor knows if you have liver disease, anemia, blood clotting problems, bone marrow problems, low white blood cell counts, bleeding problems, or any kind of infection. Also, tell your doctor if you have had cancer treatment or radiation in the past.
• Make sure your doctor knows if you have heart or blood vessel disease, congestive heart failure, or any type of swelling (such as in your ankles, feet, or hands). Your doctor may need to check your heart function before you start using this medicine.
• If you have pain, burning, redness, or swelling of your skin area where the IV needle is placed, tell your doctor right away.
• This medicine may change the color of your urine to bluish-green. The whites of your eyes may also appear slightly bluish-green. This is normal, especially within the first 24 hours after you receive the medicine.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments. Your doctor may also want to check your heart while you are using this medicine.
• Cancer medicine can cause nausea or vomiting, sometimes even after you receive medicine to prevent these effects. Ask your doctor or nurse about other ways to control any nausea or vomiting that might happen.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Burning, pain, swelling, or bruising of your skin where the needle is placed.
• Fever, chills, cough, runny or stuffy nose, sore throat, and body aches.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Pain or burning when you urinate, change in how much or how often you urinate.
• Pain or redness at the place of injection.
• Rapid weight gain.
• Shortness of breath, cold sweat, and bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Uncontrollable nausea, vomiting, or diarrhea.
• Uneven heartbeats.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Back pain, bone pain.
• Blue skin at the place of injection.
• Changes in your menstrual periods.
• Depressed mood.
• Hair loss.
• Headache.
• Mild nausea, constipation, diarrhea, heartburn, vomiting, or stomach pain or upset.
• Sores or white patches on your lips, mouth, or throat.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088