Intravenously slowly for 3-5 minutes or intravenously drip for 15-30 minutes.
Intrathecal administration of the drug is prohibited!
Mitoxantrone is a part of many chemotherapy regimens, therefore, when choosing the regimen and doses in each individual case, one should be guided by the literature data.
With monotherapy for breast cancer, non-Hodgkin's lymphomas and liver cancer the recommended dose is 14 mg / m2 body surface 1 every 3 weeks. In patients who previously received chemotherapy, as well as when combined with other chemotherapeutic agents, the dose is reduced to 10-12 mg / m2. With repeated courses, the dose of mitoxantrone is selected taking into account the degree of severity and duration of oppression of bone marrow hematopoiesis. In the case of a decrease in the number of neutrophils <1500 / μl and / or platelets <50000 / μl in previous courses, the dose of mitoxantrone is reduced by 2 mg / m2, with a decrease in the number of neutrophils <1000 / μL and / or platelets <25,000 / μL of blood, subsequent doses are reduced by 4 mg / m2.
When treating acute non-lymphoblastic leukemia in adults for induction of remission mitoxantrone prescribe in a dose of 10-12 mg / m2 daily for 2-3 days in combination with cytarabine. A detailed description of the regimens of combined chemotherapy is presented in the literature. It is possible to use high doses of mitoxantrone 14 mg / m2 and more daily for 3 days.
For treatment of hormone-resistant prostate cancer mitoxantrone prescribe in a dose of 12-14 mg / m2 1 every 21 days in combination with daily intake of low doses of glucocorticosteroids (prednisolone 10 mg / day or hydrocortisone 40 mg / day).
The maximum total dose Mitoxantrone-LENS® with intravenous administration - 200 mg / m2.
With metastatic pleural lesions mitoxantrone can be administered intrapleural, with the recommended dose being 20-30 mg. Before beginning instillation should, if possible, pleural exudate. The time of finding the drug in the pleural cavity is 48 hours, during which the patient should move as much as possible to ensure optimal intrapleural distribution of the drug. After 48 hours, the pleural cavity is re-drained, in order to remove the possible effusion. If the amount of effusion is less than 200 ml, the first treatment cycle is stopped.With an effusion volume exceeding 200 ml, a repeated instillation of 30 mg of Mitoxantrone-LENS® is prescribed. Before carrying out the repeated instillation of the drug, hematological parameters should be monitored. After carrying out the repeated instillation, it is necessary to remove mitoxantrone from a pleural cavity is not present. The maximum dose for one treatment cycle is 60 mg of Mitoxantrone-LENS®. With normal leukocyte and platelet counts, intrapleural instillation of mitoxantrone (2nd cycle) can be repeated after 4 weeks.
For 4 weeks before and 4 weeks after intrapleural administration of Mitoxantrone-LENS®, systemic therapy with cytostatic agents should be avoided.
Instructions for preparing a solution for intravenous and intrapleural administration
Before use, the Mitoxantrone-LENS® vial should be visually assessed for sediment and discoloration.
Immediately before intravenous administration, the required amount of concentrate is diluted in at least 50 ml of a 0.9% solution of sodium chloride or a 5% solution of dextrose. For intrapleural administration, the mitoxantrone concentrate is diluted in a 0.9% solution of sodium chloride untilconcentration of 2 mg / 1 ml.
Diluted solution should be used immediately after preparation.