Example orders for Mitoxantrone (Novantrone) in prostate cancer

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

Mitoxantrone (Novantrone)

Published regimens and references can be found on the prostate cancer page.

Example order set #1

• Mitoxantrone (Novantrone) 12 mg/m² IV over 15 minutes once on day 1
• Optional: Prednisone (Sterapred) 10 mg PO once per day on days 1 to 21

21-day cycles

Supportive medications

• Prochlorperazine (Compazine) 10 mg PO once 30 minutes prior to chemotherapy

Hydration:

• Normal saline IV continuous infusion at 5 mL/H
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Monitoring/precautions:

• For mitoxantrone, be aware of the risk of potentially life-threatening treatment-related cardiotoxicity. Risk of cardiac toxicity is increased for patients with: ongoing or history of cardiovascular disease, previous or ongoing radiation therapy to the mediastinal/pericardial area, prior therapy with other anthracyclines or anthracenediones, or concurrent use of other cardiotoxic drugs. It is suggested that all patients undergo monitoring of cardiac function during therapy.

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.