Drug interactions
Mitoxantrone + Trastuzumab
Severity: Major
Mitoxantrone and Trastuzumab: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Trastuzumab combined with an anthracenedione such as mitoxantrone increases the risk of heart failure and reduced left ventricular ejection fraction. Neutropenia may also be more frequent when trastuzumab is added to myelosuppressive chemotherapy.
What this interaction means in plain words
Mitoxantrone and Trastuzumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Mitoxantrone belongs to Central Nervous System; Trastuzumab belongs to Oncology.
Why it happens
Additive cardiotoxicity from HER2 inhibition of cardiomyocyte survival signalling combined with mitoxantrone's direct myocardial damage; additive myelosuppression also contributes.
What to do
Avoid concurrent use where possible. Assess LVEF before and periodically during therapy and monitor neutrophil counts.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mitoxantrone
Other interactions of Trastuzumab
Frequently asked questions
Can I take Mitoxantrone with Trastuzumab?
MediHelp rates the interaction as major. Mitoxantrone and Trastuzumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Trastuzumab combined with an anthracenedione such as mitoxantrone increases the risk of heart failure and reduced left ventricular ejection fraction. Neutropenia may also be more frequent when trastuzumab is added to myelosuppressive chemotherapy.
How serious is the interaction between Mitoxantrone and Trastuzumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible. Assess LVEF before and periodically during therapy and monitor neutrophil counts.
What other medicines interact with Mitoxantrone?
MediHelp also lists interactions of Mitoxantrone with, for example, Adenovirus types 4 and 7 live, Axicabtagene ciloleucel, Belatacept. The full list is on the Mitoxantrone page.
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