No evidence of CYP-metabolism. Mitoxantrone is not listed as a CYP inducer, and only as a weak inhibitor of CYP3A4. No observations of interference with CYP-metabolism of other drugs. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Mitoxantrone is an anthracenedione antineoplastic structurally related to doxorubicin.

Mitoxaantrone is used alone or with other agents in the treatment of metastatic breast cancer, non-Hodgkins lymphomas, adult acute myeloid leukaemias, hormone-refractory prostate cancer, liver cancer and ovarian cancer. It is administered intravenously. Common adverse reactions of mitoxantrone that can be confused with an acute porphyric attack are nausea, abdominal pain, obstipation and vomiting. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

The precise metabolic pathways of mitoxantrone have not been determined. Excreted in bile and urine, to large extent un-metabolized. In vitro drug interaction studies have demonstrated that mitoxantrone did not inhibit CYP450 1A2, 2A6, 2C9, 2C19, 2D6, 2E1 and 3A4 across a broad concentration range (Norwegian SPC), however it is listed as a weak inhibitor of CYP3A4 by Zhou (2007). No significant drug interactions have been seen in patients who have received Mitoxantrone for treatment of cancer.

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