Is Mitoxantrone safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Mitoxantrone. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.[1,2] It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration of abstinence is not clear. In one patient, mitoxantrone was still detectable in milk 28 days after a dose of 6 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[3] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.[4]
Effects on the breastfed infant
One mother received 3 daily doses of 6 mg/sq. m. of mitoxantrone intravenously along with 5 daily doses of etoposide 80 mg/sq. m. and cytarabine 170 mg/sq. m. intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age.[5]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A woman treated with mitoxantrone, etoposide and cytarabine for promyelocytic leukemia received 3 daily mitoxantrone doses of 6 mg per square meter intravenously. A mitoxantrone milk level of 120 mcg/L occurred immediately after the third dose. Milk mitoxantrone level dropped to a plateau value of about 20 mcg/L by 7 days after the third dose and remained at 18 mcg/L at 28 days after the last dose.[5]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Mitoxantrone” (LM185). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.