Indications & Dose: ACUTE MYELOID LEUKEMIA IV Adult 12mg/m2/day for 5 days. Alternatively, 12mg/m2/day for 3 days with cytarabine | ADVANCED HORMONE-REFRACTORY PROSTATE CANCER Combination therapy IV Adult 12-14mg/m2 with corticosteroids | BREAST CANCER/ LIVER CANCER/LYMPHOMAS IV Adult Initially 14mg/m2, then repeat q3wks. In debilitated patients or those who have had previous chemotherapy initial dose may reduce to 12mg/m2 | MULTIPLE SCLEROSIS IV Adult 12mg/m2 q3monthsmax lifetime cumulative dose 140mg/m2 then discontinue use with LVEF <50%

Precautions: bone marrow depression, HF, chronic debilitating illness, hepatobiliary dysfunction, elderly , children, hepatic impairment, Multiple sclerosis

ADR: Serious: HF, decreased LVEF, arrhythmias, cardiotoxicity, conjunctivitis, mucositis, seizures, renal failure, anemia, bone marrow depression, leukopenia, thrombocytopenia, hepatotoxicity, hyperuricemia, hypersensitivity reaction, hematuria, increased liver enzymes, increased BUN, creatinine, hypocalcemia, hypokalemia, hyponatremia, menorrhagia, myalgia, arthralgia, Others: headache, nausea, vomiting, diarrhea, abdominal pain, stomatitis, GI bleeding, jaundice, UTI, blue-green urine, Cough, dyspnea, rash, petechiae, bruising, alopecia, fever, systemic infection, rhinitis, pneumonia, sinusitis, back pain

DDI: Others Pimecrolimus/Denosumab/Tacrolimus/Trastuzumab increases Mitoxantrone level, Natalizumab increases risk of infections, Vaccines (Live & inactivated) levels decreases

Monitor: CBC with differential, se uric acid, vital signs, ECG, LVEF, LFT, respiratory & cardiovascular status, signs & symptoms of UTI & other infections