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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › ANTINEOPLASTIC AGENTS › ALKYLATING AGENTS › Other alkylating agents
mitobronitol
L01AX01
Adult Dosing
- Initial: 250-500 mg daily orally
- Maintenance: 125-250 mg daily or intermittently based on hematologic response
- Course total dose typically ranges from 10 to 30 g per treatment cycle
Pediatric Dosing
- Safety and efficacy in pediatric patients not established
Indications
- Palliative treatment of chronic myeloid leukemia (CML)
- Treatment of polycythemia vera
- Management of certain advanced lymphomas and ovarian carcinomas (historical use)
Mechanism of Action
- Bifunctional alkylating agent derived from mannitol
- Undergoes non-enzymatic conversion to reactive epoxide intermediates
- Causes DNA cross-linking and inhibition of DNA synthesis, leading to cell cycle arrest and apoptosis
Contraindications
- Hypersensitivity to mitobronitol or other hexitol derivatives
- Severe bone marrow depression or pre-existing profound cytopenias
- Severe hepatic or renal impairment
- Pregnancy and lactation
Adverse Reactions
- Severe myelosuppression (leukopenia, thrombocytopenia, anemia)
- Nausea, vomiting, and anorexia
- Diarrhea and stomatitis
- Elevated liver enzymes and bilirubin
- Secondary malignancies with long-term use
Drug Interactions
- Additive bone marrow suppression with other myelotoxic chemotherapeutic agents or radiation therapy
- Decreased efficacy of vaccines due to immunosuppression
- Potential potentiation of anticoagulant effects with coumarin derivatives
Curated Content: Needs Vetting Before Put to Clinical Use