Multiple Sclerosis: Novantrone Therapy

Novantrone is a drug that works by suppressing the immune system to lessen its attack on the body. It can slow increases in disability and reduce the relapse rate in people with worsening forms of relapsing-remitting, progressive-relapsing, and secondary-progressive MS.

Novantrone also reduces the number of new lesions in the brain as seen on MRI.

How Is the Medication Given?

Novantrone is administered directly into a vein through an intravenous (IV) drip. The treatment may take place at a treatment center every three months.

What Happens Before Treatment?

Before treatment begins, the following tests will be given:

• Blood tests (blood cell counts and liver function tests).
• Electrocardiogram (EKG or ECG).
• Echocardiogram heart test (to determine the strength of your heart muscle).
• Height and weight.
• Education session. You will learn about pre-treatment and post-treatment medication to control nausea, when to get blood tests, and continuing treatment.

What Should My Doctor Know Before I Start Novantrone?

Tell your doctor if you have any of the following conditions:

• Dental disease
• Gout
• Heart disease*
• Infection (especially a viral infection such as chicken pox or herpes)
• Liver disease
• Recent radiation therapy*
• Allergies
• Pregnant or trying to get pregnant
• Breastfeeding
• Unusual or unexpected bleeding
• Have received chemotherapy*

Your neurologist will discuss the potential benefits and risks of Novantrone with you and your family. If you have any concerns or questions, discuss them with your doctor.

* Patients who have or have had heart disease or cancer treatment should not take Novantrone. Serious side affects could result. Your doctor should thoroughly check for warning signs before beginning your treatment with Novantrone.

What Can I Expect During Treatment?

Plan to be at the treatment center for 2 hours. During this time you will be given Novantrone through an IV drip. Wear comfortable, warm clothes.

Your nurse will check your blood pressure, pulse, and weight before treatment and will review your pre-treatment test results.

Bring something to occupy your time, such as a book.

What Can I Expect After Treatment?

Because Novantrone suppresses your immune system (the body's system for fighting illness), you will have an increased risk of infection after treatment. It's important to avoid contact with people who are sick.

Call your doctor immediately if you have any of the following symptoms:

• Fever
• Chills
• Sore throat or cough
• Sores on lips or in mouth
• Shortness of breath
• Stomach pain
• Vomiting
• Diarrhea
• Painful or difficult urination
• Uneven or rapid heartbeat
• Swollen feet or ankles
• Unusual bleeding or bruising
• Pain, swelling, redness, or irritation at the injection site

What Are Other Side Effects of Novantrone?

In addition to the possible side effects listed above, other side effects that often go away as your body adjusts to the medication include:

• A blue-green color of urine for 24 hours after receiving Novantrone.
• Mild or moderate nausea.
• Menstrual irregularities in women.
• Hair loss that may be mild to moderate (hair will usually grow back after treatment is discontinued).

Reviewed by the doctors at the Mellen Center for Multiple Sclerosis Research at The Cleveland Clinic.