Can you take mitoxantrone while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone. 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. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.
Quoted from Mitoxantrone — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised July 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of mitoxantrone. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Glatiramer
- Immune Globulin
- Interferon Beta
How much mitoxantrone gets into breastmilk
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.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
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.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take mitoxantrone while breastfeeding?
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of mitoxantrone while breastfeeding?
LactMed lists Glatiramer, Immune Globulin, Interferon Beta as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does mitoxantrone pass into breastmilk?
LactMed's measured drug levels for mitoxantrone are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking mitoxantrone?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on mitoxantrone
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.