Mitoxantrone

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Mitoxantrone

Examples of brand names: Novantrone [EU/DE; documented in the 2016 EMA document, current market status unresolved]

ATC code: L01DB07

Main use (for orientation): Selected malignancies and highly active relapsing multiple sclerosis when alternatives are unavailable; distinguish according to the product information

Documented research summary

CBD/CBN/THC inhibit ABCG2 in cells and alter mitoxantrone measurements when it is used as a transporter probe; laboratory finding only. CBD plus mitoxantrone produced additive or synergistic cellular antitumour effects depending on the model. No verified clinical pharmacokinetic study of the pair was found.

Uncertainties and limitations

Intravenous Fresenius mitoxantrone. ABCG2 cell findings are laboratory measurements, not predictions of drug interactions.

Shared enzymes must not be equated with clinical evidence of an interaction; CBD/THC findings cannot be extrapolated to other cannabinoids.

Separately recorded findings

5 separately recorded findings. Each statement applies to its documented study context.

CBD – laboratory and animal studies

Finding ID: B0115

Type of result: Context-specific finding; read the limitations

Observation: Accumulation and sensitivity increased in the overexpressing cells.

Mechanism: Inhibition of ABCG2/BCRP transport

Study type: In-vitro cell assay

Context studied: Overexpressing cell model; concentration dependence.

Clinical interpretation: Clinical relevance unknown

Limitations and uncertainties: No clinical chemotherapy benefit or clinical AUC increase established. Additional context from merged row B0250: overexpressing cell lines, subtoxic cannabinoid concentrations. No clinical prediction of concentration, dose or toxicity; topotecan sensitivity and mitoxantrone uptake are different endpoints. In the same study, the plant cannabinoids tested inhibited basal and substrate-stimulated ABCG2 ATPase activity; no change in ABCG2 expression was observed. Shared mechanistic study context, not additional independent evidence.

Original sources for this finding: The multidrug transporter ABCG2 (BCRP) is inhibited by plant-derived cannabinoids [ME06]

THC – laboratory and animal studies

Finding ID: B0117

Type of result: Context-specific finding; read the limitations

Observation: Accumulation and sensitivity increased in the overexpressing cells.

Mechanism: Inhibition of ABCG2/BCRP transport

Study type: In-vitro cell assay

Context studied: Overexpressing cell model; concentration dependence.

Clinical interpretation: Clinical relevance unknown

Limitations and uncertainties: No clinical chemotherapy benefit or clinical AUC increase established. Additional context from merged row B0250: overexpressing cell lines, subtoxic cannabinoid concentrations. No clinical prediction of concentration, dose or toxicity; topotecan sensitivity and mitoxantrone uptake are different endpoints. In the same study, the plant cannabinoids tested inhibited basal and substrate-stimulated ABCG2 ATPase activity; no change in ABCG2 expression was observed. Shared mechanistic study context, not additional independent evidence.

Original sources for this finding: The multidrug transporter ABCG2 (BCRP) is inhibited by plant-derived cannabinoids [ME06]

CBN – laboratory and animal studies

Finding ID: B0119

Type of result: Context-specific finding; read the limitations

Observation: Accumulation and sensitivity increased in the overexpressing cells.

Mechanism: Inhibition of ABCG2/BCRP transport

Study type: In-vitro cell assay

Context studied: Overexpressing cell model; concentration dependence.

Clinical interpretation: Clinical relevance unknown

Limitations and uncertainties: No clinical chemotherapy benefit or clinical AUC increase established. Additional context from merged row B0250: overexpressing cell lines, subtoxic cannabinoid concentrations. No clinical prediction of concentration, dose or toxicity; topotecan sensitivity and mitoxantrone uptake are different endpoints. In the same study, the plant cannabinoids tested inhibited basal and substrate-stimulated ABCG2 ATPase activity; no change in ABCG2 expression was observed. Shared mechanistic study context, not additional independent evidence.

Original sources for this finding: The multidrug transporter ABCG2 (BCRP) is inhibited by plant-derived cannabinoids [ME06]

CBD – laboratory and animal studies

Finding ID: B0252

Type of result: Preclinical in vitro

Observation: CBD increased mitoxantrone accumulation in BeWo/Jar cells.

Mechanism: BCRP-mediated transporter probe

Study type: Laboratory measurement in placental cell lines

Context studied: Short-term exposure of 1–2 h; mitoxantrone as a BCRP probe; a separate ex-vivo perfusion experiment investigated glyburide.

Clinical interpretation: NOT a prediction of drug interactions

Limitations and uncertainties: No mitoxantrone administered to pregnant women and no claim of pregnancy-related harm; the erroneous expansion of the ratio wording in the abstract was not carried over as a numerical result.

Original sources for this finding: Cannabidiol enhances xenobiotic permeability through the human placental barrier by direct inhibition of breast cancer resistance protein: an ex vivo study. [BMED23933222]

CBD – laboratory and animal studies

Finding ID: B0253

Type of result: Preclinical

Observation: Additive effect in four melanoma cell lines; synergistic effect in canine urothelial carcinoma cell lines.

Mechanism: Cellular antitumour combination effect

Study type: Cell models

Context studied: Model-dependent combination effects.

Clinical interpretation: Experimental

Limitations and uncertainties: No clinical drug–drug interaction for the pair or established cancer treatment.

Original sources for this finding: Cannabidiol Interacts Antagonistically with Cisplatin and Additively with Mitoxantrone in Various Melanoma Cell Lines-An Isobolographic Analysis. [BMED35743195]; Combination therapy with cannabidiol and chemotherapeutics in canine urothelial carcinoma cells. [BMED34352013]

References and access status

[V2_LABEL_D0453] MITOXANTRONE (MITOXANTRONE HYDROCHLORIDE) INJECTION, SOLUTION [FRESENIUS KABI USA, LLC]

Original source / bibliographic reference

Authors: Fresenius Kabi USA, LLC

Year: 2024

Source type: Official US SPL / DailyMed

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[ME06] The multidrug transporter ABCG2 (BCRP) is inhibited by plant-derived cannabinoids

Original source / bibliographic reference

Authors: Holland ML; Lau DTT; Allen JD; Arnold JC

Year: 2007

Source type: Original study: in-vitro transporters

DOI: 10.1038/sj.bjp.0707467

PMID: 17906686

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[BMED35743195] Cannabidiol Interacts Antagonistically with Cisplatin and Additively with Mitoxantrone in Various Melanoma Cell Lines-An Isobolographic Analysis.

Original source / bibliographic reference

Authors: Marzęda P, Wróblewska-Łuczka P, Drozd M, Florek-Łuszczki M, Załuska-Ogryzek K, Łuszczki JJ.

Year: 2022

Source type: Publication; title and abstract reviewed

DOI: 10.3390/ijms23126752

PMID: 35743195

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

PubMed Central – archived text

DOI – publisher access (access restrictions may apply)

[BMED34352013] Combination therapy with cannabidiol and chemotherapeutics in canine urothelial carcinoma cells.

Original source / bibliographic reference

Authors: Inkol JM, Hocker SE, Mutsaers AJ.

Year: 2021

Source type: Publication; title and abstract reviewed

DOI: 10.1371/journal.pone.0255591

PMID: 34352013

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

PubMed Central – archived text

DOI – publisher access (access restrictions may apply)

[BMED23933222] Cannabidiol enhances xenobiotic permeability through the human placental barrier by direct inhibition of breast cancer resistance protein: an ex vivo study.

Original source / bibliographic reference

Authors: Feinshtein V, Erez O, Ben-Zvi Z, Eshkoli T, Sheizaf B, Sheiner E, Holcberg G.

Year: 2013

Source type: Publication; title and abstract reviewed

DOI: 10.1016/j.ajog.2013.08.005

PMID: 23933222

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility