Mitomycin

• Diabetic foot infections
• Chronic lymphatic leukaemia
• Chronic myelogenous leukaemia
• Gastric carcinoma
• Colorectal carcinoma
• Lung carcinoma
• Pancreatic carcinoma
• Carcinoma Cervix
• Endometrium carcinoma
• Carcinoma Breast
• Bladder carcinoma
• Head & neck carcinoma

Mitomycin is an antineoplastic antibiotic which is enzymatically reduced to its active metabolite within susceptible cells. The active metabolite appears to cause cross-linking of DNA (primarily with guanine and cytosine pairs). It is also active against gram-positive bacteria and some viruses, but its antineoplastic activity precludes its use as an antibiotic.

Adult Dose (IV - Solid Tumours): Initial: 10-20 mg/m²; may repeat 6-8 weekly depending on blood count. Do not repeat if leucocyte and platelet counts are below acceptable levels. Do not re-administer if nadir of leucocyte count is <2,000 cells/mm³.

Adult Dose (Intravesical - Superficial Bladder Tumours): Instill 10-40 mg 1-3 times/week for a total of 20 doses.

Prevention of Recurrent Bladder Tumours: Instill 20 mg every 2 weeks or 40 mg every 1-3 months.

Renal Dose: Serum creatinine >1.7 mg/dL: Avoid use; CrCl <10 mL/min: Decrease dose by 25%; CAPD: Decrease dose by 25%.

Common Side Effects (>10%):

• Hemolytic uremic syndrome (<15%)
• Myelosuppression (64%)
• Nausea/vomiting (14%)
• Fever (14%)

Less Common Side Effects (1-10%):

• Stomatitis (4%)
• Increased serum creatinine (2%)
• Mucous membrane toxicity (4%)

Other Side Effects: Fatigue, Pulmonary toxicity, Dyspnea, Cystitis, Interstitial fibrosis, Nephrotoxicity, Amenorrhea, Alopecia.

Potentially Fatal: Myelosuppression, haemolytic-uraemic syndrome.

Pregnancy Category D. May cause fetal harm during pregnancy. Contraindicated during pregnancy and lactation.

• Repeated haematologic studies are necessary during treatment and for at least 7 weeks after discontinuation of the drug.
• Discontinue use when the leucocyte count decreases to <4000/mm³ or the platelet count decreases to <150,000/mm³ or if a progressive decline in either occurs.
• Monitor patient for signs of renal or pulmonary toxicity.
• Caution in thrombocytopenia, coagulation disorders, increased bleeding tendency, renal impairment, and potentially severe infections.

Crystalline Mitomycin-C overdose symptoms include severe myelosuppression, nausea, vomiting, and mucositis. In case of overdose, symptomatic and supportive treatment should be given.

Keep out of reach of children. Store in a cool and dry place.