Mitocin

Indications

Mitomycin is an anticancer medicine. Given by injection or infusion, it is used for some cancers of the stomach, pancreas, anus, breast and other organs, usually with other treatments. It is also put directly into the bladder to treat or prevent the return of superficial bladder cancer. In eye surgery (for example glaucoma or pterygium surgery), a small amount is applied during the operation to reduce scarring.

How It Works

Mitomycin is an antitumour antibiotic. Once activated inside cells, it links the two strands of DNA together so they cannot separate. Cells then cannot copy their DNA or divide, which stops cancer cells and scar-forming cells from growing.

Dosage and Administration

Mitomycin is given only by doctors or nurses in hospital, by injection into a vein, by a tube into the bladder, or by an eye surgeon during an operation. The dose and schedule depend on the type of treatment, body size and blood counts, and are given as prescribed. After bladder instillation, you may be asked to hold urine for a set time and to drink fluids afterwards.

Interactions

• Other anticancer medicines and radiotherapy increase the risk of low blood counts.
• Vinca alkaloids such as Vinblastine can increase lung side effects.
• Live vaccines should be avoided during treatment.
• Tell the team about all medicines, including blood thinners such as Warfarin.

Contraindications

• Allergy to mitomycin.
• Very low blood counts or a serious bleeding problem.
• Severe kidney failure for injection use.
• For bladder use: a hole in the bladder wall or active bladder infection.
• Pregnancy and breastfeeding.

Side Effects

Injection: low white cells and platelets (often delayed), nausea, vomiting, mouth sores, hair thinning, tiredness, and pain or skin damage if it leaks from the vein. Rare but serious: lung scarring and a kidney and blood disorder called haemolytic uraemic syndrome. Bladder use: burning on passing urine, frequent urination, blood in urine and skin rash. Eye use: eye irritation and slow wound healing.

Get urgent medical help for fever or signs of infection, unusual bleeding or bruising, breathlessness or cough, passing very little urine, swelling, or severe pain at the injection site.

Pregnancy and Lactation

Mitomycin can harm an unborn baby. Use reliable contraception during treatment and for some months afterwards, as advised by the specialist. Do not breastfeed during treatment.

Precautions and Warnings

• Blood counts and kidney function are checked regularly.
• After bladder treatment, sit to pass urine and wash the genital area and toilet well for the time advised, to avoid skin contact with the medicine.
• Report cough or breathlessness early.

Overdose

Overdose is unlikely as it is given in hospital. It can cause severe bone marrow suppression; the medical team gives supportive care.

Therapeutic Class

Antineoplastic; cytotoxic antitumour antibiotic (alkylating-type).

Storage

Hospital medicine: store as directed on the pack, usually below 25°C, protected from light. Keep out of the reach of children.