Drug reference

Mitomycin

Antineoplastic

Also known as Mitomycin C

AntineoplasticATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 12 →

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Mechanism

Mitomycin is a cytotoxic antibiotic that interferes with the growth and replication of cancer cells.

Indications

Gastro-intestinal cancerBreast cancerNon-small cell lung cancerMetastatic pancreatic cancerSuperficial bladder tumoursStomach cancerAnal cancerAnal cancer (in combination with 5FU and cisplatin)Superficial transitional cell carcinomas (direct instillation into bladder)Adjunct to glaucoma surgery (to reduce scarring)conjunctival tumorsglaucoma surgery (to prevent scarring)pterygium surgery (to decrease recurrence)corneal scarring and surface ablation surgery (to reduce risk of scarring)

Dosing

Adult: (consult product literature or local protocols) for intravenous injection, intravenous infusion, intra-arterial infusion, local infiltration, and intravesical instillation

Pharmacokinetics

Half-life

25 to 90 min

Protein binding

Distributes widely throughout the body but is not detected in the CNS.

Metabolism

Inactivation occurs by hepatic metabolism or chemical conjugation with sulfhydryls.

Excretion

Less than 10% of the active drug is excreted in the urine or the bile.

Side effects

Common

Micturition disorders (with bladder instillation)Reduction in bladder capacity (with bladder instillation)Myelosuppression (marked leukopenia and thrombocytopenia)NauseaVomitingDiarrheaStomatitisRashFeverMalaise

Serious

Delayed bone marrow toxicity
Myelosuppression (maximal suppression may be delayed and cumulative after higher doses, recovery only after 6 to 8 weeks of pancytopenia)
Acute hemolysis (after >50 mg/m2 total dose)
Neurological abnormalities (after >50 mg/m2 total dose)
Interstitial pneumonia (after >50 mg/m2 total dose)
Glomerular damage resulting in renal failure (after >50 mg/m2 total dose, incidence 28% for total doses ≥70 mg/m2)
Interstitial pulmonary fibrosis
Congestive heart failure (infrequently with total doses >30 mg/m2)
thin, ischemic, avascular tissue prone to breakdown
leaks causing hypotony
increased risk of infection
limbal stem cell deficiency
corneal or scleral melt