mitomycin at a glance
Medicine class
Cytotoxic antibiotic with alkylating activity
Main roles
Selected advanced solid tumours and prevention of superficial bladder-cancer recurrence
Administration
Given by a specialist team intravenously or through a catheter into the bladder, depending on the product and indication
What is mitomycin used for?
The selected products license mitomycin for these specialist uses:
Intravesical relapse prevention in adults with superficial urinary bladder carcinoma after transurethral tumour removal.
Palliative intravenous treatment of advanced metastatic stomach cancer and advanced or metastatic breast cancer.
Intravenous combination treatment of non-small-cell lung cancer and advanced pancreatic cancer.
How does mitomycin work?
Mitomycin is activated inside tissues to form an alkylating agent. It binds and cross-links DNA, mainly blocking DNA synthesis; dividing cells are particularly susceptible. When placed in the bladder, it acts chiefly on the bladder lining, although small amounts may enter the bloodstream.
mitomycin preparations and strengths
Injection
Route: Parenteral
Strengths: 20 mg
How to take mitomycin
Mitomycin is prepared and administered by trained healthcare professionals; it is not taken by mouth.
For bladder treatment, the bladder is emptied and mitomycin is introduced through a catheter. Follow the unit’s instructions about fluid intake beforehand.
After passing urine following bladder treatment, sit down to reduce splashing and wash your hands and genital area with soap and water.
Tell the team before treatment if you feel unwell, have urinary-infection symptoms, visible blood in the urine, difficulty passing urine or possible pregnancy.
mitomycin side effects
Common or expected effects
- Intravesical treatment: bladder irritation or cystitis, burning or pain when urinating, urinary frequency, night-time urination and blood in the urine.
- Intravesical treatment: itching, allergic rash or contact dermatitis, sometimes affecting the palms and soles.
- Systemic treatment: nausea, vomiting and bone-marrow suppression, including reduced white cells and platelets.
- Systemic treatment: rash, cough or breathlessness, and impaired kidney function.
Get urgent medical advice
- Severe infection or sepsis associated with reduced blood cells.
- Severe allergic reaction, including facial swelling or breathing difficulty.
- Lung inflammation, new or worsening breathlessness, or pulmonary vascular disease.
- Kidney injury or haemolytic uraemic syndrome, potentially with anaemia, low platelets and reduced urine output.
- Tissue injury if intravenous mitomycin leaks outside the vein.
- Persistent severe pelvic or abdominal pain after bladder instillation, which may indicate leakage, perforation, fistula or abscess.
mitomycin in pregnancy
Mitomycin can damage genetic material and may harm an embryo, so it should not be used during pregnancy unless a specialist judges treatment essential. Discuss pregnancy plans before treatment and contact the specialist team promptly if pregnancy occurs; effective contraception is required during treatment and for the product-specified period afterwards.
mitomycin while breastfeeding
Breastfeeding is contraindicated with the selected mitomycin products because of the medicine’s genotoxic and potentially carcinogenic effects. Discuss feeding alternatives with the specialist team before treatment.
mitomycin interactions
The cancer team should review all medicines and planned vaccinations. Important interactions are most relevant to systemic mitomycin.
Other bone-marrow-suppressing chemotherapy or radiotherapy
Combined treatment may increase bone-marrow suppression and requires particular caution and monitoring.
Bleomycin or vinca alkaloids
Combination may increase pulmonary toxicity.
Fluorouracil or tamoxifen
Concurrent systemic treatment has been associated with increased risk of haemolytic uraemic syndrome.
Common questions about mitomycin
Answers are fully visible for fast scanning and source review.
Is mitomycin chemotherapy?
Yes. Mitomycin is a cytotoxic antibiotic that damages DNA and prevents susceptible cancer cells from dividing.
What is the difference between intravesical and intravenous mitomycin?
Intravesical mitomycin is placed directly inside the bladder through a catheter. Intravenous mitomycin enters the bloodstream and is used for selected advanced cancers, so systemic adverse effects are more prominent.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.