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Mitomycin

(my-toe-my-sin)

Trade/other name(s): Mitomycin C, Mutamycin

Why would this drug be used?

Mitomycin is used to treat stomach, colon, rectal, and pancreatic cancers. It may also be used for certain types of breast, head, neck, cervical, and lung cancer.

How does this drug work?

Mitomycin is part of a general group of chemotherapy drugs known as antibiotics, but it acts as an alkylating agent. It stops cells from making DNA, which results in cell death.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you have any bleeding disorder (such as hemophilia or von Willebrand's disease), or if you tend to bleed more freely than others.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine.
  • If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Any drugs or supplements that interfere with blood clotting can raise the risk of bleeding during treatment with mitomycin. These include:

  • vitamin E
  • non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and many others
  • warfarin (Coumadin)
  • ticlopidine (Ticlid)
  • clopidogrel (Plavix)

Note that many cold, flu, fever, and headache remedies contain aspirin or ibuprofen. Ask your pharmacist if you aren't sure what's in the medicines you take.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Mitomycin is given into a vein over 20 minutes once every 6 to 8 weeks, or at the intervals prescribed by your doctor. Tell the nurse right away if you notice pain, burning, swelling, or redness in or near the vein while it is given. The dose and how often you get the medicine depends on your weight, your blood counts, how well your kidneys are working, and the type of cancer being treated. Your blood counts will be checked before each treatment; if they are too low, your treatment will be delayed.

This medicine may be given along with other chemotherapy medicines. You will get medicine to stop any nausea or vomiting before the mitomycin, and to take afterward.

Precautions

This drug is given into the vein (IV). If the drug leaks out of the vein and under the skin, it may damage the tissue, causing pain, ulceration, and scarring. Rarely this has been severe enough to require skin grafts. Tell the nurse right away if you notice redness, pain, or swelling at or near the IV.

Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. Mitomycin may affect your immune system. This could make vaccinations ineffective, or even lead to serious infections if you get a live virus vaccine during or soon after treatment. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor.

A few people have lung problems while on this drug. If you notice shortness of breath or cough while you are on mitomycin, talk with your doctor right away.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • decreased white blood cell count with increased risk of infection*
  • decreased platelet count with increased risk of bleeding*
  • tiredness (fatigue)
  • hair loss, including face and body hair

Less common

  • sores in mouth or on lips
  • fever
  • loss of appetite
  • nausea*
  • vomiting*

Rare

  • inflammation of lungs with cough, trouble breathing, pneumonia, or coughing up blood*
  • kidney damage
  • inflammation or ulceration at the injection site where the drug was given*
  • kidney failure due to hemolytic uremic syndrome
  • heart damage with congestive heart failure
  • death due to infection, hemolytic uremic syndrome, or other cause

*See "Precautions" section for more detailed information.

Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved before 1984 (FDA cannot verify dates of drugs approved before 1984.)

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 01/12/2010
Last Revised: 01/12/2010