Mitem (Mitomycin)

Mitomycin is used as a chemotherapy agent that interferes with DNA synthesis in malignant cells.

• Bladder cancer: improves local disease control when administered intravesically after tumour resection.
• Gastric cancer: contributes to tumour shrinkage as part of combination regimens.
• Pancreatic cancer: adds cytotoxic effect in multi‑drug protocols.
• Esophageal cancer: enhances response rates when combined with radiotherapy.

• Mitomycin acts as a DNA cross‑linking alkylating agent. After intracellular activation, it forms covalent bonds between DNA strands, preventing replication and transcription. This DNA damage triggers cell‑cycle arrest and apoptosis, preferentially affecting rapidly dividing cancer cells while sparing most normal tissues.

Mitomycin may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Nausea and vomiting: gastrointestinal upset common during treatment.
• Myelosuppression: reduced white blood cells, platelets, and red cells.
• Hematuria: blood in urine, especially after intravesical administration.
• Fatigue: generalized tiredness during therapy.
• Skin discoloration: localized hyperpigmentation at infusion sites.

Serious or Rare Side Effects

• Pulmonary fibrosis: progressive scarring of lung tissue.
• Severe renal toxicity: impaired kidney function.
• Hemolytic‑uremic syndrome: acute kidney injury with hemolysis.
• Anaphylactic reactions: rare but potentially life‑threatening hypersensitivity.

Mitomycin requires careful monitoring and specific safety measures.

• Pregnancy: contraindicated; may cause fetal harm (Category D).
• Breastfeeding: avoid; drug can be excreted in milk.
• Renal impairment: dose adjustment may be needed; monitor kidney function.
• Hepatic dysfunction: assess liver enzymes before each cycle.
• Hematologic monitoring: regular CBCs to detect myelosuppression.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Mitomycin can interact with other medicines, altering efficacy or toxicity.

Major Interactions (Avoid)

• Antimetabolites (e.g., methotrexate): increased risk of severe bone‑marrow suppression.
• High‑dose radiation therapy: potentiates pulmonary and tissue toxicity.

Moderate Interactions (Monitor Closely)

• Nephrotoxic agents (e.g., cisplatin): may exacerbate renal injury.
• CYP450 inducers or inhibitors: can modify drug clearance.
• Anticoagulants: heightened bleeding risk due to thrombocytopenia.
• Immunosuppressants: increased infection susceptibility.
• Herbal supplements (e.g., St. John’s wort): possible alteration of plasma levels.