Mitomycin Accord Healthcare (Mitomycin)

Mitomycin is used in oncology to target rapidly proliferating cancer cells across several tumour types.

• Bladder cancer (intravesical therapy): reduces tumour recurrence after transurethral resection.
• Gastric cancer: used as part of combination chemotherapy to improve response rates.
• Pancreatic cancer: contributes to tumour shrinkage when combined with other agents.
• Breast cancer: employed in advanced disease protocols to inhibit tumor growth.
• Head and neck cancers: added to multimodal regimens to enhance local control.

• Mitomycin exerts its antineoplastic effect by forming covalent cross‑links between DNA strands, which blocks DNA replication and transcription. The resulting DNA damage triggers cell‑cycle arrest and apoptosis, preferentially affecting rapidly dividing tumor 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 occurring in many patients.
• Myelosuppression: reduced white blood cells, platelets, and red cells.
• Fatigue: persistent tiredness affecting daily activities.
• Mucositis: inflammation of the mouth and gastrointestinal lining.

Serious or Rare Side Effects

• Severe bone marrow suppression: may lead to life‑threatening infections.
• Pulmonary toxicity: interstitial pneumonitis or fibrosis.
• Hemolytic‑uremic syndrome: renal failure with hemolysis.
• Anaphylactic reactions: acute hypersensitivity requiring emergency care.
• Renal toxicity: impaired kidney function.
• Secondary malignancies: rare development of new cancers.

When using Mitomycin, clinicians should observe several safety measures to minimise risk.

• Pregnancy: Category D – avoid use unless benefits outweigh risks.
• Renal impairment: dose adjustment or avoidance may be required.
• Hepatic dysfunction: monitor liver enzymes and consider dose modification.
• Hematologic monitoring: regular blood counts to detect myelosuppression.
• Contraindications: avoid in patients with existing severe bone‑marrow suppression.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Mitomycin can interact with other medicines, affecting its efficacy or toxicity.

Major Interactions (Avoid)

• Concurrent myelosuppressive chemotherapy: may cause profound bone‑marrow suppression.
• High‑dose radiation therapy: increased risk of tissue necrosis.
• Nephrotoxic agents (e.g., cisplatin): heightened renal toxicity.
• Anticoagulants (e.g., warfarin): increased bleeding risk.

Moderate Interactions (Monitor Closely)

• NSAIDs: may exacerbate renal impairment.
• ACE inhibitors or ARBs: monitor kidney function and blood pressure.
• Diuretics: watch for electrolyte disturbances.
• Antifungal azoles: potential alteration of drug clearance.