Mitomycin Medac (Mitomycin)

Mitomycin is an alkylating chemotherapeutic agent used in the treatment of various solid tumours.

• Bladder cancer: administered intravesically to reduce tumour recurrence after transurethral resection.
• Gastric cancer: used as part of combination regimens for advanced disease.
• Pancreatic cancer: incorporated into multi‑drug protocols for metastatic cases.
• Breast cancer: given intravenously in selected metastatic settings.
• Head and neck cancer: employed in combination therapy for locally advanced disease.

• Mitomycin acts as a bioreductive alkylating agent that forms covalent cross‑links between DNA strands. After intracellular reduction, it generates reactive intermediates that bind to the N2 position of guanine, preventing DNA replication and transcription, ultimately leading to apoptosis of rapidly dividing cancer cells.

Mitomycin may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea and vomiting: gastrointestinal upset occurring during or after infusion.
• Myelosuppression: reduced white blood cells, platelets, and red cells.
• Hematuria: blood in urine, especially after intravesical administration.
• Fatigue: generalized tiredness during treatment cycles.
• Skin reactions: erythema or rash at infusion sites.

Serious or Rare Side Effects

• Pulmonary toxicity: interstitial pneumonitis or fibrosis.
• Renal impairment: acute kidney injury, particularly with intravesical use.
• Severe infection: opportunistic infections due to neutropenia.
• Hemorrhagic cystitis: bladder inflammation with bleeding.

Mitomycin requires careful monitoring and specific safety measures.

• Renal function: assess creatinine clearance before each dose.
• Hepatic function: evaluate liver enzymes to adjust therapy if needed.
• Hematologic monitoring: perform complete blood counts regularly.
• Pregnancy and lactation: avoid use; discuss risks with a specialist.
• Drug interactions: review concomitant medications for potential additive toxicity.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Mitomycin may interact with other agents that affect bone marrow or organ function.

Major Interactions (Avoid)

• High‑dose cyclophosphamide: combined myelosuppression can be life‑threatening.
• Nephrotoxic antibiotics (e.g., aminoglycosides): increased risk of renal injury.

Moderate Interactions (Monitor Closely)

• Antifungal azoles: may alter mitomycin metabolism.
• NSAIDs: can exacerbate renal toxicity.
• Radiotherapy: concurrent use may increase tissue damage.