Mitomycin Injection

How does this medication work? What will it do for me?

• Mitomycin belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics called actinomycins. Another actinomycin is dactinomycin.
• Mitomycin kills cancer cells by interfering with their growth and reproduction. It is used alone or in combination with other antineoplastic medications, radiation, or surgery to treat certain types of stomach and colon cancer. It is also used to treat a certain type of cancer of the bladder.
• Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

What form(s) does this medication come in?

• 5 mg : Each vial of sterilized, lyophilized contains mitomycin 5 mg. Nonmedicinal ingredients- hydrochloric acid, mannitol, sodium hydroxide, and water for injection.
• 20 mg : Each vial of sterilized, lyophilized contains mitomycin 20 mg. Nonmedicinal ingredients- hydrochloric acid, mannitol, sodium hydroxide, and water for injection.

How should I use this medication?

• The recommended dose and dosing schedule of mitomycin varies according to the specific condition being treated, the response to therapy, and other medications or treatments being used. The dose administered is also based on body size. Mitomycin is usually injected into a vein but can also be instilled intravesically (into the bladder) for treatment of bladder cancer.
• When intravesical treatment is performed, your doctor will likely advise you not to drink fluids for 12 hours prior to the procedure. The solution is usually maintained in the bladder for 2 hours. Very careful handling of this medication is required. It is always given under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.
• Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications.
• As well as interfering with the genetic material DNA of cancer cells, mitomycin can interfere with some of your normal cells. This can cause a number of side effects such as mouth sores. Mitomycin may cause nausea and vomiting, but it is important to keep using this medication even if you feel ill.
• Your doctor, nurse, or pharmacist can advise you on how to reduce the effects of nausea and vomiting. Keep track of any side effects and report them to your doctor as suggested in the section,

What side effects are possible with this medication?

• It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive mitomycin, contact your doctor as soon as possible to reschedule your appointment.
• This medication should be stored at room temperature and protected from light.
• Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

• Are Allergic to Mitomycin or Any Ingredients of the Medication
• Are Breastfeeding
• Have Blood Clotting Disorders or Any Increased Bleeding Tendencies
• Have Low Blood Platelet or White Blood Cell Counts

What side effects are possible with this medication?

• Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
• The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
• The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
• Contact your doctor if you experience these side effects and they are severe or bothersome.

Your pharmacist may be able to advise you on managing side effects :

• Headache
• Loss of Appetite
• Nausea and Vomiting, Weight Loss
• Purple Stripes On Nails
• Reduction in Number of Menstrual Periods
• Skin Rash
• Loss of Hair
• Unusual Tiredness or Weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur :

• Blurred Vision
• Confusion
• Cough
• Decrease or Painful Urination
• Diarrhea
• Rash
• Shortness of Breath or Difficulty Breathing
• Sores in Mouth and On Lips
• Swelling of Feet or Lower Legs
• Vomit with Blood in It

Stop taking the medication and seek immediate medical attention if any of the following occur :

• Black, Tarry Stools or Blood in Urine
• Cough or Hoarseness
• Fever or Chills
• Lower Back or Side Pain
• Painful or Difficult Urination
• Redness or Pain At Site of Injection
• Unusual Bleeding or Bruising

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?

• Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breastfeeding, and any other significant facts about your health. These factors may affect how you should use this medication.
• Blood clotting : This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.
• Infection : As well as killing cancer cells, this medication can reduce the number of cells in the body that fight infection (white blood cells). Avoid contact with people who are sick especially those with contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills.
• Kidney disease : Mitomycin may worsen kidney disease.
• Pregnancy : Use of this medication by pregnant women has not been studied. There is a possibility of birth defect if either the man or the woman is using mitomycin at the time of conception. Effective birth control should be practiced while using this medication. If you become pregnant while taking this medication, contact your doctor immediately.
• Breastfeeding : It is not known if mitomycin passes into breast milk. If you are a breast-feeding mother and are taking mitomycin, it may affect your baby. Talk to your doctor about whether you should continue breastfeeding.

What other drugs could interact with this medication?
There may be an interaction between mitomycin and any of the following :

• Amphotericin B
• Azathioprine
• Colchicine
• Flucytosine
• Ganciclovir
• Interferon
• Plicamycin
• other Cancer Medications (especially Anthracyclines)
• Zidovudine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to :

• Stop Taking One of the Medications,
• Change One of the Medications to Another,
• Change How You are Taking One or Both of the Medications, Or
• Leave Everything as Is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the from , or street drugs can affect the action of many medications, you should let your prescriber know if you use them.