Mitomycin (Mutamycin)

Trade name: Mutamycin®

Generic name : Mitomycin

Other names: Ametycine, Mitomycin-C, MMC

Therapeutic Class: Antibiotics, Antineoplastic, Alkylating Agents, Cross-Linking Reagents, Nucleic Acid Synthesis Inhibitors

Manufacturer / Distributor: Sanofi-aventis

Disponibilty: Mitomycin is available by prescription only

Indications: Mitomycin is used in the treatment of many malignancies, mainly:

· Squamous cell carcinoma (cancer) of the head and neck, lungs, and cervix

· Adenocarcinoma (cancer) of the stomach, pancreas, colon, rectum, breast and their metastases

Your physician can use Mitomycin to treat other types of cancer if they believe it may be helpful.

Dosage form: Mitomycin is given by injection into a vein

Dosage: In general, Mitomycin is taken by intravenous injection. Placement of a catheter or implantable port is often necessary. You can take Mitomycin either in hospital or at home by a nurse well trained to administer chemotherapy medications. However, it is important that Mitomycin be administered carefully under supervision of a physician who has experience in chemotherapy drugs. Mitomycin must be administered very carefully.

The dosage varies from one patient to another; to determine an effective Mitomycin dosage, your doctor will consider your body surface area (calculated from your height and weight), type of cancer being treated and its location as well as its severity (metastatic or not). If Mitomycin is taken in combination with other drugs or therapies (mainly radiotherapy), the doses can be decreased.

Mitomycin is usually injected into a vein, but it can also be administered intravesically (into the bladder) for treatment of bladder tumor. If you receive the medicine intravesically, it is recommended not to drink liquids 12 hours before the intervention. The solution usually remains in the bladder for two hours.

Overdose: as with any drug, Mitomycin overdose can be dangerous. An overdose of Mitomycin can damage the bone marrow, and cause serious kidney damage. In fact, even at normal dose, Mitomycin can cause serious urinary side effects. To reduce risk of kidney damage and side effects, drink plenty of fluids during the therapy, and keep all appointments with your doctor.

Missing dose: because Mitomycin is administered in hospital, it is basically difficult for you to miss any dose if you present for the treatment. Therefore, it is very important to keep all appointments with your doctor . If for some reasons you cannot go to the hospital for the treatment, contact your oncologist before the date scheduled for the injection.

Contraindication: Mitomycin is contraindicated in the following conditions:

· k idney failure

· allergy to Mitomycin or any of its components

· Vaccination - Mitomycin is not recommended in combination with vaccine against yellow fever, and phenytoin

· Pregnancy – Mitomycin is contraindicated during pregnancy because it is mutagenic effect; it can cause malformations in the fetus. Therefore, before beginning the therapy, talk to your doctor about a reliable birth control method to prevent pregnancy if you are sexually active.

· Breastfeeding – chemotherapy drugs affect your entire body. Some molecules of Mitomycin can be toxic to the infant; therefore it is not recommended to breast-feed during treatment with Mitomycin.

Interactions: Before taking any prescription and/or nonprescription medication, talk to your doctor; taking nutritional supplements or vitamins without approval of your physician is not recommended.

The following drugs can alter the curative effects of Mitomycin, or increase the risk of developing side effects:

· amphotericin B

· azathioprine

· colchicine

· Flucytosine

· Ganciclovir

· Interferon

· plicamycin

· zidovudine

· Certain other chemotherapy drugs, particularly anthracyclines.

Mechanism of action (MOA): Mitomycin is an antibiotic; it slows or stops the growth of cancer cells by altering the structure of their DNA, which prevents them from multiplying.

Side effects – Mitomycin attack not only cancer cells but healthy cells that multiply quickly, which often leads to adverse effects; the most common Mitomycin side effects include:

· nausea and vomiting

· loss of appetite

· diarrhea

· mouth blistering or stomatitis - inflammation of the mucous lining of any of the structures in the mouth

· Mitomycin may also cause elevated liver enzymes in the blood, absence of periods (amenorrhea) and azoospermia (no sperm in semen in the ejaculate)

See your doctor immediately if you experience any of the following medical conditions:

· dizziness

· unusual bruising or bleeding

· persistent cough

· burning or difficulty urination

· swelling of the ankles or feet

· pain, redness, or swelling at the injection site