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Mitomycin (Injection)

Commonly used brand name(s)

In the U.S.

  • Jelmyto

In Canada

  • mitoMYcin
  • Mutamycin

Available Dosage Forms:

  • Gel/Jelly

Therapeutic Class: Antibiotic

Uses for mitomycin

Mitomycin injection is used to treat low-grade upper tract urothelial cancer (LG-UTUC). LG-UTUC is a type of cancer of the lining of the upper urinary tract (eg, lining of the kidney).

Mitomycin interferes with the growth of cancer cells, which are then destroyed by the body.

Mitomycin is to be given only by or under the direct supervision of your doctor.

Before using mitomycin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For mitomycin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to mitomycin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of mitomycin injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mitomycin injection in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving mitomycin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using mitomycin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Varicella Virus Vaccine, Live
  • Zoster Vaccine, Live

Using mitomycin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Cholera Vaccine, Live
  • Dengue Tetravalent Vaccine, Live
  • Hexaminolevulinate
  • Influenza Virus Vaccine, Live
  • Poliovirus Vaccine, Live
  • Smallpox Vaccine
  • Tamoxifen
  • Typhoid Vaccine
  • Vinblastine
  • Yellow Fever Vaccine

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of mitomycin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood or bone marrow problems (eg, neutropenia, thrombocytopenia)—Use with caution. May make these conditions worse.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Perforation (hole or tear) of the bladder or upper urinary tract—Should not be used in patients with these conditions.

Proper use of mitomycin

Before receiving mitomycin, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

A nurse or other trained health professional will give you mitomycin in a medical facility. Mitomycin is given to your kidney through a tube called a catheter (eg, ureteral catheter or nephrostomy tube).

Mitomycin is given once a week for 6 weeks. If mitomycin is working properly after 3 months of treatment, you may receive it once a month for 11 months.

Your doctor will tell you to take sodium bicarbonate before each treatment with mitomycin. Follow your doctor's instructions about how and when to take this.

Missed dose

Mitomycin needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Precautions while using mitomycin

It is very important that your doctor check you closely to make sure that mitomycin is working properly. Blood and urine tests may be needed to check for unwanted effects.

Receiving mitomycin while you are pregnant can harm your unborn baby. Use an effective form of birth control during treatment with mitomycin and for at least 6 months after the last dose. Male patients with female partners should use an effective form of birth control during treatment and for at least 3 months after the last dose. If you think you have become pregnant while receiving the medicine, tell your doctor right away.

Mitomycin may cause ureteric obstruction (swelling and narrowing of the tube that carries urine from the kidney to the bladder). Check with your doctor right away if you have fever, lower back or side pain, or trouble in urinating.

Mitomycin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in urine or stools, or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Mitomycin may cause your urine to change to a violet to blue color. It is recommended to do the following after receiving mitomycin:

  • Avoid skin contact with urine for at least 6 hours.
  • Male and female patients should sit on the toilet when urinating and flush it several times after using.
  • Wash your hands, inner thighs, and genital area well with soap and water after going to the bathroom.
  • Wash the clothing soiled with urine right away and separately from any other clothing.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Mitomycin side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  • Bladder pain
  • bloody or cloudy urine
  • chest pain
  • chills
  • cough or hoarseness
  • decrease in urine output or decrease in urine-concentrating ability
  • difficult, burning, or painful urination
  • fever
  • frequent urge to urinate
  • lower back or side pain
  • pale skin
  • severe nausea and vomiting
  • sores, ulcers, or white spots on lips or in mouth
  • swollen glands
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Less common

  • Fainting or loss of consciousness
  • fast or irregular breathing
  • lower abdominal or stomach pain
  • swelling of the eyes or eyelids
  • tightness in the chest

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Skin itching

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.