Skip to Content

MitoMYcin (Ophthalmic)

Medically reviewed by Drugs.com. Last updated on Sep 10, 2020.

Pronunciation

(mye toe MYE sin)

Index Terms

  • Mitomycin-C
  • MMC

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Kit, Ophthalmic:

Mitosol: 0.2 mg

Brand Names: U.S.

  • Mitosol

Pharmacologic Category

  • Antineoplastic Agent, Antibiotic
  • Ophthalmic Agent, Miscellaneous

Pharmacology

Mitomycin alkylates DNA to produce DNA cross-linking (primarily with guanine and cytosine pairs) and inhibits DNA and RNA synthesis. Mitomycin is not cell cycle specific but has its maximum effect against cells in late G and early S phases (Perry 2012). During use in trabeculectomy (filtration surgery) for glaucoma, mitomycin topical ophthalmic application alters conjunctival vascular endothelium and inhibits fibroblast proliferation (Bindlish 2002).

Absorption

Systemic absorption following ocular administration is unknown; however, systemic concentrations are expected to be of multiple orders of magnitude lower than concentrations produced following parenteral administration.

Metabolism

Cleared from ophthalmic tissue following topical administration and irrigation; systemic metabolism primarily occurs in the liver

Use: Labeled Indications

Glaucoma surgery: Adjunct to ab externo glaucoma surgery

Contraindications

Hypersensitivity to mitomycin or any component of the formulation; pregnancy

Dosing: Adult

Glaucoma surgery (adjunctive therapy): Topical ophthalmic: 0.2 mg solution is aseptically applied via saturated sponges to surgical site of glaucoma filtration surgery for 2 minutes

Dosing: Geriatric

Refer to adult dosing.

Reconstitution

Kit should only be opened and reconstituted by sterile surgical scrub technician. To reconstitute, add 1 mL of SWFI; shake/swirl to dissolve (detailed instructions are available in the kit). If powder does not dissolve immediately, allow to stand at room temperature until it dissolves completely into solution.

Administration

For aseptic topical administration to surgical site of glaucoma filtration surgery; not for intraocular administration. The inner tray and the contents of the kit are sterile and should only be handled, opened and assembled by a sterile surgical scrub technician. Use within 1 hour of reconstitution. Technician should fully saturate sponges provided in the kit with the entire reconstituted solution (0.2 mg). Allow saturated sponges to remain undisturbed in kit for 60 seconds. Saturated sponges should be applied aseptically with the use of surgical forceps in a single layer to a treatment area ~10 mm × 6 mm (± 2 mm); sponges should be removed from the treatment area after 2 minutes. Following removal of sponges from eye, the surgical site should be copiously irrigated. Saturated sponges should be returned to the provided tray for disposal into chemotherapy waste bag. Consult product labeling for additional details.

Storage

Store at 20°C to 25°C (68°F to 77°F). Avoid excessive heat. Protect from light.

Reconstituted solution is stable for 1 hour at room temperature.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined.

Hematologic & oncologic: Hemorrhage (retinal, subconjunctival, suprachoroidal, vitreal)

Infection: Infection (bleb)

Local: Local tissue necrosis (conjunctiva)

Ophthalmic: Anterior chamber eye hemorrhage, astigmatism, bleb ulceration, blebitis, capsulotomy rupture, cataract, choroidal detachment, choroidal effusion (may include suprachoroidal effusion), chronic bleb leak, conjunctival abnormalities (degeneration), corneal changes (damage, vascularization) decreased intraocular pressure, decreased visual acuity, disk hemorrhage, endophthalmitis, epithelial keratopathy, iritis, lacrimal duct obstruction, macular edema, maculopathy, malignant glaucoma, papilledema, posterior capsule opacification, progression of cataract, retinal detachment, retinal pigment epithelial detachment, retinal vein occlusion, scleral ulceration, superficial punctate keratitis, synechiae of iris, vision loss

Miscellaneous: Encapsulated/cystic bleb, wound dehiscence, wound healing impairment

Warnings/Precautions

Concerns related to adverse effects:

• Cataract formation: An increased incidence of lenticular change and cataract formation has been correlated with mitomycin (ophthalmic) use in phakic patients.

• Corneal/scleral damage: Inadvertent corneal and/or scleral damage, including thinning or perforation, may occur with use of mitomycin (ophthalmic) solution in concentrations >0.2 mg/mL or for time periods >2 minutes. In addition, direct contact of the solution with the corneal endothelium will result in cell death.

• Hypotony: Increased incidence of postoperative hypotony has been observed with use.

Other warnings/precautions:

• Appropriate administration: Mitomycin (ophthalmic) is only intended for topical application to the surgical site of glaucoma filtration surgery. Do not administer intraocularly; intraocular administration may result in cell death, potentially causing corneal and retinal infarction, and ciliary body atrophy.

Reproductive Considerations

Use is contraindicated in women who may become pregnant during therapy.

Pregnancy Risk Factor X Pregnancy Considerations

Adverse events were observed in animal reproduction studies. Use is contraindicated in pregnant women.

Patient Education

What is this drug used for?

• It is used during eye surgery.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Sudden vision changes

• Eye pain

• Severe eye irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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