Mitomycin

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Mitomycin; Belgium: Mitomycine; Bulgaria: Mitomycin; Cyprus: Mitomycin; Czech Republic: Mitomycin; Denmark: Mitomycin; Finland: Mitostat; France: Ametycine; Germany: Ametycine, Mitem, Mito-Extra, Mitomycin, Urocin; Greece: Mitomed, Mitomycin; Hungary: Mitomycin; Ireland: Mitomycin; Italy: Mitomycin; Luxembourg: Mitomycin; Netherlands: Mitomycin; Poland: Mitomycin; Portugal: Mitomicina; Slovakia: Mitomycin; Spain: Mitomycin; Sweden: Mitomycin; UK: Mitomycin.

North America

Canada: Mitomycin; USA: Mitomycin, Mutamycin.

Latin America

Argentina: Asomután, Crisofimina, Maximitón, Mitokebir, Mitomicina, Mitonovag, Mitotie, Vetio; Brazil: Baxmicin, Mitocin; Mexico: Mitolem, Mitomicina, Mitotie, Mixandex.

Asia

Japan: Mitomycin.

Drug combinations

Chemistry

Mitomycin: C~15~H~18~N~4~O~5~. Mw: 334.33. (1) Azirino[2′,3′:3,4]pyrrolo[1,2-a]indole-4,7-dione, 6-amino-8-[[(aminocarbonyl)oxy]methyl]-1,1a,2,8,8a,8b-hexahydro-8a-methoxy-5-methyl-, [1aS-(1aα,8β,8aα,8bα)]-; (2) 6-Amino-1,1a,2,8,8a,8b-hexahydro-8-(hydroxymethyl)-8a-methoxy-5-methylazirino[2′,3′:3,4]pyrrolo[1,2-a]indole-4,7-dione carbamate (ester). CAS-50-07-7 (1972).

Pharmacologic Category

Antineoplastic Agents; Cytotoxic Antibiotics and Related Substances; Antibiotic. (ATC-Code: L01DC03).

Mechanism of action

Acts as alkylating agent and produces DNA cross-linking (primarily with guanine and cytosine pairs). Inhibits DNA and RNA synthesis. Degrades preformed DNA, causes nuclear lysis and formation of giant cells.

Therapeutic use

Treatment of adenocarcinoma of stomach or pancreas, bladder cancer, breast cancer, or colorectal cancer.

Pregnancy and lactiation implications

Mitomycin can cause fetal harm in humans. Animal studies show delayed fetal development, fetal external anomalies, and neonatal anomalies. Contraindicated during lactation.

Unlabeled use

Prevention of excess scarring in glaucoma filtration procedures in high risk of bleb failure.

Contraindications

Hypersensitivity to mitomycin or any component of the formulation. Thrombocytopenia. Coagulation disorders, increased bleeding tendency. Pregnancy.

Warnings and precautions

Hazardous agent. Bladder fibrosis/contraction reported (with intravesical administration). May cause bone marrow suppression (thrombocytopenia and leukopenia). Hemolytic-uremic syndrome, potentially fatal, reported. Potent vesicant, might cause ulceration, necrosis, cellulitis, and tissue sloughing if infiltrated. Caution in renal impairment (serum creatinine is >1.7 mg/dL). Shortness of breath and bronchospasm reported in patients receiving vinca alkaloids in combination with or after mitomycin. Use with caution in patients who have received radiation therapy or in presence of hepatobiliary dysfunction.

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