Mitomycin-C

Posted on December 2nd, 2008 by

Class: Chemotherapy

Generic Name: Mitomycin (mye-toe-MYE-sin), Mitomycin-C, MTC
Trade Name: Mutamycin®

How is this drug used? Mitomycin is FDA approved for the treatment of advanced stomach and pancreatic cancer in combination with other agents. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Mitomycin belongs to a class of agents called antitumor antibiotics.   An antitumor antibiotic produces its anti-cancer effects by binding to DNA and inhibiting the production of proteins necessary for sustaining the life of a cell.

How is mitomycin given (administered)? Mitomycin may be administered into a vein (intravenous) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used, and the overall health of the patient.  If mitomycin leaks from the vein into which it is being administered, it may cause serious damage to the surrounding tissue.  Although patients will be monitored for this, they should tell their healthcare provider immediately if they experience pain, redness, or swelling at the site in which the drug is being administered.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with mitomycin.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

Patients will also have their lung function monitored, as problems of the lung may result due to treatment with mitomycin. In addition, patients may experience an allergic-type reaction to mitomycin, although this is uncommon. This reaction is characterized by difficulty in breathing and closing of the throat. If patients should experience coughing and difficulty breathing, they should contact their healthcare provider.

Patients will also be monitored for hemolytic-uremic syndrome with blood draws. Hemolytic-uremic syndrome is an uncommon, but serious side effect that may be caused by treatment with mitomycin. With this syndrome, damage occurs to a patient’s red blood cells and lining of the blood vessel walls, which can potentially lead to kidney failure.

What are the common (occur in 30% or more of patients) side effects of treatment with mitomycin?

• Low white blood cell levels – increases the risk of infection
• Low red blood cell levels – increases the risk of anemia
• Low platelet levels – increases the risk of bleeding
• Mouth sores
• Generalized fatigue

What are the less common (occur in 10% to 29% of patients) side effects of treatment with mitomycin?

• Nausea and vomiting
• Loss of appetite
• Loss of hair
• Bladder problems – inflammation of the bladder, frequent urination, or burning, cramping or pain upon urination when given directly into the bladder (intravesically)

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Eat small meals frequently to help alleviate nausea.
• If patients have been prescribed an anti-nausea medication, they should be sure to take the prescribed doses.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

• Blistering, burning, redness or pain at the site of drug administration
• Signs of an allergic-type reaction – difficulty in breathing and closing of the throat
• Signs of pulmonary reactions – difficulty in breathing with a cough that does not produce mucous, shortness of breath, wheezing
• Decreased frequency or amount of urination
• Yellowing of the skin or eyes
• Right upper quadrant pain
• Abdominal pain
• Swelling of the feet or ankles
• Sudden weight gain
• Flu or cold-like symptoms – fever, sore throat, cough, chills
• Signs of infection – redness, swelling, pus, tenderness
• Frequent urination, burning, cramping or pain upon urination
• Persistent or severe fatigue
• Unexplained or pronounced bleeding (nosebleeds, bruising, blood in the urine, black tarry stools, etc.)
• Mouth sores
• Persistent or extreme nausea or vomiting
• Persistent or extreme diarrhea
• Skin rash or itching

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

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Tags: Chemotherapy, M

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