Mitomycin (injection route)


    Brand Name

    Canadian Brand Name

    mitoMYcin

    Mutamycin


    Description

    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.

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


    Before Using

    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 this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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.

    Drug Interactions

    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 this medicine, 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 this medicine 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 this medicine 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 Type 4, Live
    • Adenovirus Vaccine Type 7, Live
    • Bacillus of Calmette and Guerin Vaccine, Live
    • Cholera Vaccine, Live
    • Dengue Tetravalent Vaccine, Live
    • Ebola Zaire Vaccine, Live
    • Hexaminolevulinate
    • Influenza Virus Vaccine, Live
    • Poliovirus Vaccine, Live
    • Smallpox Monkeypox Vaccine, Live Non-Replicating
    • Smallpox Vaccine
    • Tamoxifen
    • Typhoid Vaccine, Live
    • Vinblastine
    • Yellow Fever Vaccine

    Other Interactions

    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 this medicine. 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

    Before receiving this medicine, 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 this medicine in a medical facility. This medicine 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 this medicine 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 this medicine. Follow your doctor's instructions about how and when to take this.

    Missed Dose

    This medicine 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

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

    Receiving this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control during treatment with this medicine 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.

    This medicine 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 this medicine:

    • 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.


    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.






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