Brand and Other Names:Mitomycin C, Mutamycin
- Classes: Antineoplastics, Antibiotic
Dosing & Uses
Dosage Forms & Strengths
powder for injection
for SI units: count in US units x10^6/L
Full dose if
- Leukocytes >3000/cu.mm
- Plts >75 x 10^3/cu.mm
Give 70% if
- Leukocytes: 2000-2999/cu.mm
- Plts: 25-74.999 x 10^3/cu.mm
Give 50% if
- Leukocytes <2000/cu.mm
- Plts <25 x 10^3/cu.mm
Serum creatinine >1.7 mg/dL: Avoid use
CrCl <10 mL/min: Decrease dose by 25%
CAPD: Decrease dose by 25%
CBC, LFTs, renal function
Do not repeat dose until WBC >4000/cu.mm and Plts >100,000/cu.mm
Always use in combo with other antineoplastics
Discontinue if progression continues after two courses
Other Indications & Uses
Off-label: Cancer of colon, breast, lung, esophagus, head & neck; bladder cancer (intravesical admin); multiple myeloma
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Hemolytic uremic syndrome (<10%)
Frequency Not Defined
Black Box Warnings
The drug should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to manage complications
Bone marrow suppression, notably thrombocytopenia and leucopenia, may contribute to overwhelming infections in an already compromised patient
Hemolytic uremic syndrome may occur with monotherapy or combination therapy and usually occurs with doses >60 mg. Blood product transfusion may exacerbate symptoms.
Thrombocytopenia, coagulation disorders, bleeding diathesis
Renal impairment (SCr >1.7 mg/dL [150.3 umol/L])
Chicken pox, recent
Pregnancy & Lactation
Pregnancy Category: D
Lactation: not known if excreted in breast milk, do not nurse
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Half-life: 48 min
Vd: 16-56 L/sq.meter
Clearance: 201-810 mL/min/sq.meter
Excretion: urine (10%)
Mechanism of Action
Crosslinks DNA, preventing replication & transciption
Y-site: aztreonam, cefepime, etoposide PO4, filgrastim, gemcitabine, piperacillin/tazobactam, sargramostim, topotecan, vinorelbine
Solution: LR, NS
Additive: dexamethasone Na-phosphate, heparin, hydrocortisone Na-succinate
Syringe: bleomycin, cisplatin, cyclophosphamide, doxorubicin, droperidol, fluorouracil, furosemide, heparin, leucovorin, methotrexate, metoclopramide, vinblastine, vincristine
Y-site: amifostine, bleomycin, cisplatin, cyclophosphamide, doxorubicin, droperidol, fluorouracil, furosemide, granisetron, heparin, leucovorin, melphalan, methotrexate, metoclopramide, ondansetron, teniposide, thiotepa, vinblastine, vincristine
Reconstitute with SWI to a concentration of 0.5 mg/mL
- IV push: dose/syringe (concentration is 0.5 mg/mL); maximum syringe size for IVP is a 30 mL syringe & syringe should be <75% full
- IVPB: dose/100 mL NS
Administer slow IV push by central line only
Flush with 5-10 mL of IV solution before & after drug administration
IVPB infusion should be closely monitored for adequate vein patency
Frequently causes necrosis
Plastic surgeon may be required
Store intact vials of lyophilized powder at RT
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