Mitomycin belongs to a family of natural products that contain aziridine, usually isolated from a strain of bacteria called Streptomyces lavendulae. One of the compounds, mitomycin C finds its value as a chemotherapy agent because of its anti-tumor properties.
Mitomycin is marketed under the brand name Mutamycin. This drug is not recommended as a single therapy. It is indicated as a useful therapeutic agent for the treatment of disseminated adenocarcinoma of the pancreas and the stomach. It is not recommended as replacement for surgery and radiotherapy.
Mitomycin is administered intravenously. Doses are available at vials of 5, 10, 20, and 40 mg of miomycin and mannitol. A single recommended dosage is at 20 mg/m2 for intravenous catheter.
Prior to administration, each patient must be evaluated to determine the dosage needed for the patient. Higher doses have not been found to be more effective than recommended dosage.
Less common side effects include headaches, nausea, dizziness, gastrointestinal problems such as flatulence and loss of appetite. Studies have shown that mitomycin has been found to cause bone marrow toxicity, which have been found to occur within 8 weeks of therapy. The drug may also produce cumulative myelosuppression.
Apart from bone marrow toxicity, mitomycin has also been found to produce toxicity in the kidneys, mucous membrane and pulmonary toxicity. Complications such as ulcers, dyspnea, and kidney failure result from these side effects.
Heart failure has also been found out to be one of the serious side effects of mitomycin use. Fever, vomiting, and anorexia are some of the less serious yet acute side effects of the drug.
Mitomycin has been found to be contraindicated in patients with know hypersensitivity to the drug or its known components. It is also contraindicated in patients with thrombocytopenia, blood coagulation disorders and an increase in their bleeding tendencies.
Patients under mitomycin therapy have to be carefully observed during therapy and even post-therapy. Patients with known heart, intestinal and kidney problems should be given extreme caution when administering the drug. The drug may cause extreme toxicity in the bone marrow, kidneys and heart which may cause conditions that will become fatal to the patient.
Although it is not known to pose a risk to the pregnant woman and child, caution must always be exercised when administering the drug to pregnant women. Women who are breastfeeding or plan to breastfeed must always consult their physician prior to the administration of the drug as it is not known if mitomycin passes on to breast milk.
There are no known studies for pediatric and geriatric patients. However, caution must always be exercised when administering the drug as there may be various reactions to the drug.
Mitomycin has the following structural formula:
• Molecular formula of mitomycin is C15H18N4O5
• Chemical IUPAC Name is 6-Amino-1,1a,2,8,8a,8b-hexahydro-8-(hydroxymethyl)-8a-methoxy-5- methyl-azirino[2',3':3,4]pyrrolo[1,2-a]indole-4,7-dione carbamate (ester)
• Molecular weight is 334.327 g/mol
Brand name(s): Ametycin, Ametycine, Mit-C, Mitamycin, Mito-C, Mitocin-C, Mitomycin-C, Mitomycinum, Mitomycyna C, Mitozytrex, Muamycin, Mutamycin, Mytomycin, Mytozytrex
Review published on: 13 September 2009
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