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Medicine Overview of Mitomycin 2mg Injection
বাংলা
English
Indication
Diabetic foot infections, Chronic lymphatic leukaemia, Chronic myelogenous leukaemia, Gastric carcinoma, Colorectal carcinoma, Lung carcinoma, Pancreatic carcinoma, Carcinoma Cervix, Endometrium carcinoma, Carcinoma Breast, Bladder carcinoma, Head & neck carcinoma.
Administration
IV Preparation
Reconstitute with SWI to a concentration of 0.5 mg/mL
IV Administration
Administer slow IV push by central line only
Flush with 5-10 mL of IV solution before & after drug administration
Adult Dose
Adult: IV Solid tumours Suggested regimen: Initial: 10-20 mg/m2; may repeat 6-8 wkly depending on blood count. Do not repeat if leucocyte and platelet counts are below acceptable levels. Do not re-administer if the nadir of the leucocyte count is <2,000 cells/mm3.
Intravesical Superficial bladder tumours Instill 10-40 mg 1-3 times/wk for a total of 20 doses. Prevention of recurrent bladder tumours Instill 20 mg 2 wkly or 40 mg 1-3-mthly.
Child Dose
Safety and efficacy not established
Renal Dose
Renal Impairment
Serum creatinine >1.7 mg/dL: Avoid use
CrCl <10 mL/min: Decrease dose by 25%
CAPD: Decrease dose by 25%
Contraindication
Thrombocytopenia, coagulation disorders, increase in bleeding tendency due to other causes. Renal impairment, potentially severe infections. Pregnancy and lactation.
Mode of Action
Mitomycin is an antineoplastic antibiotic which is enzymatically reduced to its active metabolite within susceptible cells. The active metabolite appears to cause cross-linking of DNA (primarily with guanine and cytosine pairs). It also active against gram-positive bacteria and some viruses, but its antineoplastic activity precludes its use as an antibiotic.
Precaution
Repeated haematologic studies are necessary during treatment and for at least 7 wk after discontinuation of the drug. Discontinue use when the leucocyte count decreases to <4000/mm3 or the platelet count decreases to <150,000/mm3 or if a progressive decline in either occurs. Monitor patient for signs of renal or pulmonary toxicity.
Side Effect
>10%
Hemolytic uremic syndrome (<15%),Myelosuppression (64%),Nausea/vomiting (14%),Fever (14%)
1-10%
Stomatitis (4%),Increased serum creatinine (2%),Mucous membrane toxicity (4%)
Frequency Not Defined
Fatigue,Pulmonary toxicity,Dyspnea,Cystitis,Interstitial fibrosis,Nephrotoxicity,Amenorrhea,Alopecia
Potentially Fatal: Myelosuppression, haemolytic-uraemic syndrome.
Pregnancy Category Note
Pregnancy Category: D
Lactation: Not known if excreted in breast milk, do not nurse
Interaction
Increased incidence of cardiotoxicity w/ doxorubicin.
Potentially Fatal: Increased risk of intravascular haemolysis and renal failure w/ fluorouracil. Increased risk of haemolytic uraemic syndrome w/ tamoxifen. Acute pulmonary toxicity w/ vinca alkaloids (e.g. vinblastine, vinorelbine). Increased bone marrow depressant effects of aclarubicin.