Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041WARNING Blood related problems: Mitomycin may cause serious decreases in your red blood cell, white blood cell and platelet levels which can cause infections, anemia, bruising and bleeding (see Precautions To Be Aware Of Before Taking This Medication). Kidney related problems: Mitomycin can cause a serious, and sometimes fatal, condition called hemolytic uremic syndrome (HUS). This condition causes the platelets in your blood to clump together, which leads to reduced blood flow to the kidney and can cause kidney failure. Your doctor or healthcare provider will monitor you carefully while you are receiving mitomycin therapy to make sure that you do not experience this problem.
Uses For This Medication
- Mitomycin is used in combination with other chemotherapy medications to treat adults with stomach cancer, and pancreatic cancer. Mitomycin has also been evaluated to treat adults with bladder cancer.
- Mitomycin, prepared as a topical eye drop solution, is also commonly used to control intraocular pressure and other conditions in patients with glaucoma who undergo various types of eye surgeries.
- This medication may also be given for other conditions as determined by your doctor.
- Mitomycin, given by direct injection into the bladder (intravesical instillation) after surgical removal of the tumor, may reduce the recurrence rate.
- Are allergic to mitomycin or any of its components.
- Have low platelet levels.
- Have a blood clotting disorder or an increased tendency to bleed.
Precautions to be Aware of Before Taking This Medication
Blood related precautions
- This medication will likely temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises.
- This medication will likely temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands with soap and water well and often, and brush and floss your teeth daily.
- This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
Organ related precautions
- This medication may cause changes in the ability of your kidneys to work normally. Your doctor or healthcare provider will check your kidneys regularly, usually through blood tests, while you are on this medication to make sure that your kidneys are working properly. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
- Cough and shortness of breath can occur in patients receiving vinblastine or vinorelbine (Navelbine®), especially those patients who are receiving either of these medications in combination with mitomycin or who have received mitomycin in the past. Your doctor or healthcare provider will watch you carefully during and after the administration of these medications to make sure that you do not experience any cough or shortness of breath. In addition, you should let your doctor or healthcare provider know if you experience these symptoms at a later time.
- This medication can cause scarring of the bladder and/or contractions in the bladder. This only occurs when mitomycin is being given by an injection into the bladder to treat bladder cancer.
- Oxygen therapy during or after mitomycin treatment can increase a person’s risk of developing serious lung problems. Therefore, oxygen should be given if absolutely necessary, and then, only in the smallest amount needed.
- Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
Patient specific precautions
- It is not known if this medication is safe and effective in children.
Pregnancy and Breastfeeding Precautions
- This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
- It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
- Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
Medication and Food InteractionsBefore using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with mitomycin and the following medications:
- Vinorelbine (Navelbine®)
- Tamoxifen (Nolvadex®)
- All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
- You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
- Side effects can occur when mitomycin is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with mitomycin alone.
More common side effects
- Decreased white blood cell and/or platelet levels (see Precautions To Be Aware Of Before Taking This Medication)
- Sores in mouth or on lips
- Hair loss
Less common side effects
- Decreased red blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
- Nausea, vomiting, loss of appetite
Rare side effectsThis is not a complete list of the rare side effects reported with mitomycin. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
- Cough, difficulty breathing
- Kidney problems (see Precautions To Be Aware Of Before Taking This Medication)
- Hemolytic Uremic Syndrome (see Warning)
- Redness, swelling and pain at injection site, rash
- Headache, fatigue, weakness
- Congestive heart failure
- Vision changes
- Scarring of the bladder, bladder contractions (only when mitomycin is given by injection into the bladder) (see Precautions To Be Aware Of Before Taking This Medication)
How To Take This Medication
- This medication may be given by injection into a vein (IV) by a healthcare professional. This medication can be given in different doses depending on your weight, your type of condition and whether mitomycin is being given with other chemotherapy medications.
- Mitomycin may also be given by direct injection into the bladder (intravesical instillation) by a healthcare professional for treatment of superficial bladder cancer.
- Mitomycin can also be prepared as a topical eye drop solution for controlling intraocular pressure and other conditions in patients with refractory glaucoma who undergo certain types of eye surgeries.
- Antiemetics, which are medications to help prevent and control nausea and vomiting, will be given before mitomycin either by mouth (orally) or by injection into a vein (IV).
- In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
- It is unlikely that you will need to store this medication. However, in the event that you do, the unopened containers should be stored at controlled room temperature.
- Keep this medication out of the reach of children or pets.
- Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.