Parenteral Manual

MitoMYcin

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Mutamycin
Classification: 
Antineoplastic antibiotic - CYTOTOXIC
Original Date: 
May 2012
Revised Date: 
June 2015
Indications: 
  • Labelled indications: adjunct to surgery, radiation or chemotherapy for adenocarcinoma of the stomach and colon;  topical therapy for superficial transitional cell carcinoma of urinary bladder
  • Unlabeled indications:  topical therapy for esophageal strictures;  topical therapy in ophthalmologic procedures/surgery

THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.

Reconstitution and Stability: 
  • Available as 5 mg and 20 mg vials
  • Store at room temperature, protect from light
  • Reconstitute 5 mg vial with 10 ml sterile water for injection to get 0.5 mg/mL solution
  • Reconstitute  20 mg vial with 40 mL sterile water for injection to get 0.5 mg/mL solution
  • Reconstituted solution stable 14 days refrigerated or 7 days room temperature,  protect from light
Compatibility: 

-Solutions Compatible:  0.45% NaCl and 0.9% NaCl,  ringer's lactate

-Additives/Above Cassette Compatible:  dexamethasone, heparin, hydrocortisone, furosemide, metoclopramide

-Y-site Compatible:  furosemide, granisetron, heparin, leucovorin, metoclopramide, ondansetron

Incompatible:  dextrose solutions

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion YES - over 15-30 minutes via freely-running saline solution
Consider using a central venous catheter
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • 20 mg/m2IV as a single dose
  • 2 mg/m2/day IV for 5 days, drug-free interval for 2 days then repeat (therefore total dose of 20 mg/m2given over 10 days)
  • Intravesicular administration: 20 – 40 mg intravesically retained for 2 hours then drained, once weekly for 8 weeks
  • Mitomycin solution diluted to 0.1-0.3 mg/mL applied locally for esophageal strictures and ophthalmologic procedures

Dosage adjustment in renal/hepatic impairment

Renal impairment: administer 75% of dose with creatinine clearance <10 mL/min

Hepatic impairment: No information  

 

 

Potential hazards of parenteral administration: 
  • Vesicant
  • Common:  fever,nausea,vomiting (considered to have low emetogenic potential), myelosuppression, thrombotic thrombocytopenia  purpura, hemolytic uremia syndrome, dematitis, palmar rash with desquamation
  • Occasional:  alopecia, mucositis, increased serum creatinine
  • Rare:  dyspnea, extravasation reactions (If extravasation occurs, click HERE for treatment guidelines), heart failure, hepatic sinusoidal obstruction syndrome, interstitial fibrosis, pulmonary infiltrates, rash, renal failure
Notes: 
  • To prevent extravasation -administer via freely running saline solution(preferably using a central venous catheter)
  • Monitoring:  CBC with differential, serum creatinine
  • When used intravesically may cause bladder fibrosis/contraction

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.