Mitomycin – Uses, Dosage, Side Effects, Interactions

Mitomycin is a methylazirinopyrroloindoledione antineoplastic antibiotic isolated from the bacterium Streptomyces caespitosus and other Streptomyces bacterial species. Bioreduced mitomycin C generates oxygen radicals, alkylates DNA, and produces interstrand DNA cross-links, thereby inhibiting DNA synthesis. Preferentially toxic to hypoxic cells, mitomycin C also inhibits RNA and protein synthesis at high concentrations. Mitomycin is a medication used in the treatment of anal carcinoma, bladder carcinoma, breast carcinoma, head and neck malignancies, and some other gastrointestinal carcinomas. It is in the antineoplastic antibiotic class of medications.

Mitomycin is an antineoplastic antibiotic first isolated by Japanese microbiologists in the 1950s from cultures of Streptomyces caespitosus. It is an alkylating agent that inhibits DNA synthesis (and, at higher concentrations, RNA and protein synthesis) by cross-linking the complementary strands of the DNA double helix.^[rx] Few other antibiotics have been discovered that work via this alkylating mechanism, making mitomycin relatively unique in the space of microbiota-derived therapies.^[rx]

Mitomycin’s cross-linking activity has resulted in its approval for the treatment of a variety of cancers – the most recent of which is an April 2020 approval for its use in low-grade Upper Tract Urothelial Cancer (LG-UTUC)^[rx] – as well as adjunctly to ab externo glaucoma surgeries.

Potential bis-alkylating heterocyclic quinones were synthesized in order to explore their antitumoral activities by bioreductive alkylation.^[rx]

In the bacterium Legionella pneumophila, mitomycin C induces competence, a condition necessary for the process of natural transformation that transfers DNA and promotes recombination between cells.^[rx] Exposure of the fruitfly Drosophila melanogaster to mitomycin C increases recombination during meiosis, a key stage of the sexual cycle.^[rx] It has been suggested that during the sexual process in prokaryotes (transformation) and eukaryotes (meiosis), DNA cross-links and other damages introduced by mitomycin C may be removed by recombinational repair.^[rx]

Types

Mitomycin A

Mitomycins are antitumor antibiotics made by Streptomyces caespitosus (griseovinaceseus); Mitomycin C is used as an antineoplastic drug; [Merck Index] Mitomycins: Used as DNA alkylating/cross-linking agents;

Mitomycin B

Mitomycins are antitumor antibiotics made by Streptomyces caespitosus (griseovinaceseus); Mitomycin C is used as an antineoplastic drug; [Merck Index] Mitomycins: Used as DNA alkylating/cross-linking agents; [HSDB]

Mitomycin C

Mitomycin is one of the older chemotherapy drugs, which has been around and in use for decades. It is an antibiotic that has been shown to have antitumor activity. Mitomycin selectively inhibits the synthesis of deoxyribonucleic acid (DNA). The guanine and cytosine content correlates with the degree of mitomycin-induced cross-linking. At high concentrations of the drug, cellular RNA and protein synthesis are also suppressed. Mitomycin has been shown in vitro to inhibit B cell, T cell, and macrophage proliferation and impair antigen presentation, as well as the secretion of interferon-gamma, TNFa, and IL-2.

The drug inhibits DNA synthesis and cross-links DNA at the N6 position of adenine and at the O6 and N2 positions of guanine. In addition, single-strand breakage of DNA is caused by reduced mitomycin; this can be prevented by free radical scavengers. Its action is most prominent during the late G1 and early S phases of the cell cycle.

or

Mitomycin is an antibiotic that is isolated from the broth of Streptomyces caespitosus. This drug has demonstrated antitumor activity.[rx][rx] Mitomycin belongs to a group of alkylating agents that work by cross-linking the complementary strands found in DNA with absolute specificity and high efficiency for the CpG sequence.[rx]

Once activated by a reduction cascade, a series of spontaneous transformations cause mitomycin to attack DNA twice, resulting in cross-linking of strands of DNA double helix, thereby inhibiting DNA synthesis. Mitomycin is non-specific for a particular cell cycle phase but can exert its maximum effect in both the late G as well as the early S-phases.[rx]

It also suppresses RNA and protein synthesis at higher concentrations, hence being useful against some bacteria, spirochetes, and viruses. Lending to its toxic profile, mitomycin has a limited role as an antibiotic.[rx] Mitomycin also causes chromosomal breaks, thus leading to shortened strands of DNA, which eventually leads to chromosomal damage; this property renders mitomycin a potent carcinogen and teratogen.[rx]

In glaucoma surgery, the antifibrotic property of mitomycin prevents tissue scarring when surgeons create a surgical ocular flap to relieve excess fluid buildup.[rx]

Use in Cancer

Mitomycin is approved to be used alone or with other drugs to treat:

• Gastric (stomach) and pancreatic adenocarcinoma that is locally advanced or has metastasized (spread to other parts of the body). It is used in patients whose disease has not gotten better with other types of treatment.
• Urothelial cancer in the upper urinary tract. It is given directly into the ureter or kidney as a treatment for adults with low-grade disease. This use is approved for the Jelmyto brand of mitomycin.

Mitomycin is also being studied in the treatment of other types of cancer.

Contraindications

• Hypersensitivity to the active component or any of the ingredients
• In patients with thrombocytopenia, coagulation disorder, or an increase in bleeding tendency due to other causes
• a bad infection
• hemolytic uremic syndrome, a condition that affects the kidney and the blood
• decreased function of bone marrow
• anemia
• increased risk of bleeding due to clotting disorder
• an increased risk of bleeding
• decreased blood platelets
• low levels of white blood cells
• heart failure
• x-ray results showing lung tissue changes
• stomatitis, a condition with painful swelling and sores inside the mouth
• decreased kidney function
• pregnancy
• a patient who is producing milk and breastfeeding

Dosage

Strengths: 5 mg; 20 mg; 40 mg; 1 mg/mL

Stomach Cancer

• After full hematologic recovery from any previous chemotherapy: 20 mg/m2 IV at 6- to 8-week intervals
• Because of cumulative myelosuppression, patients should be reevaluated after each course of this drug and the dose reduced if the patient has experienced toxicity.
• Doses greater than 20 mg/m2 have not been shown to be more effective and are more toxic than lower doses.
• For disseminated adenocarcinoma of the stomach in proven combination with other approved chemotherapeutic agents or as palliative treatment when other modalities have failed
• For disseminated adenocarcinoma of the pancreas in proven combination with other approved chemotherapeutic agents or as palliative treatment when other modalities have failed

Gastric Cancer

• After full hematologic recovery from any previous chemotherapy: 20 mg/m2 IV at 6- to 8-week intervals
• Because of cumulative myelosuppression, patients should be reevaluated after each course of this drug and the dose reduced if the patient has experienced toxicity.
• Doses greater than 20 mg/m2 have not been shown to be more effective and are more toxic than lower doses.
• For disseminated adenocarcinoma of the stomach in proven combination with other approved chemotherapeutic agents or as palliative treatment when other modalities have failed
• For disseminated adenocarcinoma of the pancreas in proven combination with other approved chemotherapeutic agents or as palliative treatment when other modalities have failed

Dose Adjustments

DOSE ADJUSTMENTS:
NADIR AFTER THE PREVIOUS DOSE:

• Leukocytes greater than 4000/mm3 and platelets greater than 100,000/mm3: Give 100% of the prior dose.
• Leukocytes 3000 to 3999/mm3 and platelets 75,000 to 99,999/mm3: Give 100% of the prior dose.
• Leukocytes 2000 to 2999/mm3 and platelets 25,000 to 74,999/mm3: Give 70% of the prior dose.
• Leukocytes less than 2000 and platelets less than 25,000/mm3: Give 50% of the prior dose.
• No repeat dosage should be given until the leukocyte count has returned to 4000/mm3 and platelet count to 100,000/mm3.
• When this drug is used in combination with other myelosuppressive agents, the doses should be adjusted accordingly.
• If the disease continues to progress after 2 courses of this drug, therapy should be stopped since the chances of response are minimal.

Administration advice:

• Inspect visually for particulate matter and discoloration prior to administration.
• Give this drug IV only and avoid extravasation. If extravasation occurs, cellulitis, ulceration, and slough may result.

Reconstitution/preparation techniques:

• Each vial contains either mitomycin 5 mg and mannitol 10 mg, mitomycin, 20 mg and mannitol 40 mg or mitomycin 40 mg and mannitol 80 mg. To administer, add Sterile Water for Injection, 10 mL, 40 mL or 80 mL respectively. Shake to dissolve. If product does not dissolve immediately, allow to stand at room temperature until solution is obtained.
• The manufacturer’s product information should be consulted for more information.
• Avoid excessive heat (over 40C; 104F).
• Reconstituted with sterile water for injection to a concentration of 0.5 mg/mL is stable for 14 days refrigerated or 7 days at room temperature.
• This drug is stable in 0.9% sodium chloride injection for 12 hours.
• This drug is stable in sodium lactate injection for 24 hours.

Monitoring:

• Platelet count
• White blood cell count
• Differential
• Hemoglobin

Side Effects

The Most Common

• nausea
• vomiting
• loss of appetite or weight
• sores in the mouth and throat
• headache
• fainting
• blurred vision
• hair loss
• loss of strength and energy
• rash
• pain, itching, redness, swelling, blisters, or sores on the skin especially near the injection site
• shortness of breath
• difficulty breathing
• fast, irregular, or pounding heartbeat

Most  common

• Black, tarry stools
• blood in urine or stools
• signs of infection (fever, weakness, cold or flu symptoms, skin sores, frequent or recurring illness);
• wheezing, chest tightness, new or worsening cough, trouble breathing;
• blisters or ulcers in your mouth, red or swollen gums, trouble swallowing; or
• pain, burning, redness, swelling, irritation, or skin changes where the injection was given.
• cough or hoarseness
• fever or chills
• lower back or side pain
• painful or difficult urination
• pinpoint red spots on skin
• unusual bleeding or bruising

Rare

• Cough
• decreased urination
• shortness of breath
• sores in mouth and on lips
• swelling of feet or lower legs
• Bloody vomit
• Loss of appetite
• nausea and vomiting
• Numbness or tingling in fingers and toes
• purple-colored bands on nails
• skin rash
• unusual tiredness or weakness

Drug Interactions

DRUG	INTERACTION
Abatacept	The risk or severity of adverse effects can be increased when Mitomycin is combined with Abatacept.
Abciximab	The risk or severity of bleeding can be increased when Abciximab is combined with Mitomycin.
Acenocoumarol	The risk or severity of bleeding can be increased when Acenocoumarol is combined with Mitomycin.
Acetyldigitoxin	Acetyldigitoxin may decrease the cardiotoxic activities of Mitomycin.
Acetylsalicylic acid	The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Mitomycin.
Adalimumab	The risk or severity of adverse effects can be increased when Adalimumab is combined with Mitomycin.
Adenovirus type	The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Mitomycin.
Aldesleukin	The risk or severity of adverse effects can be increased when Aldesleukin is combined with Mitomycin.
Alefacept	The risk or severity of adverse effects can be increased when Alefacept is combined with Mitomycin.
Alemtuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mitomycin.
Allogeneic pr	The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Mitomycin.
Allopurinol	The risk or severity of adverse effects can be increased when Allopurinol is combined with Mitomycin.
Alteplase	The risk or severity of bleeding can be increased when Alteplase is combined with Mitomycin.
Altretamine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Altretamine.
Amsacrine	The risk or severity of adverse effects can be increased when Amsacrine is combined with Mitomycin.
Anagrelide	The risk or severity of bleeding can be increased when Anagrelide is combined with Mitomycin.
Anakinra	The risk or severity of adverse effects can be increased when Anakinra is combined with Mitomycin.
Anastrozole	The risk or severity of cardiotoxicity can be increased when Mitomycin is combined with Anastrozole.
Ancrod	The risk or severity of bleeding can be increased when Ancrod is combined with Mitomycin.
Anifrolumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Anifrolumab.
Anistreplase	The risk or severity of bleeding can be increased when Anistreplase is combined with Mitomycin.
Anthrax immune	The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Mitomycin.
Anthrax vaccine	The risk or severity of infection can be increased when Anthrax vaccine is combined with Mitomycin.
Antilymphocyte	The risk or severity of adverse effects can be increased when Mitomycin is combined with Antilymphocyte immunoglobulin (horse).
Antithrombin Alfa	The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Mitomycin.
Antithrombin III	The risk or severity of bleeding can be increased when Antithrombin III human is combined with Mitomycin.
Antithymocyte	The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Mitomycin.
Apixaban	The risk or severity of bleeding can be increased when Apixaban is combined with Mitomycin.
Apremilast	The risk or severity of adverse effects can be increased when Mitomycin is combined with Apremilast.
Ardeparin	The risk or severity of bleeding can be increased when Ardeparin is combined with Mitomycin.
Argatroban	The risk or severity of bleeding can be increased when Argatroban is combined with Mitomycin.
Arsenic trioxide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Arsenic trioxide.
Articaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Articaine.
AstraZeneca	The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Mitomycin.
Azacitidine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Azacitidine.
Azathioprine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Azathioprine.
Bacillus	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Mitomycin.
Bacillus calm	The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Mitomycin.
Bacillus calmette	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Mitomycin.
Baricitinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Baricitinib.
Basiliximab	The risk or severity of adverse effects can be increased when Basiliximab is combined with Mitomycin.
BCG vaccine	The risk or severity of infection can be increased when BCG vaccine is combined with Mitomycin.
Beclomethasone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Beclomethasone dipropionate.
Belatacept	The risk or severity of adverse effects can be increased when Mitomycin is combined with Belatacept.
Belimumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Belimumab.
Belinostat	The risk or severity of adverse effects can be increased when Mitomycin is combined with Belinostat.
Belumosudil	The risk or severity of adverse effects can be increased when Mitomycin is combined with Belumosudil.
Bemiparin	The risk or severity of bleeding can be increased when Bemiparin is combined with Mitomycin.
Bendamustine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Bendamustine.
Bendroflumethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Mitomycin.
Benzocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Benzocaine.
Benzthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Mitomycin.
Benzyl alcohol	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Benzyl alcohol.
Betamethasone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Betamethasone.
Betrixaban	The risk or severity of bleeding can be increased when Betrixaban is combined with Mitomycin.
Bevacizumab	The risk or severity of cardiotoxicity can be increased when Bevacizumab is combined with Mitomycin.
Bexarotene	The risk or severity of adverse effects can be increased when Mitomycin is combined with Bexarotene.
Bimekizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Bimekizumab.
Bivalirudin	The risk or severity of bleeding can be increased when Bivalirudin is combined with Mitomycin.
Bleomycin	The risk or severity of adverse effects can be increased when Bleomycin is combined with Mitomycin.
Blinatumomab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Blinatumomab.
Bordetella	The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Mitomycin.
Bortezomib	The risk or severity of adverse effects can be increased when Bortezomib is combined with Mitomycin.
Bosutinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Bosutinib.
Brentuximab ve	The risk or severity of adverse effects can be increased when Mitomycin is combined with Brentuximab vedotin.
Brodalumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Brodalumab.
Budesonide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Budesonide.
Bupivacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Bupivacaine.
Busulfan	The risk or severity of adverse effects can be increased when Mitomycin is combined with Busulfan.
Butacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Butacaine.
Butamben	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Butamben.
Cabazitaxel	The risk or severity of adverse effects can be increased when Mitomycin is combined with Cabazitaxel.
Canakinumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Canakinumab.
Cangrelor	The risk or severity of bleeding can be increased when Cangrelor is combined with Mitomycin.
Capecitabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Capecitabine.
Caplacizumab	The risk or severity of bleeding can be increased when Caplacizumab is combined with Mitomycin.
Capsaicin	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Capsaicin.
Carbamazepine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Carbamazepine.
Carboplatin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Carboplatin.
Carfilzomib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Carfilzomib.
Carmustine	The risk or severity of adverse effects can be increased when Carmustine is combined with Mitomycin.
Certolizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Certolizumab pegol.
Chlorambucil	The risk or severity of adverse effects can be increased when Chlorambucil is combined with Mitomycin.
Chloramphenicol	The risk or severity of adverse effects can be increased when Mitomycin is combined with Chloramphenicol.
Chloroprocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Chloroprocaine.
Chlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Mitomycin.
Ciclesonide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ciclesonide.
Cilostazol	The risk or severity of bleeding can be increased when Cilostazol is combined with Mitomycin.
Cinchocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Cinchocaine.
Cisplatin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Cisplatin.
Cladribine	The risk or severity of adverse effects can be increased when Cladribine is combined with Mitomycin.
Clobetasol	The risk or severity of adverse effects can be increased when Mitomycin is combined with Clobetasol propionate.
Clofarabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Clofarabine.
Clopidogrel	The risk or severity of bleeding can be increased when Clopidogrel is combined with Mitomycin.
Clostridium tetani	The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Mitomycin.
Clozapine	The risk or severity of neutropenia can be increased when Mitomycin is combined with Clozapine.
Cocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Cocaine.
Corticotropin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Corticotropin.
Cortisone acetate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Cortisone acetate.
Corynebacterium	The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Mitomycin.

Cyanocobalamin	The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Mitomycin.
Cyclopenthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Mitomycin.
Cyclophosphamide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Cyclophosphamide.
Cyclosporine	Mitomycin may increase the immunosuppressive activities of Cyclosporine.
Cyclothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Mitomycin.
Cytarabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Cytarabine.
Dabigatran	The risk or severity of bleeding can be increased when Dabigatran is combined with Mitomycin.
Dabigatran etexilate	The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Mitomycin.
Dacarbazine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dacarbazine.
Dactinomycin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dactinomycin.
Dalteparin	The risk or severity of bleeding can be increased when Dalteparin is combined with Mitomycin.
Danaparoid	The risk or severity of bleeding can be increased when Danaparoid is combined with Mitomycin.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Mitomycin.
Dasatinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dasatinib.
Daunorubicin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Daunorubicin.
Decitabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Decitabine.
Defibrotide	The risk or severity of bleeding can be increased when Defibrotide is combined with Mitomycin.
Deflazacort	The risk or severity of adverse effects can be increased when Mitomycin is combined with Deflazacort.
Denosumab	The risk or severity of adverse effects can be increased when Denosumab is combined with Mitomycin.
Desirudin	The risk or severity of bleeding can be increased when Desirudin is combined with Mitomycin.
Deslanoside	Deslanoside may decrease the cardiotoxic activities of Mitomycin.
Desoximetasone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Desoximetasone.
Deucravacitinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Deucravacitinib.
Dexamethasone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dexamethasone.
Dexrazoxane	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dexrazoxane.
Dextran	The risk or severity of bleeding can be increased when Dextran is combined with Mitomycin.
Dicoumarol	The risk or severity of bleeding can be increased when Dicoumarol is combined with Mitomycin.
Difluocortolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Difluocortolone.
Digitoxin	Digitoxin may decrease the cardiotoxic activities of Mitomycin.
Digoxin	Digoxin may decrease the cardiotoxic activities of Mitomycin.
Dimethyl fumar	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dimethyl fumarate.
Dinutuximab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Dinutuximab.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Diphenhydramine.
Dipyridamole	The risk or severity of bleeding can be increased when Dipyridamole is combined with Mitomycin.
Diroximel fumarate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Diroximel fumarate.
Docetaxel	The risk or severity of adverse effects can be increased when Mitomycin is combined with Docetaxel.
Doxorubicin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Doxorubicin.
Drotrecogin alfa	The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Mitomycin.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Dyclonine.
Ebola Zaire vaccine	The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Mitomycin.
Eculizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Eculizumab.
Edetic acid	The risk or severity of bleeding can be increased when Edetic acid is combined with Mitomycin.
Edoxaban	The risk or severity of bleeding can be increased when Edoxaban is combined with Mitomycin.
Efalizumab	The risk or severity of adverse effects can be increased when Efalizumab is combined with Mitomycin.
Emapalumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Emapalumab.
Enoxaparin	The risk or severity of bleeding can be increased when Enoxaparin is combined with Mitomycin.
Epirubicin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Epirubicin.
Epoprostenol	The risk or severity of bleeding can be increased when Epoprostenol is combined with Mitomycin.
Eptifibatide	The risk or severity of bleeding can be increased when Eptifibatide is combined with Mitomycin.
Eribulin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Eribulin.
Erythropoietin	The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Mitomycin.
Estramustine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Estramustine.
Etanercept	The risk or severity of adverse effects can be increased when Etanercept is combined with Mitomycin.
Ethyl chloride	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Ethyl chloride.
Etidocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Etidocaine.
Etoposide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Etoposide.
Everolimus	The risk or severity of adverse effects can be increased when Mitomycin is combined with Everolimus.
Famtozinameran	The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Mitomycin.
Filgotinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Filgotinib.
Fingolimod	Mitomycin may increase the immunosuppressive activities of Fingolimod.
Floxuridine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Floxuridine.
Flucytosine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Flucytosine.
Fludarabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fludarabine.
Fludrocortisone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fludrocortisone.
Fluindione	The risk or severity of bleeding can be increased when Fluindione is combined with Mitomycin.
Flunisolide	The risk or severity of adverse effects can be increased when Flunisolide is combined with Mitomycin.
Fluocinolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluocinolone acetonide.
Fluocinonide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluocinonide.
Fluocortolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluocortolone.
Fluorometholone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluorometholone.
Fluorouracil	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluorouracil.
Flupentixol	The risk or severity of myelosuppression can be increased when Flupentixol is combined with Mitomycin.
Fluprednisolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluprednisolone.
Fluticasone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluticasone.
Fluticasone furoate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluticasone furoate.
Fluticasone prop	The risk or severity of adverse effects can be increased when Mitomycin is combined with Fluticasone propionate.
Fondaparinux	The risk or severity of bleeding can be increased when Fondaparinux is combined with Mitomycin.
Gallium nitrate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Gallium nitrate.
Gemcitabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Gemcitabine.
Gemtuzumab	The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Mitomycin.
Glatiramer	The risk or severity of adverse effects can be increased when Mitomycin is combined with Glatiramer.
Golimumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Golimumab.
Guselkumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Guselkumab.
Haemophilus	The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Mitomycin.
Heparin	The risk or severity of bleeding can be increased when Heparin is combined with Mitomycin.
Hepatitis A Vaccine	The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Mitomycin.
Hepatitis B Vaccine	The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Mitomycin.
Human adenovirus	The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Mitomycin.
Hydrochlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Mitomycin.
Hydrocortisone a	The risk or severity of adverse effects can be increased when Mitomycin is combined with Hydrocortisone acetate.
Hydrocortisone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Hydrocortisone butyrate.
Hydrocortisone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Hydrocortisone succinate.
Hydroflumethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Mitomycin.
Hydroxychloroquine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Hydroxychloroquine.
Hydroxyurea	The risk or severity of adverse effects can be increased when Mitomycin is combined with Hydroxyurea.
Ibritumomab tiuxetan	The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Mitomycin.
Ibrutinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ibrutinib.
Icosapent ethyl	The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Mitomycin.
Idarubicin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Idarubicin.
Idelalisib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Idelalisib.

Leflunomide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Leflunomide.
Lenalidomide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Lenalidomide.
Lepirudin	The risk or severity of bleeding can be increased when Lepirudin is combined with Mitomycin.
Levobupivacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Levobupivacaine.
Lidocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Lidocaine.
Linezolid	The risk or severity of adverse effects can be increased when Mitomycin is combined with Linezolid.
Lipegfilgrastim	Mitomycin may increase the myelosuppressive activities of Lipegfilgrastim.
Lomustine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Lomustine.
Lopinavir	The serum concentration of Mitomycin can be increased when it is combined with Lopinavir.
Magnesium	The serum concentration of Magnesium can be decreased when it is combined with Mitomycin.
Measles virus	The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Mitomycin.
Mechlorethamine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mechlorethamine.
Meloxicam	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Meloxicam.
Melphalan	The risk or severity of adverse effects can be increased when Mitomycin is combined with Melphalan.
Meningococcal	The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Mitomycin.
Mepivacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Mepivacaine.
Mepolizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mepolizumab.
Meprednisone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Meprednisone.
Mercaptopurine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mercaptopurine.
Methimazole	The risk or severity of adverse effects can be increased when Mitomycin is combined with Methimazole.
Methotrexate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Methotrexate.
Methoxy	The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Mitomycin.
Methylprednisolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Methylprednisolone.
Mitoxantrone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mitoxantrone.
Moderna COVID	The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Mitomycin.
Modified vaccinia	The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Mitomycin.
Mometasone furoate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mometasone furoate.
Monomethyl fuma	The risk or severity of adverse effects can be increased when Mitomycin is combined with Monomethyl fumarate.
Mosunetuzumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mosunetuzumab.
Mumps virus	The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Mitomycin.
Muromonab	The risk or severity of adverse effects can be increased when Muromonab is combined with Mitomycin.
Mycophenolate m	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mycophenolate mofetil.
Mycophenolic acid	The risk or severity of adverse effects can be increased when Mitomycin is combined with Mycophenolic acid.
Nadroparin	The risk or severity of bleeding can be increased when Nadroparin is combined with Mitomycin.
Natalizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Natalizumab.
Nelarabine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Nelarabine.
Nilotinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Nilotinib.
Nimesulide	The risk or severity of bleeding can be increased when Nimesulide is combined with Mitomycin.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Mitomycin.
Obinutuzumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Obinutuzumab.
Ocrelizumab	Ocrelizumab may increase the immunosuppressive activities of Mitomycin.
Ofatumumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ofatumumab.
Olaparib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Olaparib.
Ouabain	Ouabain may decrease the cardiotoxic activities of Mitomycin.
Oxaliplatin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Oxaliplatin.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Oxetacaine.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Oxybuprocaine.
Ozanimod	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ozanimod.
Paclitaxel	The risk or severity of adverse effects can be increased when Mitomycin is combined with Paclitaxel.
Palbociclib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Palbociclib.
Palifermin	The therapeutic efficacy of Palifermin can be decreased when used in combination with Mitomycin.
Panobinostat	The risk or severity of adverse effects can be increased when Mitomycin is combined with Panobinostat.
Parnaparin	The risk or severity of bleeding can be increased when Parnaparin is combined with Mitomycin.
Pazopanib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pazopanib.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Mitomycin.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pegcetacoplan.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Mitomycin.
Peginterferon alfa-2	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Mitomycin.
Peginterferon alfa-2b	The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Mitomycin.
Peginterferon beta-	The risk or severity of adverse effects can be increased when Mitomycin is combined with Peginterferon beta-1a.
Pemetrexed	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pemetrexed.
Penicillamine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Penicillamine.
Pentosan polysulfate	The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Mitomycin.
Pentostatin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pentostatin.
Pentoxifylline	The risk or severity of bleeding can be increased when Pentoxifylline is combined with Mitomycin.
Pertussis vaccine	The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Mitomycin.
Pertuzumab	The risk or severity of cardiotoxicity can be increased when Mitomycin is combined with Pertuzumab.
Phenindione	The risk or severity of bleeding can be increased when Phenindione is combined with Mitomycin.
Phenol	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Phenol.

Phenprocoumon	The risk or severity of bleeding can be increased when Phenprocoumon is combined with Mitomycin.
Phenylalanine	The risk or severity of adverse effects can be increased when Phenylalanine is combined with Mitomycin.
Pimecrolimus	The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Mitomycin.
Pirfenidone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pirfenidone.
Polythiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Mitomycin.
Pomalidomide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pomalidomide.
Ponatinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ponatinib.
Ponesimod	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ponesimod.
Pralatrexate	The risk or severity of adverse effects can be increased when Mitomycin is combined with Pralatrexate.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Pramocaine.
Prasugrel	The risk or severity of bleeding can be increased when Prasugrel is combined with Mitomycin.
Prednisolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Prednisolone.
Prednisone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Prednisone.
Prilocaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Prilocaine.
Procaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Procaine.
Procarbazine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Procarbazine.
Proparacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Proparacaine.
Propoxycaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Propoxycaine.
Propylthiouracil	The risk or severity of adverse effects can be increased when Mitomycin is combined with Propylthiouracil.
Protein C	The risk or severity of bleeding can be increased when Protein C is combined with Mitomycin.
Protein S human	The risk or severity of bleeding can be increased when Protein S human is combined with Mitomycin.
Rab globulin	The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Mitomycin.
Rabies antigen, A	The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Mitomycin.
R antigen, B	The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Mitomycin.
Raltitrexed	The risk or severity of adverse effects can be increased when Raltitrexed is combined with Mitomycin.
Ravulizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ravulizumab.
Reteplase	The risk or severity of bleeding can be increased when Reteplase is combined with Mitomycin.
Reviparin	The risk or severity of bleeding can be increased when Reviparin is combined with Mitomycin.
Rilonacept	The risk or severity of adverse effects can be increased when Mitomycin is combined with Rilonacept.
Risankizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Risankizumab.
Rituximab	The risk or severity of adverse effects can be increased when Rituximab is combined with Mitomycin.
Rivaroxaban	The risk or severity of bleeding can be increased when Rivaroxaban is combined with Mitomycin.
Roflumilast	Roflumilast may increase the immunosuppressive activities of Mitomycin.
Ropeginterferon	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ropeginterferon alfa-2b.
Ropivacaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Ropivacaine.
Rotavirus vaccine	The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Mitomycin.
Rubella virus vaccine	The risk or severity of infection can be increased when Rubella virus vaccine is combined with Mitomycin.
Ruxolitinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ruxolitinib.
Sarilumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Sarilumab.
Satralizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Satralizumab.
Secukinumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Secukinumab.
Siltuximab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Siltuximab.
Siponimod	The risk or severity of adverse effects can be increased when Mitomycin is combined with Siponimod.
Sipuleucel-T	The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Mitomycin.
Sirolimus	The risk or severity of adverse effects can be increased when Mitomycin is combined with Sirolimus.
Smallpox	The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Mitomycin.
Sodium citrate	The risk or severity of bleeding can be increased when Sodium citrate is combined with Mitomycin.
Sorafenib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Sorafenib.
Spesolimab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Spesolimab.
Streptokinase	The risk or severity of bleeding can be increased when Streptokinase is combined with Mitomycin.
Streptozocin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Streptozocin.
Sulfamethoxazole	The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Mitomycin.
Sulfasalazine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Sulfasalazine.
Sulfinpyrazone	The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Mitomycin.
Sulodexide	The risk or severity of bleeding can be increased when Sulodexide is combined with Mitomycin.
Sunitinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Sunitinib.
Tacrolimus	Tacrolimus may increase the immunosuppressive activities of Mitomycin.
Tamoxifen	The risk or severity of cardiotoxicity can be increased when Mitomycin is combined with Tamoxifen.
Tedizolid phosphate	The risk or severity of myelosuppression can be increased when Mitomycin is combined with Tedizolid phosphate.
Temozolomide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Temozolomide.
Temsirolimus	The risk or severity of adverse effects can be increased when Mitomycin is combined with Temsirolimus.
Tenecteplase	The risk or severity of bleeding can be increased when Tenecteplase is combined with Mitomycin.
Teniposide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Teniposide.
Teprotumumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Teprotumumab.
Teriflunomide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Teriflunomide.
Tetracaine	The risk or severity of methemoglobinemia can be increased when Mitomycin is combined with Tetracaine.
Thalidomide	The risk or severity of adverse effects can be increased when Mitomycin is combined with Thalidomide.
Thiotepa	The risk or severity of adverse effects can be increased when Mitomycin is combined with Thiotepa.
Ticagrelor	The risk or severity of bleeding can be increased when Ticagrelor is combined with Mitomycin.
Tick-borne ence	The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Mitomycin.
Ticlopidine	The risk or severity of bleeding can be increased when Ticlopidine is combined with Mitomycin.
Tinzaparin	The risk or severity of bleeding can be increased when Tinzaparin is combined with Mitomycin.
Tioguanine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Tioguanine.
Tirofiban	The risk or severity of bleeding can be increased when Tirofiban is combined with Mitomycin.
Tixocortol	The risk or severity of adverse effects can be increased when Mitomycin is combined with Tixocortol.
Tocilizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Tocilizumab.
Tofacitinib	Mitomycin may increase the immunosuppressive activities of Tofacitinib.
Topotecan	The risk or severity of adverse effects can be increased when Mitomycin is combined with Topotecan.
Tositumomab	The risk or severity of adverse effects can be increased when Tositumomab is combined with Mitomycin.
Trabectedin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Trabectedin.
Trastuzumab	Trastuzumab may increase the neutropenic activities of Mitomycin.
Trastuzumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Trastuzumab emtansine.
Tretinoin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Tretinoin.
Triamcinolone	The risk or severity of adverse effects can be increased when Mitomycin is combined with Triamcinolone.
Trichlormethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Mitomycin.
Trifluridine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Trifluridine.
Triflusal	The risk or severity of bleeding can be increased when Triflusal is combined with Mitomycin.
Trilostane	The risk or severity of adverse effects can be increased when Mitomycin is combined with Trilostane.
Typhoid vaccine	The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Mitomycin.
Typhoid Vaccine	The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Mitomycin.
Typhoid Vi pol	The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Mitomycin.
Ublituximab	The risk or severity of infection can be increased when Ublituximab is combined with Mitomycin.
Upadacitinib	The risk or severity of adverse effects can be increased when Mitomycin is combined with Upadacitinib.
Urokinase	The risk or severity of bleeding can be increased when Urokinase is combined with Mitomycin.
Varicella zoster	The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Mitomycin.
Varicella zoster	The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Mitomycin.
Vedolizumab	The risk or severity of adverse effects can be increased when Mitomycin is combined with Vedolizumab.
Vibrio cholerae	The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Mitomycin.
Vilanterol	The risk or severity of adverse effects can be increased when Mitomycin is combined with Vilanterol.
Vinblastine	The risk or severity of bronchospasm, shortness of breath, and dyspnea can be increased when Vinblastine is combined with Mitomycin.

Vincristine	The risk or severity of bronchospasm, shortness of breath, and dyspnea can be increased when Vincristine is combined with Mitomycin.
Vindesine	The risk or severity of bronchospasm, shortness of breath, and dyspnea can be increased when Vindesine is combined with Mitomycin.
Vinflunine	The risk or severity of bronchospasm, shortness of breath, and dyspnea can be increased when Vinflunine is combined with Mitomycin.
Vinorelbine	The risk or severity of bronchospasm, shortness of breath, and dyspnea can be increased when Vinorelbine is combined with Mitomycin.
Voclosporin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Voclosporin.
Vorapaxar	The risk or severity of bleeding can be increased when Vorapaxar is combined with Mitomycin.
Vorinostat	The risk or severity of adverse effects can be increased when Mitomycin is combined with Vorinostat.
Warfarin	The risk or severity of bleeding can be increased when Warfarin is combined with Mitomycin.
Ximelagatran	The risk or severity of bleeding can be increased when Ximelagatran is combined with Mitomycin.
Yellow fever vaccine	The risk or severity of infection can be increased when Yellow fever vaccine is combined with Mitomycin.
Zidovudine	The risk or severity of adverse effects can be increased when Mitomycin is combined with Zidovudine.

Pregnancy and Lactation

AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned.

Pregnancy

Based on findings in animals and mechanism of action, JELMYTO can cause fetal harm when administered to a pregnant woman. There are no available data on JELMYTO use in pregnant women to inform the drug-associated risk. In animal reproduction studies, administration of mitomycin resulted in teratogenicity (see Data). Advise pregnant women of the
potential risk to a fetus. The estimated background risk of major birth defects and miscarriage for the indicated population is
unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% – 4% and 15% – 20%, respectively.

Lactation

There are no data on the presence of mitomycin in human milk, the effects on the breastfed child, or the effects on milk production. Because of the potential for serious adverse reactions in a breastfed child, advise women not to breastfeed during treatment with JELMYTO and for 1 week following the last
dose.

Why is this medication prescribed?

Mitomycin is used in combination with other medications to treat cancer of the stomach or pancreas that has spread to other parts of the body and has not improved or worsened after treatment with other medications, surgery, or radiation therapy. Mitomycin is a type of antibiotic that is only used in cancer chemotherapy. It slows or stops the growth of cancer cells in your body.

How should this medicine be used?

Mitomycin comes as a powder to be mixed with liquid and injected intravenously (into a vein) by a doctor or nurse in a medical facility. It is usually injected once every 6 to 8 weeks.

Your doctor may need to delay your treatment or change your dose if you experience certain side effects. It is important for you to tell your doctor how you are feeling during your treatment with mitomycin injection.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Other uses for this medicine

Mitomycin is also sometimes used to treat anal cancer (cancer that begins in the anus), cervical cancer, a type of lung cancer (non-small cell lung cancer; NSCLC), and malignant mesothelioma (cancer in the lining of the chest or abdomen). Mitomycin is also sometimes used intravesically (infused directly into the bladder) to treat bladder cancer. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before receiving mitomycin,

• tell your doctor and pharmacist if you are allergic to mitomycin, any other medications, or any of the ingredients in mitomycin injection. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention if you have ever received doxorubicin (Adriamycin, Rubex). Your doctor may need to monitor you carefully for side effects.
• tell your doctor if you have a blood or bleeding disorder or if you recently noticed any unusual bruising or bleeding. Your doctor may not want you to receive a mitomycin injection.
• tell your doctor if you have or have ever had kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not breastfeed during your treatment with mitomycin.

References