mitomycin

Brand Name :

Mutamycin, Mitomycin C

Synonyms :

mitomycin

Class :

Antibiotic, Anti-neoplastic

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Actions and Spectrum: 

  • mitomycin is a chemotherapy drug commonly used to treat several types of cancer, including bladder, lung, and stomach cancers. The mechanism of action of mitomycin is unique and involves its ability to cross-link and damage DNA, thereby inhibiting DNA synthesis and ultimately leading to cell death. 
  • Specifically, mitomycin works by forming a complex with oxygen molecules, which then activates the drug to create highly reactive molecules called free radicals. These free radicals then cross-link the DNA strands, causing them to break and ultimately preventing the cell from replicating correctly. 
  • mitomycin has a broad spectrum of activity against many cancer cells, including those resistant to other chemotherapy drugs. However, its use is limited by its potential for severe side effects, including bone marrow suppression, gastrointestinal toxicity, and kidney damage. 

DRUG INTERACTION

mitomycin

&

  • Pembrolizumab / Berahyaluronidase
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  • barley grass
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  • interferon alfacon-1
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  • pyridoxal phosphate
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  • beta-alanine
  • dihomo-gamma-linolenic acid
  • urea/hydrocortisone
  • R21/Matrix-M vaccine
  • povidone-iodine (ophthalmic)
  • pheniramine
  • hydrocortisone rectal
  • chloroxylenol/pramoxine/zinc acetate
  • chloroxylenol/pramoxine
  • dextrose/sucrose/vitamin C/zinc sulphate
  • furazolidone/metronidazole/dicyclomine
  • ergocalciferol (vitamin D2)
  • benoxaprofen (discontinued)
  • teicoplanin
  • carbomer
  • chromic chloride / iron (ii) chloride tetrahydrate / potassium iodide / manganese chloride / sodium fluoride / sodium selenite pentahydrate / sodium molybdate dihydrate / zinc chloride/ cupric chloride
  • bufylline
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  • opium tincture, squill oxymel
  • dibrompropamidine
  • metronidazole/tetracycline/bismuth subsalicylate
  • agnus- castus
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  • alendronic acid / colecalciferol
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  • dried ferrous sulfate/folic acid
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  • soya-bean oil, medium-chain triglycerides
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  • macrogol
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  • berdazimer topical (Pending FDA Approval)
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  • viscum abietis
  • pramoxine vaginal
  • bupivacaine implant
  • cromolyn sodium, inhaled
  • pneumococcal vaccine 20-valent
  • bimatoprost ophthalmic implant
  • tick-borne encephalitis vaccine
  • chloroprocaine ophthalmic
  • travoprost intraocular implant (Pending FDA approval)
  • typhoid polysaccharide vaccine
  • sodium phosphate
  • human papillomavirus vaccine, nonavalent
  • peanut immunotherapy epicutaneous (FDA approval pending)
  • cromolyn sodium, intranasal
  • red blood cells(Blood component)
  • oral mucoadhesive
  • clindamycin vaginal
  • whole blood (Blood Component)
  • fibrinogen/thrombin
  • levothyroxine/liothyronine
  • ipratropium intranasal
  • metronidazole vaginal
  • cyamemazine
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  • acepromazine
  • emylcamate
  • methionine
  • amino acids and electrolytes in dextrose with calcium
  • slippery elm
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  • hemoglobin crosfumaril
  • moperone
  • chlormidazole
  • brilaroxazine
  • palopegteriparatide
  • diazepam buccal
  • benegrastim (pending for FDA approval)
  • COVID-19 vaccine, adjuvanted-Novavax
  • vestronidase alfa-vjbk
  • tebipenem (Pending FDA Approval)
  • tislelizumab (Pending FDA Approval)
  • zolbetuximab (Pending FDA Approval)
  • zoliflodacin (pending FDA approval)
  • zibotentan and dapagliflozin
  • fluorine F18 DCFPyL
  • debamestrocel
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  • sabizabulin(Pending FDA approval)
  • fexapotide(Phase 3 Clinical trial)
  • diatrizoic acid
  • drotaverine
  • diethyl phthalate
  • enclomiphene
  • epalrestat
  • ethamsylate
  • flupirtine
  • imidurea
  • sodium glycolate
  • feracrylum
  • ethacridine
  • furazolidone/metronidazole
  • ozagrel hydrochloride
  • leptazol
  • l-glutamic acid /vitamin B complex
  • etizolam
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  • ethoheptazine citrate
  • etophylline and theophylline
  • etophylline
  • finger millet
  • drotaverine/mefenamic acid
  • dichloroxylenol
  • pneumococcal 7-valent vaccine
  • diclofenac and metaxalone
  • dipivefrin ophthalmic
  • enbucrilate
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  • potassium gluconate
  • aclarubicin
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  • adrenochrome monosemicarbazone
  • selenium sulfide topical
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  • amsacrine
  • amylmetacresol
  • sulfonated phenolics in aqueous solution
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  • clonazepam/escitalopram oxalate
  • allylestrenol
  • andrographolide
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  • technetium Tc-99m sestamibi
  • rubidium Rb-82
  • somapacitan
  • sodium sulfate, magnesium sulfate and potassium sulfate
  • almitrine
  • gramicidin
  • nikethamide
  • technetium Tc-99m sodium pertechnetate
  • betiatide
  • prilocaine/epinephrine
  • amlexanox
  • acetaminophen/salicylamide/phenyltoloxamine
  • neomycin topical
  • zilucoplan
  • antazoline and xylometazoline
  • toripalimab
  • iron isomaltoside
  • meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine
  • meningococcal A C Y and W-135 diphtheria conjugate vaccine
  • tetradecyl Sulfuric Acid
  • benzoyl peroxide, clindamycin phosphate, adapalene
  • ethylephedrine
  • actarit
  • pyrantel tartrate
  • tenofovir disoproxil fumarate or tenofovir DF
  • melitracen
  • amitriptylinoxide(Phase 4 Clinical Trials)
  • threonine
  • ditiocarb zinc
  • epicriptine
  • levallorphan
  • kinetin
  • laurocapram
  • pentagastrin
  • parthenolide
  • nicoboxil
  • protionamide
  • prulifloxacin
  • proscillaridin
  • tizanidine and rofecoxib
  • tolnaftate, gentamicin, chinoform and betamethasone valerate
  • pine bark extract
  • pipenzolate methylbromide
  • bephenium hydroxynaphthoate
  • niclosamide
  • pyrvinium
  • pipenzolate methylbromide/phenobarbitone
  • piracetam/ginkgo biloba/vinpocetine
  • benzyl benzoate/disulfiram
  • benzyl benzoate
  • loperamide/simethicone
  • piroctone olamine
  • sodium fusidate
  • piroxicam topical/capsaicin/menthol/methyl salicylate
  • sodium metabisulfite
  • sodium lauryl sulfate
  • taspoglutide
  • glyclopyramide
  • tolnaftate, gentamicin, iodochlorohydroxyquinoline, chlorocresol, betamethasone valerate
  • serratiopeptidase
  • sodium antimony gluconate
  • triamterene / benzthiazide
  • tribenoside / lidocaine
  • triclocarban
  • triprolidine/dextromethorphan  
  • vitamins/minerals/omega-3 Fatty acids
  • soyabean oil
  • sucralfate/oxethazaine
  • sucralfate/tinidazole/povidone iodine
  • sodium cromoglycate
  • aloe vera/liquid paraffin/white soft paraffin
  • aloe vera/jojoba oil/vitamin E
  • allantoin/triclosan/vitamin e/zinc oxide
  • alpha-Lipoic acid/minerals/multivitamins
  • alprazolam/paracetamol
  • alprazolam/melatonin
  • azithromycin/ambroxol
  • atorvastatin/clopidogrel/aspirin
  • aceclofenac, paracetamol and serratiopeptidase
  • alfacalcidol, vitamin B-complex, minerals and antioxidants
  • alpha- lipoic acid, vitamin b complex and vitamin c
  • alpha-galactosidase and simethicone
  • alpha-galactosidase, amylase, proteases, lipase and lactase
  • amikacin and cefepime
  • aminophylline, ephedrine and phenobarbitone
  • artesunate, sulphadoxine and pyrimethamine
  • finasteride/tamsulosin
  • flavoxate/ofloxacin
  • fenofibrate/metformin
  • lignocaine, hydrocortisone topical and allantoin
  • linoleic acid and sodium lactate
  • troxerutin
  • meclizine/nicotinic acid
  • mecobalamin/ginkgo Biloba
  • spirulina
  • loperamide and furazolidone
  • ketoconazole/cetrimide
  • ketoconazole/zinc pyrithione
  • lercanidipine/atenolol
  • levocetirizine/montelukast/ambroxol
  • levarterenol
  • levocetirizine/phenylpropanolamine 
  • indapamide/amlodipine
  • itopride/methyl polysiloxane
  • mebendazole/levamisole
  • eberconazole/mometasone
  • gliclazide/metformin/pioglitazone
  • fluconazole/tinidazole
  • haemocoagulase
  • halometasone
  • hesperidin
  • imipramine/chlordiazepoxide
  • idebenone / l-arginine / zinc sulphate/selenium/proanthocyanidin
  • mecobalamin and piracetam
  • mesterolone
  • mosapride and pantoprazole
  • atorvastatin, co enzyme q10, vitamin e, zinc, and selenium
  • azithromycin and benzalkonium chloride
  • beta carotene, vitamin c, vitamin e, minerals, lutein, eicosapentaenoic acid, docosahexenoic acid and vit b12
  • alpha-galactosidase
  • aloe vera gel/vitamin e/lactic acid
  • aloe vera gel/jojoba/vitamin e/glycerine
  • famotidine and domperidone
  • faropenem medoxomil
  • nedosiran
  • fluconazole/ornidazole/azithromycin
  • ebastine/montelukast
  • eberconazole
  • dienogest/estradiol valerate
  • ambroxol/salbutamol
  • benzoic acid/salicylic acid/ichthammol/ triamcinolone acetonide
  • desloratadine/ambroxol
  • dexibuprofen/paracetamol
  • atorvastatin/ramipril
  • diastase
  • diastase and simethicone
  • diazepam and propranolol
  • dexrabeprazole / domperidone
  • dexrabeprazole
  • dexketoprofen /paracetamol
  • beta carotene/vitamin C/minerals
  • aloe vera gel/urea
  • aloe vera gel/glycerine
  • alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
  • alprazolam/propranolol
  • alprazolam /sertraline
  • ibuprofen/dextropropoxyphene
  • ambroxol/cetirizine/phenylephrine/ guaiphenesin/menthol
  • dextropropoxyphene/dexchlorpheniramine maleate/bromhexine
  • promegestone
  • batroxobin
  • bencyclane
  • benfluorex
  • acetylpheneturide
  • abarelix
  • abetimus
  • naftidrofuryl
  • nalorphine
  • oxiracetam
  • letosteine
  • lafutidine
  • leuprorelin
  • levodropropizine
  • glutaral
  • losartan/ramipril
  • gallopamil
  • lanatoside c
  • lauromacrogol
  • gestodene
  • aceclofenac/methyl salicylate/menthol/linseed oil/capsaicin
  • aceclofenac/paracetamol/tizanidine
  • alginic acid/magaldrate/simethicone
  • aceclofenac/paracetamol
  • aceclofenac/rabeprazole
  • alginic acid
  • pantoprazole and domperidone
  • urokinase
  • rimiterol
  • olanzapine/fluoxetine
  • normethadone/hydroxyephedrine
  • myrtol
  • moxonidine
  • propylhexedrine
  • sodium hypochlorite solution
  • sodium chloride/sodium citrate
  • Hepatitis B Vaccine (Recombinant [Adjuvanted])
  • Hepatitis B Vaccine (Recombinant)
  • aceclofenac and serratiopeptidase
  • levosulpiride
  • niaprazine
  • tromantadine
  • trimetazidine
  • vinburnine
  • mizoribine
  • molgramostim
  • mosapride
  • eugenol
  • tolperisone
  • etamsylate
  • etynodiol
  • mizolastine
  • metenolone
  • reproterol
  • rebamipide
  • mephenoxalone
  • metandienone
  • furosemide/spironolactone
  • hydroxycarbamide
  • tenonitrozole
  • fenoverine
  • fenquizone
  • tiapride
  • tibolone
  • furazolidone
  • furosemide & amiloride
  • fosfestrol
  • fluclorolone
  • flubendazole
  • tertatolol
  • tetracosactide
  • tetryzoline
  • tolciclate
  • trapidil
  • troxipide
  • temoporfin
  • telbivudine
  • teprenone
  • hexamidine
  • mebhydrolin
  • mepartricin
  • fencamfamin
  • medazepam
  • theodrenaline
  • thiamazole
  • thiocolchicoside
  • psilocybin
  • veralipride
  • pyritinol
  • opipramol
  • oprelvekin
  • betamethasone + gentamicin
  • betamethasone + neomycin
  • betamethasone + salicylic acid
  • oxedrine
  • bopindolol
  • orgotein (investigational)
  • oxaceprol
  • ormeloxifene
  • bevantolol
  • bifemelane
  • clebopride
  • demoxytocin
  • cicletanine
  • cefsulodin
  • chlortalidon
  • sisomicin
  • somatrem
  • carbazochrome
  • caroverine
  • cathine
  • ipriflavone
  • isepamicin
  • silymarin
  • simethicone
  • sermorelin
  • diloxanide
  • dimethindene
  • diosmin/hesperidin
  • calamine
  • canrenone
  • captodiame
  • imidapril
  • cefetamet
  • cefodizime
  • cefoperazone + sulbactam
  • ivermectin + albendazole
  • serrapeptase
  • bromisoval
  • beraprost
  • pridinol
  • proglumide
  • bamipine
  • barnidipine
  • bamifylline
  • benzbromarone
  • betamethasone/fusidic acid
  • para-chlorophenol
  • pantethine
  • nomifensine
  • pemoline
  • parnaparin
  • pentolinium
  • nialamide
  • novobiocin
  • nicergoline
  • octocrylene
  • octisalate
  • oftasceine
  • oxolamine
  • oxyphencyclimine
  • penfluridol
  • pentoxyverine
  • phenoxymethylpenicillin
  • picloxydine
  • pilsicainide hydrochloride
  • piperazine
  • pirarubicin
  • policresulen
  • prifinium bromide
  • prethcamide
  • pristinamycin
  • pirenzepine
  • piribedil
  • pimethixene
  • pargyline
  • phosphatidyl choline
  • phthalylsulfathiazole
  • phytomenadione
  • pranlukast
  • pinazepam
  • oxyphenonium
  • noxytiolin
  • periciazine
  • pethidine
  • phenindamine
  • histidine
  • isoleucine
  • proline
  • lauric acid
  • lymecycline
  • hypromellose
  • abiraterone acetate and niraparib
  • ichthammol
  • levamisole
  • naftazone
  • nefopam
  • oxprenolol
  • oxybuprocaine
  • elranatamab-bcmm
  • lapyrium
  • isoaminile
  • iotrolan
  • mazindol
  • masoprocol
  • lypressin
  • meradimate
  • molsidomine
  • monobenzone
  • mequinol/gluconolactone/ lactobionic acid/ arbutin
  • medifoxamine
  • mebutamate
  • metergoline
  • methantheline
  • methdilazine
  • metocurine
  • micronomicin
  • metaraminol
  • mephenesin
  • menadione
  • medrysone
  • metixene
  • levobetaxolol
  • guaiacol glycerol ether
  • eucalyptol
  • sodium tetradecyl sulfate
  • sugammadex
  • carbetocin
  • certoparin
  • chlorcyclizine/pseudoephedrine
  • cephapirin
  • indecainide
  • iobitridol
  • iomeprol
  • chlorphenesin
  • msud analog
  • msud maxamum
  • iceland moss
  • glutethimide
  • hexachlorophene
  • haloprogin
  • deferoxamine
  • ethchlorvynol
  • dexpanthenol topical
  • etilefrine
  • deslanoside
  • carbocromen
  • diazolidinylurea
  • dibenzepin
  • etofamide
  • guanoxan
  • halazepam
  • guanadrel sulfate
  • dapiprazole
  • soapwort
  • debrisoquine
  • l-tryptophan
  • chlormerodrin
  • chlorquinaldol
  • cetrimonium
  • carbocisteine
  • chlorcyclizine/codeine
  • technetium Tc-99m tetrofosmin
  • technetium Tc-99m disofenin
  • technetium Tc-99m gluceptate
  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
  • technetium tc-99m medronate
  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
  • technetium Tc-99m pyrophosphate
  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • Trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • Elamipretide
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • Methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-hydroxytryptophan (5-htp)
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
mitomycin + 

coccidioidin skin test 

may decrease the diagnostic effect of immunosuppressants

cOVID-19 vaccine 

may decrease the therapeutic effect of immunosuppressants

deferiprone 

may increase the neutropenic effect of myelosuppressive agents

denosumab 

may increase the immunosuppressive effect of immunosuppressants

influenza virus vaccine 

may decrease the therapeutic effect of immunosuppressants

lenograstim 

may decrease the therapeutic effect of antineoplastic agents

lipegfilgrastim 

may decrease the therapeutic effect of antineoplastic agents

palifermin 

may increase the toxic effect of antineoplastic agents

rabies vaccine 

may increase the hypersensitivity reaction of immunosuppressants

ropeginterferon alfa 2b 

may decrease the myelosuppressive effect of myelosuppressive agents

sipuleucel-T 

may decrease the therapeutic effect of immunosuppressants

poliovirus vaccine, live, trivalent

may decrease the therapeutic effect of immunosuppressants

poliovirus vaccine inactivated

may decrease the therapeutic effect of immunosuppressants

measles mumps and rubella vaccine, live

may diminish the therapeutic effect

cOVID-19 subunit vaccine

may diminish the therapeutic effect

smallpox (vaccinia) vaccine, live

may diminish the therapeutic effect

cOVID-19 vaccine

may diminish the therapeutic effect

measles mumps and rubella vaccine, live

may diminish the therapeutic effect

cOVID-19 subunit vaccine

may diminish the therapeutic effect

smallpox (vaccinia) vaccine, live

may diminish the therapeutic effect

cOVID-19 vaccine

may diminish the therapeutic effect

spironolactone and hydrochlorothiazide

may enhance the toxic effects of the other by pharmacodynamic synergism

amiloride/hydrochlorothiazide

may enhance the toxic effects of the other by pharmacodynamic synergism

ethacrynic acid

may enhance the toxic effects of the other by pharmacodynamic synergism

dichlorphenamide

may enhance the toxic effects of the other by pharmacodynamic synergism

torsemide

may enhance the toxic effects of the other by pharmacodynamic synergism

abrocitinib 

may increase the immunosuppressive effect of immunosuppressants

baricitinib 

may increase the immunosuppressive effect of immunosuppressants

bcg vaccine 

may decrease the therapeutic effect of myelosuppressive agents

cladribine 

may increase the myelosuppressive effect of myelosuppressive agents

dengue vaccine 

may increase the toxic effect of immunosuppressants

deucravacitinib 

may increase the immunosuppressive effect of immunosuppressants

fexinidazole 

may increase the toxic effect of myelosuppressive agents

natalizumab 

may increase the immunosuppressive effect of immunosuppressants

pimecrolimus 

may increase the immunosuppressive effect of immunosuppressants

ruxolitinib 

may increase the immunosuppressive effect of immunosuppressants

tacrolimus 

may increase the immunosuppressive effect of immunosuppressants

typhoid vaccine 

may decrease the therapeutic effect of immunosuppressants

upadacitinib 

may increase the immunosuppressive effect of immunosuppressants

yellow fever vaccine 

may increase the toxic effect of immunosuppressants

chikungunya vaccine, live

may diminish the pharmacodynamic antagonistic effect of each other when combined

measles, mumps, rubella, and varicella vaccine, live 

may diminish the pharmacodynamic antagonistic effect of each other when combined

measles mumps and rubella vaccine, live

may diminish the pharmacodynamic antagonistic effect of each other when combined

cOVID-19 subunit vaccine

may diminish the pharmacodynamic antagonistic effect of each other when combined

smallpox (vaccinia) vaccine, live

may diminish the pharmacodynamic antagonistic effect of each other when combined

balsalazide

may increase the myelosuppressive effect of myelosuppressive agents

sulfasalazine

may increase the myelosuppressive effect of myelosuppressive agents

inebilizumab 

may increase the immunosuppressive effect of immunosuppressants

ocrelizumab 

may increase the immunosuppressive effect of immunosuppressants

olopatadine 

may increase the myelosuppressive effect of myelosuppressive agents

pneumococcal vaccine 

may decrease the therapeutic effect of immunosuppressants

pembrolizumab

may diminish the therapeutic effect

nivolumab

may diminish the therapeutic effect

abatacept

may diminish the therapeutic effect

pembrolizumab

may diminish the therapeutic effect

nivolumab

may diminish the therapeutic effect

abatacept

may diminish the therapeutic effect

bempedoic acid

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

caspofungin

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

darolutamide

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

clarithromycin

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

lonafarnib

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

etoposide

when both drugs are combined, there may be an increased risk or severity of adverse effects   

carmustine

when both the drugs are combined, the risk or severity of adverse effects increases    

topotecan

when both drugs are combined, there may be an increased risk or severity of adverse effects  

lenacapavir

may increase the levels of serum concentration

abiraterone

may increase the levels of serum concentration

mibefradil

may increase the levels of serum concentration

isoniazid

may increase the levels of serum concentration

mexiletine

may increase the levels of serum concentration

typhoid vaccine 

may reduce the therapeutic effect of typhoid Vaccine

primidone

may decrease the levels of serum concentration

phenobarbital

may decrease the levels of serum concentration

carbamazepine

may decrease the levels of serum concentration

efavirenz

may decrease the levels of serum concentration

isoniazid

may decrease the levels of serum concentration

maralixibat

may increase the levels of serum concentration

lenacapavir

may increase the levels of serum concentration

curcumin

may increase the levels of serum concentration

glecaprevir

may increase the levels of serum concentration

caspofungin

may increase the levels of serum concentration

abatacept 

it may enhance the risk of side effects when combined with mitomycin

abciximab 

it may enhance the risk of bleeding when combined with mitomycin

acenocoumarol 

it may enhance the risk of bleeding when combined with mitomycin

acetylsalicylic acid 

it may enhance the risk of bleeding when combined with mitomycin

adalimumab 

it may enhance the risk of side effects when combined with mitomycin

beclomethasone dipropionate 

it may enhance the risk of side effects when combined with mitomycin

belatacept 

it may enhance the risk of side effects when combined with mitomycin

belimumab 

it may enhance the risk of side effects when combined with mitomycin

belinostat 

it may enhance the risk of side effects when combined with mitomycin

belumosudil 

it may enhance the risk of side effects when combined with mitomycin

hydrotalcite 

it may enhance the risk of side effects when combined with misoprostol

prednisolone

may decrease the serum concentration

propofol

may decrease the serum concentration

 

Dosage Forms & Strengths 

Powder for Injection 

5mg 

20mg 

40mg 

Pancreatic Cancer 

Indicated for Pancreatic Cancer, Stomach cancer:


20mg/m2 intravenous every 6 to 8 weeks



Anal Cancer 

10mg/m2 intravenous bolus on days 1 to 29. Do not exceed 20mg/dose



Dose Adjustments

Administer 50% if:
Platelet count is less than 25 x 10^3/mmÂł
Leukocyte count is less than 2000/mmÂł

Administer 70% if:
Platelet count is less than 25-74.999 x 10^3/mmÂł
Leukocyte count is less than 2000-2999/mmÂł

Administer Full dose if:
Platelet count is more than 75 x 10^3/mmÂł
Leukocyte count is more than 3000/mmÂł

Renal Impairment
CrCl<10ml/min: Decrease the dose by 25%
Serum creatinine>1.7mg/dL: Usage avoided

 

Safety and efficacy not established 

 

Refer adult dosing 

Frequency defined 

>10% 

Myelosuppression (64%) 

Fever (14%) 

Hemolytic uremic syndrome (≤15%) 

Nausea/vomiting (14%) 

1-10% 

Increased serum creatinine (2%) 

Stomatitis (4%) 

Mucous membrane toxicity (4%)  

Frequency not defined 

Pulmonary toxicity 

Cystitis 

Nephrotoxicity 

Alopecia 

Fatigue 

Dyspnea 

Interstitial fibrosis 

Amenorrhea 

Black box warning: 

mitomycin has a black box warning, the most severe type of warning issued by the U.S. Food and Drug Administration (FDA). The black box warning for mitomycin highlights the potential for severe and sometimes fatal side effects associated with this medication.  

The black box warning notes explicitly the following potential risks associated with mitomycin use: 

  • Bone marrow suppression: mitomycin can suppress bone marrow function, leading to decreased white blood cell, red blood cell, and platelet counts. This can increase the risk of infection, anemia, and bleeding. 
  • Gastrointestinal toxicity: mitomycin can cause severe and potentially life-threatening gastrointestinal toxicity, including nausea, vomiting, diarrhea, and mucositis. 
  • Renal toxicity: mitomycin can cause kidney damage, including acute renal failure. 
  • Pulmonary toxicity: mitomycin can cause lung damage, including interstitial pneumonitis and pulmonary fibrosis. 
  • Secondary malignancies: mitomycin can increase the risk of developing secondary malignancies, including leukemia and bladder cancer. 

Contraindications/caution: 

Contraindications: 

mitomycin should not be used in patients with a history of hypersensitivity to mitomycin or its components. Other contraindications include: 

  • Severe bone marrow suppression: Mitomycin can cause bone marrow suppression, and its use is contraindicated in patients with severe bone marrow suppression. 
  • Severe liver or kidney disease: mitomycin is primarily eliminated from the body through the kidneys and liver, and its use is contraindicated in patients with severe liver or kidney disease. 
  • Pregnancy and breastfeeding: mitomycin can cause fetal harm and is contraindicated in pregnant and breastfeeding women. 
  • Recent vaccination: mitomycin can interfere with the immune system’s response to vaccines, and its use is contraindicated in patients who have received a live vaccine within the past 30 days. 
  • Infection: mitomycin can suppress the immune system and increase the risk of infection. Its use is contraindicated in patients with active infections. 

Caution: 

In addition to contraindications, several cautions should be considered when using mitomycin. These include: 

  • Renal impairment: mitomycin is primarily eliminated from the body through the kidneys, and its use should be avoided or closely monitored in patients with renal impairment. 
  • Hepatic impairment: mitomycin is metabolized in the liver, and its use should be avoided or closely monitored in patients with hepatic impairment. 
  • Previous radiation therapy: Previous radiation therapy may increase the risk of pulmonary toxicity associated with mitomycin. 
  • Prior use of chemotherapy: Prior use of certain chemotherapy drugs, such as cisplatin, may increase the risk of renal toxicity associated with mitomycin. 
  • Cardiovascular disease: mitomycin can cause cardiovascular toxicity, and its use should be closely monitored in patients with preexisting cardiovascular disease. 
  • Neurological disease: mitomycin can cause neurological toxicity, including confusion and seizures, and its use should be avoided or closely monitored in patients with preexisting neurological disease. 
  • Immunodeficiency: mitomycin can suppress the immune system, and its use should be avoided or closely monitored in patients with immunodeficiency. 
  • Elderly patients: Elderly patients may be more susceptible to the side effects of mitomycin and should be closely monitored during treatment. 

Pregnancy consideration: D 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology: 

mitomycin is an antineoplastic (anti-cancer) drug that belongs to the class of drugs known as alkylating agents. It works by cross-linking DNA, which inhibits DNA synthesis and ultimately leads to cell death. 

Pharmacodynamics: 

The pharmacodynamics of mitomycin is complex and involves multiple mechanisms of action. 

  • mitomycin works by cross-linking DNA strands, inhibiting DNA synthesis and causing cell death. It also interferes with RNA transcription and inhibits the formation of new blood vessels, which is essential for tumor growth and survival. 
  • mitomycin is a prodrug activated by an enzymatic reduction in the presence of oxygen. Once activated, it forms a free radical that reacts with DNA to form cross-links. The cross-links prevent the DNA strands from separating, which inhibits DNA replication and ultimately leads to cell death. 

Pharmacokinetics: 

Absorption 

mitomycin is not orally bioavailable and must be administered intravenously. 

Distribution 

mitomycin has a high volume of distribution, ranging from 16-56 L/m², indicating that it is extensively distributed throughout the body. The drug is highly protein-bound (approximately 60-80%) to plasma proteins, primarily to albumin. 

Metabolism 

mitomycin is metabolized primarily by bioreductive activation in the liver to form active metabolites, including mitomycin radicals, which are responsible for its cytotoxic effects. The metabolism of mitomycin is mediated by several enzymes, including NADPH-cytochrome P450 reductase and DT-diaphorase. 

Elimination and Excretion 

The drug is eliminated primarily by the kidneys, with about 10% excreted unchanged in the urine. The clearance of mitomycin ranges from 201-810 mL/min/m². The drug is rapidly cleared from the body, with an average half-life of 48 minutes. 

Administration: 

  • mitomycin is a cytotoxic drug administered intravenously by a healthcare professional in a hospital or clinic setting. The dosage and administration of mitomycin will vary depending on the patient’s age, weight, medical history, and type and stage of the cancer being treated. 
  • mitomycin is typically administered once every 6 to 8 weeks, although the exact dosing schedule may vary depending on the patient’s response to treatment and any adverse effects experienced. The drug is usually given as a slow infusion for 30 to 60 minutes, with the dose and infusion rate determined by the healthcare provider. 

Patient information leaflet 

Generic Name: mitomycin 

Pronounced: [ MYE-toe-MYE-sin ] 

Why do we use mitomycin? 

mitomycin is an antineoplastic (anticancer) drug that is used in the treatment of various types of cancer, including: 

  • Bladder cancer: mitomycin is a treatment option for superficial bladder cancer that has not spread into the bladder’s muscle layer. 
  • Breast cancer: mitomycin may be combined with other chemotherapy drugs to treat advanced or metastatic breast cancer. 
  • Gastrointestinal cancer: mitomycin is used in the treatment of various types of gastrointestinal cancers, including stomach cancer, pancreatic cancer, and colorectal cancer. 
  • Lung cancer: mitomycin is used as a treatment option for non-small cell lung cancer alone or in combination with other chemotherapy drugs. 
  • Head and neck cancer: mitomycin may be a soothing treatment option for head and neck cancer that has spread to other parts of the body. 
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mitomycin

Brand Name :

Mutamycin, Mitomycin C

Synonyms :

mitomycin

Class :

Antibiotic, Anti-neoplastic

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No data available for drug.

Dosage Forms & Strengths 

Powder for Injection 

5mg 

20mg 

40mg 

Pancreatic Cancer 

Indicated for Pancreatic Cancer, Stomach cancer:


20mg/m2 intravenous every 6 to 8 weeks



Anal Cancer 

10mg/m2 intravenous bolus on days 1 to 29. Do not exceed 20mg/dose



Dose Adjustments

Administer 50% if:
Platelet count is less than 25 x 10^3/mmÂł
Leukocyte count is less than 2000/mmÂł

Administer 70% if:
Platelet count is less than 25-74.999 x 10^3/mmÂł
Leukocyte count is less than 2000-2999/mmÂł

Administer Full dose if:
Platelet count is more than 75 x 10^3/mmÂł
Leukocyte count is more than 3000/mmÂł

Renal Impairment
CrCl<10ml/min: Decrease the dose by 25%
Serum creatinine>1.7mg/dL: Usage avoided

Safety and efficacy not established 

Refer adult dosing 

DRUG INTERACTION

mitomycin

&

mitomycin + 

coccidioidin skin test 

may decrease the diagnostic effect of immunosuppressants

cOVID-19 vaccine 

may decrease the therapeutic effect of immunosuppressants

deferiprone 

may increase the neutropenic effect of myelosuppressive agents

denosumab 

may increase the immunosuppressive effect of immunosuppressants

influenza virus vaccine 

may decrease the therapeutic effect of immunosuppressants

lenograstim 

may decrease the therapeutic effect of antineoplastic agents

lipegfilgrastim 

may decrease the therapeutic effect of antineoplastic agents

palifermin 

may increase the toxic effect of antineoplastic agents

rabies vaccine 

may increase the hypersensitivity reaction of immunosuppressants

ropeginterferon alfa 2b 

may decrease the myelosuppressive effect of myelosuppressive agents

sipuleucel-T 

may decrease the therapeutic effect of immunosuppressants

poliovirus vaccine, live, trivalent

may decrease the therapeutic effect of immunosuppressants

poliovirus vaccine inactivated

may decrease the therapeutic effect of immunosuppressants

measles mumps and rubella vaccine, live

may diminish the therapeutic effect

cOVID-19 subunit vaccine

may diminish the therapeutic effect

smallpox (vaccinia) vaccine, live

may diminish the therapeutic effect

cOVID-19 vaccine

may diminish the therapeutic effect

measles mumps and rubella vaccine, live

may diminish the therapeutic effect

cOVID-19 subunit vaccine

may diminish the therapeutic effect

smallpox (vaccinia) vaccine, live

may diminish the therapeutic effect

cOVID-19 vaccine

may diminish the therapeutic effect

spironolactone and hydrochlorothiazide

may enhance the toxic effects of the other by pharmacodynamic synergism

amiloride/hydrochlorothiazide

may enhance the toxic effects of the other by pharmacodynamic synergism

ethacrynic acid

may enhance the toxic effects of the other by pharmacodynamic synergism

dichlorphenamide

may enhance the toxic effects of the other by pharmacodynamic synergism

torsemide

may enhance the toxic effects of the other by pharmacodynamic synergism

abrocitinib 

may increase the immunosuppressive effect of immunosuppressants

baricitinib 

may increase the immunosuppressive effect of immunosuppressants

bcg vaccine 

may decrease the therapeutic effect of myelosuppressive agents

cladribine 

may increase the myelosuppressive effect of myelosuppressive agents

dengue vaccine 

may increase the toxic effect of immunosuppressants

deucravacitinib 

may increase the immunosuppressive effect of immunosuppressants

fexinidazole 

may increase the toxic effect of myelosuppressive agents

natalizumab 

may increase the immunosuppressive effect of immunosuppressants

pimecrolimus 

may increase the immunosuppressive effect of immunosuppressants

ruxolitinib 

may increase the immunosuppressive effect of immunosuppressants

tacrolimus 

may increase the immunosuppressive effect of immunosuppressants

typhoid vaccine 

may decrease the therapeutic effect of immunosuppressants

upadacitinib 

may increase the immunosuppressive effect of immunosuppressants

yellow fever vaccine 

may increase the toxic effect of immunosuppressants

chikungunya vaccine, live

may diminish the pharmacodynamic antagonistic effect of each other when combined

measles, mumps, rubella, and varicella vaccine, live 

may diminish the pharmacodynamic antagonistic effect of each other when combined

measles mumps and rubella vaccine, live

may diminish the pharmacodynamic antagonistic effect of each other when combined

cOVID-19 subunit vaccine

may diminish the pharmacodynamic antagonistic effect of each other when combined

smallpox (vaccinia) vaccine, live

may diminish the pharmacodynamic antagonistic effect of each other when combined

balsalazide

may increase the myelosuppressive effect of myelosuppressive agents

sulfasalazine

may increase the myelosuppressive effect of myelosuppressive agents

inebilizumab 

may increase the immunosuppressive effect of immunosuppressants

ocrelizumab 

may increase the immunosuppressive effect of immunosuppressants

olopatadine 

may increase the myelosuppressive effect of myelosuppressive agents

pneumococcal vaccine 

may decrease the therapeutic effect of immunosuppressants

pembrolizumab

may diminish the therapeutic effect

nivolumab

may diminish the therapeutic effect

abatacept

may diminish the therapeutic effect

pembrolizumab

may diminish the therapeutic effect

nivolumab

may diminish the therapeutic effect

abatacept

may diminish the therapeutic effect

bempedoic acid

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

caspofungin

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

darolutamide

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

clarithromycin

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

lonafarnib

it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

etoposide

when both drugs are combined, there may be an increased risk or severity of adverse effects   

carmustine

when both the drugs are combined, the risk or severity of adverse effects increases    

topotecan

when both drugs are combined, there may be an increased risk or severity of adverse effects  

lenacapavir

may increase the levels of serum concentration

abiraterone

may increase the levels of serum concentration

mibefradil

may increase the levels of serum concentration

isoniazid

may increase the levels of serum concentration

mexiletine

may increase the levels of serum concentration

typhoid vaccine 

may reduce the therapeutic effect of typhoid Vaccine

primidone

may decrease the levels of serum concentration

phenobarbital

may decrease the levels of serum concentration

carbamazepine

may decrease the levels of serum concentration

efavirenz

may decrease the levels of serum concentration

isoniazid

may decrease the levels of serum concentration

maralixibat

may increase the levels of serum concentration

lenacapavir

may increase the levels of serum concentration

curcumin

may increase the levels of serum concentration

glecaprevir

may increase the levels of serum concentration

caspofungin

may increase the levels of serum concentration

abatacept 

it may enhance the risk of side effects when combined with mitomycin

abciximab 

it may enhance the risk of bleeding when combined with mitomycin

acenocoumarol 

it may enhance the risk of bleeding when combined with mitomycin

acetylsalicylic acid 

it may enhance the risk of bleeding when combined with mitomycin

adalimumab 

it may enhance the risk of side effects when combined with mitomycin

beclomethasone dipropionate 

it may enhance the risk of side effects when combined with mitomycin

belatacept 

it may enhance the risk of side effects when combined with mitomycin

belimumab 

it may enhance the risk of side effects when combined with mitomycin

belinostat 

it may enhance the risk of side effects when combined with mitomycin

belumosudil 

it may enhance the risk of side effects when combined with mitomycin

hydrotalcite 

it may enhance the risk of side effects when combined with misoprostol

prednisolone

may decrease the serum concentration

propofol

may decrease the serum concentration

Actions and Spectrum: 

  • mitomycin is a chemotherapy drug commonly used to treat several types of cancer, including bladder, lung, and stomach cancers. The mechanism of action of mitomycin is unique and involves its ability to cross-link and damage DNA, thereby inhibiting DNA synthesis and ultimately leading to cell death. 
  • Specifically, mitomycin works by forming a complex with oxygen molecules, which then activates the drug to create highly reactive molecules called free radicals. These free radicals then cross-link the DNA strands, causing them to break and ultimately preventing the cell from replicating correctly. 
  • mitomycin has a broad spectrum of activity against many cancer cells, including those resistant to other chemotherapy drugs. However, its use is limited by its potential for severe side effects, including bone marrow suppression, gastrointestinal toxicity, and kidney damage. 

Frequency defined 

>10% 

Myelosuppression (64%) 

Fever (14%) 

Hemolytic uremic syndrome (≤15%) 

Nausea/vomiting (14%) 

1-10% 

Increased serum creatinine (2%) 

Stomatitis (4%) 

Mucous membrane toxicity (4%)  

Frequency not defined 

Pulmonary toxicity 

Cystitis 

Nephrotoxicity 

Alopecia 

Fatigue 

Dyspnea 

Interstitial fibrosis 

Amenorrhea 

Black box warning: 

mitomycin has a black box warning, the most severe type of warning issued by the U.S. Food and Drug Administration (FDA). The black box warning for mitomycin highlights the potential for severe and sometimes fatal side effects associated with this medication.  

The black box warning notes explicitly the following potential risks associated with mitomycin use: 

  • Bone marrow suppression: mitomycin can suppress bone marrow function, leading to decreased white blood cell, red blood cell, and platelet counts. This can increase the risk of infection, anemia, and bleeding. 
  • Gastrointestinal toxicity: mitomycin can cause severe and potentially life-threatening gastrointestinal toxicity, including nausea, vomiting, diarrhea, and mucositis. 
  • Renal toxicity: mitomycin can cause kidney damage, including acute renal failure. 
  • Pulmonary toxicity: mitomycin can cause lung damage, including interstitial pneumonitis and pulmonary fibrosis. 
  • Secondary malignancies: mitomycin can increase the risk of developing secondary malignancies, including leukemia and bladder cancer. 

Contraindications/caution: 

Contraindications: 

mitomycin should not be used in patients with a history of hypersensitivity to mitomycin or its components. Other contraindications include: 

  • Severe bone marrow suppression: Mitomycin can cause bone marrow suppression, and its use is contraindicated in patients with severe bone marrow suppression. 
  • Severe liver or kidney disease: mitomycin is primarily eliminated from the body through the kidneys and liver, and its use is contraindicated in patients with severe liver or kidney disease. 
  • Pregnancy and breastfeeding: mitomycin can cause fetal harm and is contraindicated in pregnant and breastfeeding women. 
  • Recent vaccination: mitomycin can interfere with the immune system’s response to vaccines, and its use is contraindicated in patients who have received a live vaccine within the past 30 days. 
  • Infection: mitomycin can suppress the immune system and increase the risk of infection. Its use is contraindicated in patients with active infections. 

Caution: 

In addition to contraindications, several cautions should be considered when using mitomycin. These include: 

  • Renal impairment: mitomycin is primarily eliminated from the body through the kidneys, and its use should be avoided or closely monitored in patients with renal impairment. 
  • Hepatic impairment: mitomycin is metabolized in the liver, and its use should be avoided or closely monitored in patients with hepatic impairment. 
  • Previous radiation therapy: Previous radiation therapy may increase the risk of pulmonary toxicity associated with mitomycin. 
  • Prior use of chemotherapy: Prior use of certain chemotherapy drugs, such as cisplatin, may increase the risk of renal toxicity associated with mitomycin. 
  • Cardiovascular disease: mitomycin can cause cardiovascular toxicity, and its use should be closely monitored in patients with preexisting cardiovascular disease. 
  • Neurological disease: mitomycin can cause neurological toxicity, including confusion and seizures, and its use should be avoided or closely monitored in patients with preexisting neurological disease. 
  • Immunodeficiency: mitomycin can suppress the immune system, and its use should be avoided or closely monitored in patients with immunodeficiency. 
  • Elderly patients: Elderly patients may be more susceptible to the side effects of mitomycin and should be closely monitored during treatment. 

Pregnancy consideration: D 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology: 

mitomycin is an antineoplastic (anti-cancer) drug that belongs to the class of drugs known as alkylating agents. It works by cross-linking DNA, which inhibits DNA synthesis and ultimately leads to cell death. 

Pharmacodynamics: 

The pharmacodynamics of mitomycin is complex and involves multiple mechanisms of action. 

  • mitomycin works by cross-linking DNA strands, inhibiting DNA synthesis and causing cell death. It also interferes with RNA transcription and inhibits the formation of new blood vessels, which is essential for tumor growth and survival. 
  • mitomycin is a prodrug activated by an enzymatic reduction in the presence of oxygen. Once activated, it forms a free radical that reacts with DNA to form cross-links. The cross-links prevent the DNA strands from separating, which inhibits DNA replication and ultimately leads to cell death. 

Pharmacokinetics: 

Absorption 

mitomycin is not orally bioavailable and must be administered intravenously. 

Distribution 

mitomycin has a high volume of distribution, ranging from 16-56 L/m², indicating that it is extensively distributed throughout the body. The drug is highly protein-bound (approximately 60-80%) to plasma proteins, primarily to albumin. 

Metabolism 

mitomycin is metabolized primarily by bioreductive activation in the liver to form active metabolites, including mitomycin radicals, which are responsible for its cytotoxic effects. The metabolism of mitomycin is mediated by several enzymes, including NADPH-cytochrome P450 reductase and DT-diaphorase. 

Elimination and Excretion 

The drug is eliminated primarily by the kidneys, with about 10% excreted unchanged in the urine. The clearance of mitomycin ranges from 201-810 mL/min/m². The drug is rapidly cleared from the body, with an average half-life of 48 minutes. 

Administration: 

  • mitomycin is a cytotoxic drug administered intravenously by a healthcare professional in a hospital or clinic setting. The dosage and administration of mitomycin will vary depending on the patient’s age, weight, medical history, and type and stage of the cancer being treated. 
  • mitomycin is typically administered once every 6 to 8 weeks, although the exact dosing schedule may vary depending on the patient’s response to treatment and any adverse effects experienced. The drug is usually given as a slow infusion for 30 to 60 minutes, with the dose and infusion rate determined by the healthcare provider. 

Patient information leaflet 

Generic Name: mitomycin 

Pronounced: [ MYE-toe-MYE-sin ] 

Why do we use mitomycin? 

mitomycin is an antineoplastic (anticancer) drug that is used in the treatment of various types of cancer, including: 

  • Bladder cancer: mitomycin is a treatment option for superficial bladder cancer that has not spread into the bladder’s muscle layer. 
  • Breast cancer: mitomycin may be combined with other chemotherapy drugs to treat advanced or metastatic breast cancer. 
  • Gastrointestinal cancer: mitomycin is used in the treatment of various types of gastrointestinal cancers, including stomach cancer, pancreatic cancer, and colorectal cancer. 
  • Lung cancer: mitomycin is used as a treatment option for non-small cell lung cancer alone or in combination with other chemotherapy drugs. 
  • Head and neck cancer: mitomycin may be a soothing treatment option for head and neck cancer that has spread to other parts of the body. 

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