Mitomycin

In this article, we will discuss Mitomycin (Dosage Overview). So, let’s get started.

Indications

Mitomycin is indicated for the treatment of adult patients with low-grade Upper Tract Urothelial Cancer (LG-UTUC).

Dosage

Important Administration Instructions
See the Instructions for Administration provided separately.

Mitomycin is for pyelocalyceal use only. Mitomycin is not for intravenous use, topical use, or oral administration. Prior to every instillation, instruct the patient to take 1.3 g of sodium bicarbonate orally the evening prior to, the morning of, and 30 minutes prior to the instillation procedure (total of 3.9 g). General anesthesia, local anesthesia, sedation, prophylactic antibiotics and/or antihistamines may be used at the discretion of the treating urologist. If the patient is to be anesthetized, advise the patient not to take sodium bicarbonate within 30 minutes prior to the treatment. Consider withholding diuretics one day prior to instillation until 4 hours post-instillation. When instilling Mitomycin, the entire syringe must be emptied within one minute. Advise patients that Mitomycin may discolor urine to a violet to blue color following the instillation procedure. Advise patients to avoid contact with urine for at least six hours post-instillation, to void urine sitting on a toilet, and to flush the toilet several times after use.

Recommended Dosage

The dose of Mitomycin to be instilled is 4 mg per mL via ureteral catheter or a nephrostomy tube, with total instillation volume based on volumetric measurements using pyelography, not to exceed 15 mL (60 mg of mitomycin).

Instill Mitomycin once weekly for six weeks. For patients with a complete response 3 months after Mitomycin initiation, Mitomycin instillations may be administered once a month for a maximum of 11 additional instillations.

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