[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antitumour antibiotics](https://durgical.com/en/pharmacology/classes/antitumour-antibiotics/) › Mitomycin [Pharmacology](https://durgical.com/en/pharmacology/) · [Antitumour antibiotics](https://durgical.com/en/pharmacology/classes/antitumour-antibiotics/) # Mitomycin A Streptomyces drug that, once activated in the cell, cross-links DNA. Used for anal, gastric and pancreatic cancers and inside the bladder. Updated 2026-11-01 - Class: [Antitumour antibiotics](https://durgical.com/en/pharmacology/classes/antitumour-antibiotics/) - Target: DNA (cross-links at guanine and adenine) - ATC code: L01DC03 ## ⚠ High-alert medication An error with this medicine can cause serious harm: double checks and protocols are used. Also called: mitomycin C ## Mechanism of action Mitomycin is a prodrug. After enzymatic or chemical reduction inside the cell it becomes a bifunctional or trifunctional alkylating agent that cross-links DNA at guanine (O6 and N7) and adenine (N6). DNA synthesis stops, and attempts at repair produce strand breaks. - Reduction inside the cell activates mitomycin - It alkylates guanine and adenine - DNA cross-links stop DNA synthesis ## Pharmacokinetics **Absorption** Intravenous, or instilled into the bladder for superficial bladder tumours. **Metabolism** Inactivated mainly in the liver. **Half-life** Short: it is cleared from the blood in well under two hours. ## Indications - Disseminated adenocarcinoma of the stomach, in combination. [Gastric cancer →](https://durgical.com/en/conditions/gastric-cancer/) - Disseminated adenocarcinoma of the pancreas, in combination. [Pancreatic cancer →](https://durgical.com/en/conditions/pancreatic-cancer/) - Superficial transitional-cell bladder tumours, by bladder instillation. [Bladder cancer →](https://durgical.com/en/conditions/bladder-cancer/) - Anal cancer, in combination with fluorouracil. ## Adverse effects ### Common - Bone-marrow suppression (mainly platelets and white cells), followed for weeks after treatment - Mouth sores and hair loss - Nausea and vomiting ### Serious (rare, important) - Haemolytic uraemic syndrome (haemolytic anaemia, low platelets, irreversible kidney failure) - Severe myelosuppression with sepsis - Interstitial lung toxicity - Tissue necrosis and sloughing after extravasation ## Contraindications - Previous hypersensitivity or idiosyncratic reaction to mitomycin - Thrombocytopenia, coagulation disorders or increased bleeding tendency - Raised serum creatinine (kidney impairment) ## Key interactions **Vinca alkaloids (vincristine, vinblastine, vinorelbine)** Acute breathlessness and severe bronchospasm have occurred most often with this combination. ## What is monitored - Platelets, white cells and haemoglobin during treatment and for weeks afterwards - Creatinine, haemoglobin and blood smear for signs of haemolytic uraemic syndrome - Cough and breathlessness ## Administration and safety - Vesicant: given intravenously with care to avoid extravasation, which causes necrosis. - The route on the order (intravenous or bladder instillation) is checked before giving it. - Hazardous drug: prepared and given following hazardous-drug handling procedures (impervious gloves, no skin contact) and disposed of as cytotoxic waste. ## Nursing care - Independent double check of drug, patient, route and cycle before giving it (high-alert medicine). - Watch the infusion site closely and ask about pain or burning. - Bleeding precautions while platelets are low; counts are followed for weeks after the dose. - Teaching: report dark urine, less urine, unusual tiredness, bruising, cough or breathlessness. ## Pregnancy and breastfeeding Safe use in pregnancy has not been established; it is teratogenic in animals. ## Memory aid MITOmycin «MIxes Two strands Of DNA» once the cell activates it. Watch the kidneys and platelets: think HUS. ## Test yourself Think of the answer, then tap the question to see it. ## How does mitomycin damage DNA? After reductive activation inside the cell it becomes an alkylating agent that cross-links DNA at guanine and adenine. ## Which serious syndrome combining haemolysis, low platelets and kidney failure is linked to mitomycin? Haemolytic uraemic syndrome. ## Which combination with mitomycin has been linked to acute bronchospasm? Mitomycin with vinca alkaloids. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/mitomycin/) ## Related drugs - [Bleomycin](https://durgical.com/en/pharmacology/bleomycin/) - [Vincristine](https://durgical.com/en/pharmacology/vincristine/) ## Related conditions - [Gastric cancer](https://durgical.com/en/conditions/gastric-cancer/) - [Pancreatic cancer](https://durgical.com/en/conditions/pancreatic-cancer/) - [Bladder cancer](https://durgical.com/en/conditions/bladder-cancer/) [← Back to the class: Antitumour antibiotics](https://durgical.com/en/pharmacology/classes/antitumour-antibiotics/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [DailyMed - MITOMYCIN injection, powder, lyophilized, for solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5917f7a7-cd20-407b-8dda-9fd58c5f47a6) (DailyMed (U.S. National Library of Medicine), 2026); [DailyMed - VINCRISTINE SULFATE injection, solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b22e4c8e-dbe1-4d4b-a026-e1812974071c) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 70 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01DC03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/mitomycin/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/mitomycin/