A chemotherapy medicine also used in the bladder and eye surgery
Mitomycin
A chemotherapy medicine used for some cancers, as a bladder wash for bladder cancer, and in some eye surgery.
What is Mitomycin?
Mitomycin is a chemotherapy (cytotoxic) medicine used to treat certain cancers. It can be given into a vein for some cancers, placed directly into the bladder as a wash to treat bladder cancer, and applied during some eye and glaucoma surgery. Its most important risks are a fall in blood cells (raising the chance of infection, bleeding and anaemia) and, less often, serious lung or kidney problems. It can severely damage tissue if it leaks from the vein, and it must be handled as a cytotoxic medicine. It is given only by specialist teams with careful monitoring.
Education and reference only. This is a plain-language guide to Mitomycin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Mitomycin is a cytotoxic chemotherapy medicine, meaning it kills or stops the growth of cancer cells. It has several different uses: it can be given into a vein to treat some cancers, it can be put directly into the bladder as a wash (an instillation) to treat or prevent bladder cancer, and a small amount is sometimes applied by surgeons during certain eye operations, including glaucoma surgery, to improve healing. It is a powerful medicine given only by specialist cancer, urology or eye teams, with careful monitoring and special handling.
How it works
Mitomycin works by damaging the DNA inside cells so they can no longer divide and grow, which is how it kills cancer cells. Because cancer cells divide quickly, they are particularly affected, but some healthy fast-dividing cells — such as those in the bone marrow that make blood cells — can also be hit, which is why it can lower blood counts. When it is put into the bladder, it acts mainly on the bladder lining with less reaching the rest of the body. In eye surgery, a small amount is used locally to reduce scarring during healing.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist chemotherapy medicine used in the UK to treat certain cancers and, in lower-strength forms, in bladder and eye surgery.
Practical use
How to take Mitomycin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given only by specialist teams — into a vein, as a bladder wash, or applied during eye surgery — never by yourself.
- Report any fever, signs of infection, unusual bruising or bleeding straight away, as your blood counts may be low.
- Tell your team about new breathlessness, a persistent cough, or a drop in how much you are passing urine.
- The drip site is watched very carefully, as the medicine can cause severe tissue damage if it leaks from the vein.
- If it is put into your bladder, follow the advice you are given on handling your urine safely afterwards.
Weighing it up
Advantages & disadvantages of Mitomycin
Advantages
- An effective chemotherapy medicine for certain cancers.
- Can be placed directly into the bladder to treat or help prevent bladder cancer with less reaching the rest of the body.
- Used in small amounts during some eye and glaucoma surgery to improve healing.
Disadvantages
- Can lower blood cells, raising the risk of infection, bleeding and anaemia.
- Can, less commonly, cause serious lung or kidney problems.
- Can cause severe tissue damage if it leaks from the vein, and must be handled as a cytotoxic medicine.
Practical use
Good to know
The dominant safety points with mitomycin are about its effect on the body's cells. It can lower the blood cells made in the bone marrow, which raises the risk of infections, bleeding and bruising, and tiredness from anaemia, so blood counts are checked regularly and any fever or unusual bruising should be reported urgently. Less commonly it can cause serious lung problems (breathlessness and a cough) and serious kidney problems, including a condition affecting the blood and kidneys together, so breathing and kidney function are watched. A crucial point is that if it leaks out of the vein it can cause severe tissue damage, so the drip site is checked very carefully. It is a cytotoxic medicine that must be handled and disposed of safely by trained staff. When used in the bladder, people are given advice on handling their urine safely afterwards.
Who should not take it / use with caution
- People who have had a serious allergic reaction to mitomycin should not be given it.
- It is avoided or used with great care in people with very low blood counts or serious lung or kidney problems.
- It should not be used in pregnancy or breastfeeding, and effective contraception is advised around treatment.
Monitoring
- Regular blood counts to check for a fall in blood cells.
- Watching breathing and checking kidney function for the less common serious effects.
- Careful checking of the drip site, as a leak can cause severe tissue damage.
Side effects
- A fall in blood cells, raising the risk of infection, bleeding, bruising and tiredness from anaemia.
- Nausea, mouth soreness or tiredness.
- Less commonly, serious lung problems, serious kidney problems, or, when used in the bladder, bladder irritation and a rash on the hands.
Key interactions
- Using it with other medicines that lower blood counts can add to the effect on the bone marrow.
- Live vaccines are generally avoided during chemotherapy because the immune system is weakened.
- Tell your team about all your medicines, as several can interact with chemotherapy.
Available as: A solution for a drip into a vein, a wash placed into the bladder, or a solution applied during eye surgery.
Answers
Mitomycin: frequently asked questions
What is mitomycin used for?
It is a chemotherapy medicine used to treat certain cancers; it can be given into a vein, placed into the bladder as a wash for bladder cancer, or applied during some eye surgery.
Why are my blood counts checked?
Mitomycin can lower the blood cells made in the bone marrow, raising the risk of infection, bleeding and anaemia, so blood counts are monitored regularly.
What should I report urgently?
Report any fever or signs of infection, unusual bruising or bleeding, new breathlessness or a lasting cough, or a drop in how much urine you pass, straight away.
Why is the drip site watched so closely?
If mitomycin leaks out of the vein it can cause severe damage to the surrounding tissue, so the drip site is checked very carefully while it is given.
Is the bladder wash different from the drip?
Yes. When put into the bladder it acts mainly on the bladder lining with less reaching the rest of the body, and you are given advice on handling your urine safely afterwards.
The wider class
About Cytotoxic chemotherapy
Mitomycin belongs to the cytotoxic chemotherapy class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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