Mitonco

Uses

This is used for Diabetic foot infections; Chronic lymphatic leukaemia; Chronic myelogenous leukaemia; Gastric, Colorectal, Lung, Pancreatic, Cervix, Endometrium, Breast, Bladder, Head & neck carcinoma.

Mitonco is also used to associated treatment for these conditions: Adenocarcinoma of the Pancreas, Adenocarcinoma of the Stomach, Breast Cancer, Cancer, Anal, Cancer, Bladder, Cervical Cancers, Head and Neck Carcinoma, Mesothelioma, Non-Small Cell Lung Carcinoma (NSCLC), Ab externo surgery Glaucoma, Low-grade Upper Tract Urothelial Cancer (LG-UTUC)

How Mitonco works

Mitonco is activated in vivo to a bifunctional and trifunctional alkylating agent. Binding to DNA leads to cross-linking and inhibition of DNA synthesis and function. Mitonco is cell cycle phase-nonspecific.

Dosage

Mitonco dosage

Solid tumours Suggested regimen: Initial: 10-20 mg/m2; may repeat 6-8 wkly depending on blood count. Do not repeat if leucocyte and platelet counts are below acceptable levels. Do not re-administer if the nadir of the leucocyte count is <2,000 cells/mm3

Intravesical Superficial bladder tumours: Instill 10-40 mg 1 -3 times/wk for a total of 20 doses

Prevention of recurrent bladder tumours: Instill 20 mg 2 wkly or 40 mg 1-3-mthly.

Intravenous: Reconstitute by adding 10, 40 or 80 mL of sterile water for inj to a vial labeled as containing 5, 20, or 40 mg respectively, to provide a soln containing approx 0.5 mg/mL. The vial should be shaken to enhance dissolution. If the powd for inj does not dissolve immediately, allow the vial to stand at room temp until complete dissolution occurs.

Side Effects

Hemolytic uremic syndrome (<15%), Myelosuppression (64%), Nausea/ vomiting (14%), Fever (14%), Stomatitis (4%), Increased serum creatinine (2%), Mucous membrane toxicity (4%) , Fatigue, Pulmonary toxicity, Dyspnea, Cystitis, Interstitial fibrosis, Nephrotoxicity, Amenorrhea, Alopecia, Myelosuppression, haemolytic-uraemic syndrome.

Toxicity

Oral, mouse: LD₅₀ = 23 mg/kg; Oral, rat: LD₅₀ = 30 mg/kg. Symptoms of overdose include nausea and vomiting.

Precaution

Repeated haematologic studies are necessary during treatment and for at least 7 wk after discontinuation of the drug. Discontinue use when the leucocyte count decreases to <4000/mm3 or the platelet count decreases to <150,000/mm3 or if a progressive decline in either occurs. Monitor patient for signs of renal or pulmonary toxicity.

Interaction

Increased incidence of cardiotoxicity with doxorubicin.

Food Interaction

Mitonco Drug Interaction

Moderate: doxorubicinMinor: ciprofloxacin, levofloxacinUnknown: charcoal, amoxicillin, RHO Immunoglobulin , lorazepam, amoxicillin / clavulanate, citalopram, sulfamethoxazole / trimethoprim, glucose, diltiazem, iodine / potassium iodide, pregabalin, metoprolol, metoprolol, mirabegron, acetaminophen, cholecalciferol, ondansetron

Mitonco Disease Interaction

Major: infections, bleeding disorders, myelosuppression, renal dysfunction

Elimination Route

Erratic.

Half Life

8-48 min

Elimination Route

Approximately 10% of a dose of mitomycin is excreted unchanged in the urine.

Pregnancy & Breastfeeding use

Pregnancy category- D

Contraindication

Hypersensitivity. Patient with platelet counts <100,000/mm3, leukocyte counts <4,000/mm3 or serum creatinine concentration >1.7 mg/dL. Patient with substantial prolongation of prothrombin time or bleeding time, coagulation disorders, increased bleeding tendency. Pregnancy and lactation.

Storage Condition

Powder for injection: Store between 15-30°C. Protect from light.

Reconstituted solution: Stable for 1 wk when stored between 15-25°C and 2 wk when stored between 2-8°C.

Innovators Monograph

You find simplified version here Mitonco