L01DC03 - Mitomycin |
Propably not porphyrinogenic |
PNP |
Rationale
Probably non-CYP metabolism. No observations of interferences with CYP-metabolism of other drugs. Not listed as CYP-inducer or inhibitor. However, side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Mitomycin is an antineoplastic antibiotic produced by the growth of Streptomyces caespitosus.
Therapeutic characteristics
Mitomycin is used, with other antineoplastic agents, in the treatment of many solid tumours including those of the bladder, breast, cervix, eye, stomach, and prostate. It is administered intravenously or as an intravescical instillation. Common adverse reactions of mitomycin that can be confused with an acute porphyric attack are nausea, abdominal pain and vomiting. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmakokinetics
Mitomycin is mainly but not completely metabolized in the liver. Probably non-CYP metabolism. Not listed as CYP substrate, inducer or inhibitor (Rendic, 2002; Zhou, 2007). Baumhakel (2001) found no clear inhibitory effect of mitomycin on CYP3A4. No reports of interference with CYP-metabolism of other drugs.
Published experience
Used uneventfully in the treatment of metastatic breastcancer in 54 year old PV woman (De Wet, 1992).
IPNet drug reports
No.
References
- Scientific articles
- Rendic, S. Summery of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448. #1025
- Zhou, S.F., Xue, C.C., et al. Clinically important drug interactions potentially involving mechanism-based inhibition of cytochrome P450 3A4 and the role of therapeutic drug monitoring. Ther Drug Monit 2007; 29(6):687:710. #1027
- Baumhäkel M, Kasel D, et al. Screening for inhibitory effects of antineoplastic agents on CYP3A4 in human liver microsomes. Int J Clin Pharmacol Ther. 2001 Dec;39(12):517-28. #2019
- De Wet M, Jooste R, et al. Ondansetron in a patient with porphyria. S Afr Med J. 1992 Dec;82(6):480. #2023
- Drug reference publications
- McEvoy GK, editor. Mitomycin. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (07.05.10). #2024
- Sweetman SC, editor. Martindale: The complete drug reference. Mitomycin. Pharmaceutical Press 2009. #2025
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