Medication Pearl of the Day: Mitomycin (Jelmyto)
Indication: Jelmyto is an alkylating drug indicated for the treatment of adult patients with low-grade upper tract urothelial cancer.
- Dosing: Administer 1.3 g of sodium bicarbonate orally the evening prior to, the morning of, and 30 minutes prior to instillation procedure.
- Dosage forms: Two 40 mg (each) single-dose vials of mitomycin for pyelocalyceal solution.
- Adverse events: The most common adverse reactions (≥ 20%) are ureteric obstruction, flank pain, urinary tract infection, hematuria, renal dysfunction, fatigue, nausea, abdominal pain, dysuria, and vomiting.
- Mechanism of action: Mitomycin inhibits the synthesis of DNA. The guanine and cytosine content correlates with the degree of mitomycin-induced cross-linking. At high concentrations of the drug, cellular RNA and protein synthesis are also suppressed.
- Manufacturer: UroGen Pharma
Source: LABEL (fda.gov)