Mitomycin
Mitomycin is a chemotherapy medicine (an alkylating or DNA-blocking drug) used for stomach and pancreatic cancer that has spread, certain bladder and upper urinary tract cancers, and as an add-on during glaucoma surgery, depending on the product.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 19 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Mitomycin is a chemotherapy standby, on the market since about 1981 and available generically, that cross-links DNA to stop cells dividing; the injection pairs with other drugs for stomach or pancreatic cancer that has spread, while other brands treat low-grade bladder and upper urinary tract cancers or aid glaucoma surgery. It is a tough drug, with nausea, vomiting and tiredness common; Jelmyto adds flank pain, blood in the urine and painful urination. Its boxed warning covers drops in platelets and white cells that invite bleeding and overwhelming infection, plus hemolytic uremic syndrome, which destroys red blood cells and can cause permanent kidney failure, so report fever, bruising or reduced urine promptly.
Clinical pearls
- Blood counts are checked repeatedly during treatment and for at least eight weeks after, and courses wait for recovery.
- Report pain, redness or skin breakdown where the IV went in, since leaked mitomycin can cause ulcers and tissue death.
- With Jelmyto, flank pain plus fever can mean a blocked ureter (the tube draining the kidney) and needs prompt attention.
- With Jelmyto or Zusduri, use effective contraception during treatment and for months afterward, since mitomycin can harm a developing baby.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
Mitomycin should only be given by a doctor experienced in cancer chemotherapy, in a setting with proper testing and treatment facilities.
It commonly causes bone marrow suppression, meaning low platelets and white blood cells. This can lead to overwhelming infections, especially in people who are already weakened.
It can also cause hemolytic uremic syndrome (HUS). This is a serious condition with destruction of red blood cells, low platelets, and irreversible kidney failure. It can happen at any time during systemic treatment, and most cases occur at higher total doses. Blood transfusions may make it worse. Report signs of infection, bleeding, or kidney problems right away.
Patient information guide A plain-language walkthrough of Mitomycin, written from its FDA label.
What Mitomycin is used for
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Mitomycin is used in several cancer and eye surgery settings, depending on the product.
- Mutamycin and Mitomycin (intravenous injection): disseminated adenocarcinoma of the stomach or pancreas, in combination with other approved chemotherapy, and as palliative treatment when other approaches have failed.
- Zusduri: adults with recurrent low-grade intermediate-risk non-muscle invasive bladder cancer.
- Jelmyto: adults with low-grade upper tract urothelial cancer.
- Mitosol: an add-on during ab externo glaucoma surgery.
How Mitomycin works
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Mitomycin blocks the synthesis of DNA, which cells need in order to divide. It works by cross-linking DNA strands, and this relates to the guanine and cytosine content of the DNA. At high concentrations, it also suppresses RNA and protein production.
Mitomycin dosage
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Mutamycin and Mitomycin injection are given by a healthcare professional into a vein only, as a single dose through a working IV catheter. Courses are spaced several weeks apart, after blood counts have fully recovered from earlier chemotherapy.
- Your team re-evaluates you after each course.
- The dose is reduced if you had toxicity or low blood counts.
- Higher doses were not shown to work better and are more toxic.
Follow your prescriber and the product label.
Dosing details from the FDA-approved label
From the Mitomycin prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Mitomycin intravenous dosing after full hematological recovery from any previous chemotherapy
- 20 mg/m2 intravenously as a single dose via a functioning intravenous catheter, at 6 to 8 week intervals
- Maximum: Doses greater than 20 mg/m2 have not been shown to be more effective, and are more toxic than lower doses
- Because of cumulative myelosuppression, reevaluate patients fully after each course and reduce the dose if any toxicities occurred; adjust by nadir: leukocytes >4000/mm3 and platelets >100,000/mm3 give 100% of prior dose; leukocytes 3000-3999 and platelets 75,000-99,999 give 100%; leukocytes 2000-2999 and platelets 25,000-74,999 give 70%
Read the label’s full dosing text
DOSAGE AND ADMINISTRATION Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Mitomycin for injection should be given intravenously only, using care to avoid extravasation of the compound. If extravasation occurs, cellulitis, ulceration, and slough may result. Each vial contains either mitomycin 5 mg and mannitol 10 mg, mitomycin, 20 mg and mannitol 40 mg or mitomycin 40 mg and mannitol 80 mg. To administer, add Sterile Water for Injection, 10 mL, 40 mL or 80 mL respectively. Shake to dissolve. If product does not dissolve immediately, allow to stand at room temperature until solution is obtained. After full hematological recovery (see guide to dosage adjustment) from any previous chemotherapy, the following dosage schedule may be used at 6 to 8 week intervals: 20 mg/m 2 intravenously as a single dose via a functioning intravenous catheter. Because of cumulative myelosuppression, patients should be fully reevaluated after each course of mitomycin, and the dose reduced if the patient has experienced any toxicities. Doses greater than 20 mg/m 2 have not been shown to be more effective, and are more toxic than lower doses. The following schedule is suggested as a guide to dosage adjustment: Nadir After Prior Dose L e uk o c y t e s / m m 3 P l a t e l e t s / m m 3 Percentage of Prior Dose To Be Given >4000 >100,000 100% 3000 to 3999 75,000 to 99,999 100% 2000 to 2999 25,000 to 74,999 70% <2000 <25,000 50% No repeat dosage should be given until leukocyte count has returned to 4000/mm 3 and a platelet count to 100,000/mm 3 . When mitomycin for injection is used in combination with other myelosuppressive agents, the doses should be adjusted accordingly. If the disease continues to progress after two courses of mitomycin for injection, the drug should be stopped since chances of response are minimal. STABILITY Unreconstituted mitomycin stored at room temperature is stable for the lot life indicated on the package. Avoid excessive heat (over 40°C, 104°F). Reconstituted with Sterile Water for Injection to a concentration of 0.5 mg per mL, mitomycin for injection is stable for 14 days refrigerated or 7 days at room temperature. Diluted in various I.V. fluids at room temperature, to a concentration of 20 to 40 micrograms per mL: I.V.
Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →
Mitomycin side effects
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Bone marrow suppression is the most common and most severe toxic effect. Other effects reported with Jelmyto include:
Common side effects
- Low blood counts (bone marrow suppression), especially low platelets and white blood cells
- Nausea and vomiting
- Abdominal pain
- Tiredness
- Flank pain (Jelmyto)
- Blood in the urine (Jelmyto)
- Urinary tract infection (Jelmyto)
- Painful urination (Jelmyto)
- Ureteric obstruction
- Kidney dysfunction
When to get medical help
- Fever, chills, or other signs of infection, since low white blood cells can lead to serious or deadly infections
- Unusual bruising or bleeding, which can signal low platelets
- Reduced urine, swelling, or pale skin and fatigue, which could signal hemolytic uremic syndrome (HUS) or kidney problems
- Pain, redness, or skin breakdown at the IV site, which can mean the drug leaked out of the vein
- Flank pain or fever with Jelmyto, which can signal a blocked ureter (the tube from the kidney to the bladder)
- Allergic reactions
Mitomycin warnings and precautions
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- Bone marrow suppression: low platelets and white blood cells can cause serious or fatal infection. Blood counts are checked during treatment and for at least eight weeks after.
- Hemolytic uremic syndrome (HUS): a serious complication with red blood cell destruction, low platelets, and irreversible kidney failure.
- Kidney toxicity: mitomycin injection should not be given with serum creatinine above 1.7 mg percent.
- Leakage from the vein: can cause cellulitis, ulceration, and tissue slough.
- Pregnancy: can cause fetal harm.
- Ureteric obstruction: a risk with Jelmyto.
Mitomycin interactions
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The label notes a few points to be aware of.
- Other chemotherapy drugs: HUS can occur with mitomycin alone or combined with other cytotoxic drugs.
- Blood transfusions: may worsen HUS symptoms.
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Mitomycin
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- Kidney problems: mitomycin injection should not be given if serum creatinine is above 1.7 mg percent. Avoid Zusduri in severe kidney impairment.
- Pregnancy: can cause fetal harm. Safe use in pregnancy has not been established.
- Contraception: for Zusduri and Jelmyto, use effective contraception during treatment and for 6 months (females) or 3 months (males with female partners) after the last dose.
- Breastfeeding: avoid during Zusduri treatment and for 1 week after.
- Zusduri should not be used with bladder perforation or prior allergy to mitomycin.
- Children: safety and effectiveness have not been established for Zusduri.
- Older adults: no significant overall differences in safety or efficacy were seen with Zusduri.
What Mitomycin does in the body
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There is not enough data to describe how drug exposure relates to its effects or how those effects change over time.
How your body processes Mitomycin
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Mitomycin is broken down mainly in the liver, and also in other tissues. Systemically absorbed mitomycin is cleared quickly from the blood, and about 10% leaves unchanged in the urine. With Jelmyto, which is placed in the kidney area, the drug forms a gel that releases mitomycin over about 4 to 6 hours. Blood levels were less than 1% of those expected after an IV dose.
How to store Mitomycin
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Store dry powder at 25°C (77°F); excursions permitted between 15° and 30°C (59° and 86°F). Protect from light. Avoid excessive heat, over 40°C (104°F).
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Mitomycin
26 supplements and herbal products have documented interactions with Mitomycin in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 1
- Moderate · 15
- Minor · 10
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Mitomycin: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Mitomycin — the kind of thing our pharmacy team would talk through with you at the counter.
What is mitomycin used for?
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How will I receive it?
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What side effects should I expect?
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When should I call my doctor right away?
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Is it safe during pregnancy?
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Do I need any lab tests?
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Is Mitomycin available over the counter?
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When was Mitomycin first available?
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Who makes Mitomycin?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Mitomycin on HelloPharmacist
Mitomycin forms and strengths (how it comes)
Mitomycin is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Injection
How this form is used
- Mutamycin and Mitomycin are used with other approved chemotherapy drugs for disseminated adenocarcinoma of the stomach or pancreas.
- Mutamycin and Mitomycin are also used as palliative treatment when other approaches have failed.
- Mutamycin and Mitomycin are not recommended as single-agent primary therapy or to replace surgery or radiotherapy.
- Mutamycin and Mitomycin are given into a vein only, with care to avoid leakage outside the vein.
- Mutamycin and Mitomycin are given as a single dose through a working IV catheter, in courses spaced weeks apart after blood counts recover.
- Mutamycin and Mitomycin doses may be reduced based on blood counts and toxicity.
Mitomycin on the U.S. market: products, makers and brands
How Mitomycin appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
13 companies list 38 Mitomycin product records with the FDA, mostly as injection; the earliest marketing or approval year on record is 1996. Brand names on the directory include Mitosol, Jelmyto, Zusduri; the rest are generics.
Also listed with the FDA, not a patient dose form: Powder (10) · Kit (6) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
How widely Mitomycin is used (Medicaid data)
A general measure of how commonly Mitomycin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Mitomycin is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Mitomycin prescribed? Of the 1,601 medications we measure, Mitomycin ranks #1,522 by Medicaid prescriptions — more than 5% of them.
Utilization by Mitomycin product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
mitomycin 5 MG Injection Most dispensed
Summed across the 1 of 16 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1740894
mitomycin 20 MG Injection
Summed across the 2 of 16 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1740900
mitomycin 40 MG Powder for Pyelocalyceal Solution
Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2375818
mitomycin 40 MG Injection
Summed across the 1 of 17 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1740898
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Mitomycin, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 5 of 51 listed Mitomycin NDCs with Medicaid activity.
Compare Mitomycin products
A representative set of FDA-listed product records for Mitomycin — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| 5 mg/10 mL | Intravenous | Accord BioPharma Inc. | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Accord BioPharma Inc. | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Accord Healthcare, Inc. | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Accord Healthcare, Inc. | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Accord Healthcare, Inc. | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Archis Pharma LLC | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Archis Pharma LLC | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Archis Pharma LLC | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | BluePoint Laboratories × 2 listings | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | BluePoint Laboratories × 2 listings | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | BluePoint Laboratories × 2 listings | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Bryant Ranch Prepack × 2 listings | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Eugia US LLC | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Eugia US LLC | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Eugia US LLC | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Fresenius Kabi USA, LLC | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Fresenius Kabi USA, LLC | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Fresenius Kabi USA, LLC | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Gland Pharma Limited | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Gland Pharma Limited | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Gland Pharma Limited | ANDA | View NDC → |
| 20 mg | Intravenous | Hikma Pharmaceuticals USA Inc. | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Hikma Pharmaceuticals USA Inc. | ANDA | View NDC → |
| 40 mg | Intravenous | Hikma Pharmaceuticals USA Inc. | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Hikma Pharmaceuticals USA Inc. | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Meitheal Pharmaceuticals Inc. | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Meitheal Pharmaceuticals Inc. | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Meitheal Pharmaceuticals Inc. | ANDA | View NDC → |
| 5 mg/10 mL | Intravenous | Sagent Pharmaceuticals | ANDA | View NDC → |
| 20 mg/40 mL | Intravenous | Sagent Pharmaceuticals | ANDA | View NDC → |
| 40 mg/80 mL | Intravenous | Sagent Pharmaceuticals | ANDA | View NDC → |
| 💊Kits | ||||
| — | — | Mobius Therapeutics LLC | NDA | View NDC → |
| — | — | UroGen Pharma, Inc | NDA | View NDC → |
| — | — | UroGen Pharma, Inc. | NDA | View NDC → |
Showing 38 of 38 products — FDA National Drug Code Directory. See every product, package size and price: browse all 38 Mitomycin NDCs →
Mitomycin side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Mitomycin — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Mitomycin in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Mitomycin FDA approval history
How Mitomycin went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Mitomycin recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Mitomycin recalls since July 2021.
✅No Mitomycin recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 632 4 dose forms · 6 strengths
-
Dose form (SCDF) Injection RxCUI 1740893In current FDA listings -
Dose form (SCDF) Ophthalmic Solution RxCUI 1244552No current FDA listingClinical drug / strength (SCD) 0.2 MG/MLRxCUI 1244553 -
Dose form (SCDF) Powder for Intravesical Solution RxCUI 2719765No current FDA listingClinical drug / strength (SCD) 40 MGRxCUI 2719766 -
Dose form (SCDF) Powder for Pyelocalyceal Solution RxCUI 2375817No current FDA listingClinical drug / strength (SCD) 40 MGRxCUI 2375818
Look up RxCUI 632 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Mitomycin supply and shortage status
Whether Mitomycin is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
Mitomycin brand names
Mitomycin is sold under 3 brand names in the FDA directory — Mitosol, Jelmyto, Zusduri. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Mitomycin: manufacturers and labelers
13 companies list Mitomycin products with the FDA. By number of product records, the largest are BluePoint Laboratories, Hikma Pharmaceuticals USA Inc., Accord Healthcare, Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Mitomycin drug class (RxNorm)
Mitomycin belongs to the Alkylating Drug class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Mitomycin page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. BluePoint Laboratories is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →