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Zusduri
mitomycin intravesical
Adult Dosing .
Dosage forms: SOL
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing
low-grade intermediate-risk non-muscle invasive bladder CA, recurrent
- [75 mg intravesically qwk x6wk]
renal dosing
- [see below]
- eGFR <30: avoid use; Info: caution advised if eGFR 30-59
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- bladder perforation
- eGFR <30
- pregnancy 1st trimester
- avoid: breastfeeding during tx and x1wk after D/C
- avoid: urine contact w/ skin for at least 24h post-instillation
- caution: eGFR 30-59
- caution: pregnancy 2nd trimester
- caution: pregnancy 3rd trimester
- caution: patients of childbearing potential
- caution: male patients of reproductive potential
Drug Interactions .
Overview
mitomycin
alkylating agent; oncologic antibiotic
- immunomodulatory effects
- myelosuppressive oncologic agent
- nephrotoxicity
Contraindicated
- BCG live intravesical
- cidofovir
- talimogene laherparepvec
Avoid/Use Alternative
- adenovirus vaccine, live
- aldesleukin
- amikacin
- amikacin inhaled
- bumetanide
- chikungunya vaccine, live
- chloramphenicol
- cholera vaccine, live
- cladribine oral
- clofarabine
- deferiprone
- dengue vaccine, live
- dexrazoxane
- etrasimod
- fexinidazole
- foscarnet
- ganciclovir
- gentamicin
- influenza nasal vaccine, live
- mannitol
- measles/mumps/rubella vaccine, live
- methotrexate
- oxaliplatin
- palifermin
- penicillamine
- pentamidine
- polymyxin B
- primaquine
- rabies vaccine
- radium Ra 223 dichloride
- ropeginterferon alfa-2b
- rotavirus vaccine, live
- smallpox vaccine, live
- streptomycin
- streptozocin
- tenofovir disoproxil
- tobramycin
- tobramycin inhaled
- typhoid vaccine, live
- valganciclovir
- varicella vaccine, live
- yellow fever vaccine, live
Monitor/Modify Tx
- abatacept
- abrocitinib
- acyclovir
- adalimumab
- adefovir dipivoxil
- afamitresgene autoleucel
- albendazole
- alectinib
- alemtuzumab
- aliskiren
- allopurinol
- amiloride
- amphotericin
- anakinra
- anifrolumab
- anthrax immune globulin
- anthrax vaccine
- anti-thymocyte globulin
- asenapine
- aspirin
- atidarsagene autotemcel
- auranofin
- avacopan
- axicabtagene ciloleucel
- axitinib
- azathioprine
- azilsartan medoxomil
- balsalazide
- baricitinib
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- benazepril
- benznidazole
- betamethasone
- betibeglogene autotemcel
- bevacizumab
- bimekizumab
- bleomycin
- botulism immune globulin
- brexucabtagene autoleucel
- brodalumab
- budesonide
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- cabozantinib
- canakinumab
- candesartan cilexetil
- capecitabine
- captopril
- carboplatin
- carfilzomib
- celecoxib
- certolizumab pegol
- chikungunya vaccine
- chlorothiazide
- chlorthalidone
- ciltacabtagene autoleucel
- cisplatin
- clindamycin
- clobetasol ophthalmic
- clozapine
- colchicine
- colistimethate
- corticotropin
- cortisone
- COVID-19 vaccine
- creatine
- crovalimab
- cyclophosphamide
- cyclosporine
- cytomegalovirus immune globulin
- danicopan
- dapsone
- deferasirox
- deferoxamine
- deflazacort
- delgocitinib topical
- deucravacitinib
- deuruxolitinib
- dexamethasone
- dexamethasone ophthalmic
- diclofenac
- diclofenac topical
- diflunisal
- difluprednate ophthalmic
- dimethyl fumarate
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- diroximel fumarate
- dupilumab
- ebola vaccine, live
- eculizumab
- efbemalenograstim alfa
- efgartigimod alfa
- eflapegrastim (G-CSF)
- elivaldogene autotemcel
- emapalumab
- enalapril
- enalaprilat
- etanercept
- ethacrynic acid
- etodolac
- everolimus
- exagamglogene autotemcel
- fenoprofen
- filgrastim (G-CSF)
- fingolimod
- flucytosine
- fludrocortisone
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluphenazine
- flurbiprofen
- fluticasone furoate
- fluticasone propionate
- fosinopril
- fostamatinib
- furosemide
- givinostat
- golimumab
- guselkumab
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydrochlorothiazide
- hydrocortisone
- hydrocortisone ophthalmic
- hydroxocobalamin IV
- hydroxychloroquine
- hydroxyurea
- ibuprofen
- ibuprofen lysine
- idecabtagene vicleucel
- ifosfamide
- immune globulin
- indapamide
- indomethacin
- inebilizumab
- infliximab
- influenza H5N1 vaccine
- influenza vaccine
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- iohexol
- iomeprol
- iopamidol
- iptacopan
- irbesartan
- ixekizumab
- Japanese encephalitis vaccine
- ketoprofen
- ketorolac
- lebrikizumab
- leflunomide
- lenvatinib
- lifileucel
- linezolid
- linvoseltamab
- lisinopril
- lisocabtagene maraleucel
- lithium
- lonafarnib
- losartan
- loteprednol ophthalmic
- lovotibeglogene autotemcel
- lumateperone
- lutetium Lu 177 vipivotide tetraxetan
- lymphocyte immune globulin, anti-thymocyte globulin
- magnesium citrate
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- meningococcal vaccine
- mercaptopurine
- mesalamine
- mesalamine rectal
- methylprednisolone
- metolazone
- mirikizumab
- mitoxantrone
- moexipril
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- nadofaragene firadenovec intravesical
- naproxen
- natalizumab
- neomycin
- nipocalimab
- nusinersen
- obecabtagene autoleucel
- ocrelizumab
- ofatumumab
- olmesartan medoxomil
- olsalazine
- oxaprozin
- ozanimod
- pamidronate
- paromomycin
- pazopanib
- pegcetacoplan
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- peginterferon beta 1a
- pemetrexed
- pentostatin
- perindopril
- pimecrolimus topical
- piroxicam
- plazomicin
- pneumococcal vaccine
- poliovirus vaccine
- polyethylene glycol
- polyethylene glycol/electrolytes
- ponesimod
- pozelimab
- prednisolone
- prednisolone ophthalmic
- prednisone
- proguanil
- pyrimethamine
- quinapril
- ramipril
- ramucirumab
- ravulizumab
- respiratory syncytial virus vaccine
- Rho(D) immune globulin
- ribavirin
- rifabutin
- rilonacept
- risankizumab
- ritlecitinib
- rituximab
- rozanolixizumab
- ruxolitinib topical
- salsalate
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- secukinumab
- siltuximab
- siponimod
- sipuleucel-T
- sirolimus
- sitagliptin
- smallpox/mpox vaccine, live
- sparsentan
- spesolimab
- spironolactone
- stiripentol
- succimer
- sulfasalazine
- sulfate bowel prep
- sulindac
- sunitinib
- sutimlimab
- tacrolimus
- telavancin
- telmisartan
- temsirolimus
- tenofovir alafenamide
- teplizumab
- teriflunomide
- tezepelumab
- thalidomide
- tick-borne encephalitis vaccine
- tildrakizumab
- tiopronin
- tisagenlecleucel
- tivozanib
- tocilizumab
- tofacitinib
- tolmetin
- torsemide
- tralokinumab
- trandolapril
- triamcinolone
- triamterene
- trimethoprim
- tuberculin purified protein derivative
- typhoid vaccine
- ublituximab
- upadacitinib
- ustekinumab
- vaccinia immune globulin
- valacyclovir
- valproic acid
- valsartan
- vamorolone
- vancomycin
- vedolizumab
- vilobelimab
- voclosporin
- willow bark
- zidovudine
- zilucoplan
- ziv-aflibercept
- zoledronic acid
- zonisamide
Caution Advised
- coccidioides immitis skin test antigen
- rilzabrutinib
Adverse Reactions .
Serious Reactions
- urethral stenosis
- urinary retention
- acute kidney injury
Common Reactions
- dysuria
- UTI
- hematuria
- urinary frequency
- fatigue
- urinary incontinence
- urinary retention
- urethral stenosis
- genital pain
- urinary urgency
- genital edema
- genital pruritus
- genital rash
- urethritis
- acute kidney injury
- balanoposthitis
- nocturia
- Cr incr.
- potassium incr.
Safety/Monitoring .
Monitoring Parameters
Cr, pregnancy test at baseline; bladder eval prior to intravesical instillation
Look/Sound-Alike Drug Names
mitoMYcin confused with: mitoXANTRONE
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use in 1st trimester, weigh risk/benefit in 2nd and 3rd trimesters; no human data available; risk of teratogenicity and embryo-fetal death based on animal data w/ systemically absorbed mitomycin and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x6mo after D/C in patients of childbearing potential and during tx and x3mo after D/C in male patients
Lactation
Clinical Summary
avoid breastfeeding during tx and x1wk after D/C; no human data available to assess risk of infant harm, though possible drug excretion into milk based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: liver primarily, other tissues; CYP450: none; Info: maximum serum conc. <1% of IV route
Excretion: urine (unchanged); Half-life: unknown; Info: 10% systemically absorbed mitomycin excreted in urine (unchanged)
Subclass: Antibiotic Oncologics
Mechanism of Action
inhibits DNA synthesis
Formulary .
No Formulary Selected
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