Mitomycin-C Kyowa 2 Mg Powder For Solution For Injection
For example, when given by injection the recommended dose is in the range of 4-10 mg given at 1-6 weekly intervals. A course ranging from 40-80 mg is often required for a satisfactory result when used alone or in combination with other treatments. Thus, the period of treatment could last from just a few weeks up to a number of months, depending on the condition being treated. In the treatment of bladder cancer, the recommended dose is 20-40mg administered into the bladder, weekly or three times a week for a total of 20 doses. The dosage may be decreased if side effects are a problem.
If during treatment you develop a dry cough, breathlessness, rapid breathing or anything else which suggests your lungs might be affected, you may require to be monitored by X-rays of your chest that could continue up to 4 weeks after the end of treatment.
If you are given more Mitomycin-C Kyowa than you should
If you have been accidentally given a higher dose you may experience symptoms such as fever, nausea, vomiting and blood disorders. Your doctor may give you supportive treatment for any symptoms that may occur.
4. POSSIBLE SIDE EFFECTS
Like all medicines, this medicine can cause side effects, although not everybody gets them.
If you notice any of the following severe reactions tell your doctor immediately:
• severe breathlessness
• pneumonia - fever, chills, shortness of breath or a cough
• severe allergic reaction - you may experience a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing), and you may feel you are going to faint.
If you experience any of the following tell your doctor as soon as possible:
• fever on the day of treatment
• loss of appetite and weight loss
• tiredness, weakness and headache
• feeling or being sick (this may shortly disappear during treatment)
• high blood pressure or flushing
• pain, swelling, redness or tenderness at the site of the injection
• sores mouth and mouth ulcers
• diarrhoea, abdominal discomfort or constipation
• hardening, thickening, redness, tenderness or swelling of the tips of the fingers and hair loss
• changes in urinating or pain when urinating
• ridging of nails, blisters on pressure points e.g. elbows
• easily pick up infections
• reduced blood flow to the fingers, toes and tip of the nose
• bleeding and bruising
• severe damage and potentially rupture of the wall of the bladder resulting in severe lower abdominal pain, difficulty or inability to pass urine, and possibly blood in the urine.
• severe damage to the penis resulting in pain in the penis, abnormal colour of the penis and potential difficulty in passing urine
• increase in blood pressure in the blood vessels of the lungs (pulmonary hypertension), e.g. leading to shortness of breath, dizziness and fainting
• obstructive disease of the pulmonary veins or pulmonary veno-occlusive disease (PVOD). Symptoms may include shortness of breath, fainting and coughing up blood.
• numbness, swelling and painful redness on palms of the hands and soles of feet (palmar-plantar erythrodysaesthesia (PPE)/hand-foot syndrome).
Kidney or liver problems have also been reported. Your doctor will monitor your kidney (urine test) and liver (blood test) regularly.
Reporting of side effects
If you get any side effects, talk to your doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme (www.mhra.gov. uk/yellowcard).
By reporting side effects you can help provide more information on the safety of this medicine.
5. HOWTO STORE MITOMYCIN-C KYOWA
Keep out of the sight and reach of children.
Mitomyicin-C Kyowa should be kept in its original packaging.
Do not use this medicine after the expiry date which is stated on the label after “Exp Date”. The expiry date refers to the last day of that month.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What Mitomycin-C Kyowa contains
- The active substance is mitomycin-C
- The other ingredient is sodium chloride
What Mitomycin-C Kyowa looks like and contents of the pack
Mitomycin-C Kyowa is a powder which is mixed before injection. It is packaged in glass vials with a rubber stopper and aluminium seal.
Marketing Authorisation Holder Manufacturer
Kyowa Kirin Ltd. Aesica Queenborough
Galabank Business Park Limited
Galashiels North Road
TD1 1QH Queenborough
UK Kent
ME11 5EL UK
This medicinal product is authorised in the Member States of the EEA under the following names:
Mitomycin-C Kyowa.
This leaflet was last revised in 05/2016.
Kyowa Kirin Limited KYOWA KIRIRI Galabank Business Park,
Galashiels, UK, TD1 1QH Tel: +44 (0) 1896 664 000 Fax: +44 (0) 1896 664 001
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SUMMARY OF PRODUCT CHARACTERISTICS TECHNICAL LEAFLET FOR THE PROFESSIONAL
Mitomycin-C Kyowa® 2mg / Mitomycin-C Kyowa® 10mg Mitomycin-C Kyowa® 20mg / Mitomycin-C Kyowa® 40mg
(Mitomycin-C JP)
1. NAME OF THE MEDICINAL PRODUCT
Mitomycin-C Kyowa, 2 mg, 10 mg, 20 mg, 40 mg powder for solution for injection.
2. QUALITATIVE AND QUANTITATIVE COMPOSITION
Mitomycin-C 2 mg, 10 mg, 20 mg, 40 mg For the full list of excipients, see section 6.1
3. PHARMACEUTICAL FORM
Powder for solution for injection.
Blue-purple crystalline powder.
4. CLINICAL PARTICULARS
4.1 Therapeutic Indications Antimitotic and Cytotoxic
Recommended for certain types of cancer in combination with other drugs or after primary therapy has failed. It has been successfully used to improve subjective and objective symptoms in a wide range of neoplastic conditions.
1. As a single agent in the treatment of superficial bladder cancer. In addition it has been shown that post-operative instillations of Mitomycin-C can reduce recurrence rates in newly diagnosed patients with superficial bladder cancer.
2. As a single agent and in combination with other drugs in metastatic breast cancer.
3. In combination with other agents in advanced squamous cell carcinoma of the uterine cervix.
4. It shows a degree of activity as part of combination therapy in carcinoma of the stomach, pancreas and lung (particularly non-small cell).
5. It shows a degree of activity as a single agent and in combinaion in liver cancer when given by the intra-arterial route.
6. It has a possible role in combination with other cytotoxic drugs in colorectal cancer.
7. It shows a degree of activity as a single agent or part of combination therapy in cancer of the head and neck.
8. It shows a degree of activity as a single agent in cancer of the prostate.
9. It has a possible role in skin cancer.
10. It has a degree of activity in leukaemia and non-solid tumours.
11. It has a possible role in sarcomas.
12. It has been successfully used in combination with surgery, pre-operatively (oesophageal squamous cell carcinoma) and post-operatively (gastric cancer).
13. It has shown to be effective when used in combination with radiotherapy.
4.2 Posology and method of administration
Paediatric population
The safety and efficacy of Mitomycin C in children has not yet been established. No data are available.
Intravenous administration
Intravenously, the dose should be given as slowly as possible and with great care in order to avoid extravasation.
The usual dose is in the range of 4-10 mg (0.06-0.15 mg/kg) given at 1-6 weekly intervals depending on whether other drugs are given in combination and on bone marrow recovery.
In a number of combination schedules, the dose is 10 mg/m2 of body surface area, the course being repeated at intervals for as long as required. A course ranging from 40-80 mg (0.58 -1.2 mg/kg) is often required for a satisfactory response when used alone or in combination. A higher dosage course may be given when used alone or as part of a particular combination schedule and total cumulative doses exceeding 2mg/kg have been given.
Intra-arterial administration
For administration into specific tissues, Mitomycin-C Kyowa can be given by the intra-arterial route directly into the tumours.
Dose reductions
Because of cumulative myelosuppression, patients should be fully re-evaluated after each course and the dose reduced if the patient has experienced any toxic effects. Doses greater than 0.6 mg/kg have not been shown to be more effective and are more toxic than lower doses.
Disease progression
If disease progression continues after two courses of treatment, the drug should be stopped since the chances of response are minimal.
Use in patients with bladder tumours
In the treatment of superficial bladder tumours the usual dose is 20-40 mg dissolved in 20-40 ml of diluent, instilled into the bladder through a urethral catheter, weekly or three times a week for a total of 20 doses. The dose should be retained by the patient for a minimum of one hour. During this one-hour period the patient should be rotated every 15 minutes to ensure that the Mitomycin-C comes into contact with all areas of the bladder urothelium.
When the bladder is emptied in the voiding process, care must be taken to ensure that no contamination occurs locally in the groin and genitalia areas.
In the prevention of recurrent superficial bladder tumours, various doses have been used. These include 20 mg in 20 ml of diluent every two weeks and 40 mg in 40 ml of diluent monthly or three monthly. The dose is instilled into the bladder through a urethral catheter.
In both cases, the dose should be adjusted in accordance with the age and condition of the patient.
4.3 Contraindications
Patients who have demonstrated a hypersensitive or idiosyncratic reaction to Mitomycin-C Kyowa or any of the components of the product in the past.
Thrombocytopenia, coagulation disorders and increased bleeding tendency.
4.4 Special warnings and precautions for use
Mitomycin-C Kyowa should be administered under the supervision of a physician experienced in cytotoxic cancer chemotherapy.
Local ulceration and cellulitis may be caused by tissue extravasation during intravenous injection and utmost care should be taken in administration.
If extravasation occurs, it is recommended that the area is immediately infiltrated with sodium bicarbonate 8.4% solution, followed by an injection of 4 mg dexamethasone. A systemic injection of 200 mg of Vitamin B6 may be of some value in promoting the regrowth of tissues that have been damaged.
Patients should be carefully monitored with frequent laboratory testing (haematological test, liver function test, renal function test, etc.) paying particular attention to peripheral blood count including platelet count. No repeat dose should be given unless the leucocyte count is above 3.0 x 109/L or more and the platelet count is 90 x 109/L or more.
The nadir is usually around four weeks after treatment and toxicity is usually cumulative, with increasing risk after each course of treatment. Serious adverse reactions such as bone marrow depression may occur. If any abnormality is observed, appropriate measures such as reduction of the dose and suspension of administration should be taken.
Extravascular leakage may cause induration or necrosis at the injection site. Intraarterial administration may cause skin disorders such as pain, redness, erythema, blisters, erosion and ulceration which may lead to skin/muscle necrosis. Since the influx of the drug solution into other sites than the targeted site in the administration to the hepatic artery may cause gastroduodenal ulcer, haemorrhage, perforation, etc, the location of the end of the catheter and drug distribution area should be confirmed photographically or by other means, paying attention to possible deviation or shift of the catheter and infusion rate. Administration should be discontinued and appropriate measures should be taken, if any of such symptoms develops.
Severe renal toxicity has occasionally been reported after treatment and renal function should be monitored before starting treatment and again after each course.
Mitomycin-C Kyowa should be administered with care in children and patients with the following:
• Hepatic or renal dysfunction as adverse reactions may be enhanced
• Bone marrow depression and bleeding tendency as these may be exacerbated
• Infections as these may be aggravated due to bone marrow depression
• Varicella as fatal systemic disorders may occur
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In case administration of this drug is required in children or patients with reproductive possibility, potential effects on gonad should be considered. The safety of Mitomycin-C injection in children has not been established. Special attention should be paid to the manifestation of adverse reactions when administered in children.
Because elderly patients often have reduced physiological function, bone marrow depression, which may be protracted, and renal disorder are likely to occur. Administer Mitomycin-C Kyowa with caution in this population while closely monitoring patient’s condition and paying special attention to the dose and dosing interval.
Occurrence of acute leukaemia (in some cases following preleukaemic phase) and myelodysplastic syndrome has been reported in patients treated with Mitomycin-C Kyowa concomitantly with other antineoplastic agents.
4.5 Interactions with other medicinal products and other forms of interaction
Mitomycin-C Kyowa should be administered with care when it is coadministered with other antineoplastic agents or irradiation. The adverse reactions of each drug may be enhanced, for example bone marrow depression. With vinca alkaloids adverse reactions of shortness of breath and bronchospasm may be enhanced.
4.6 Fertility, pregnancy and lactation
Mitomycin-C Kyowa should not normally be administered to patients who are pregnant, who may possibly be pregnant or to mothers who are breastfeeding. Teratological changes have been noted in animal studies.
4.7 Effects on ability to drive and use machines
Generalised weakness and lethargy have been reported on rare occasions. If affected, patients should be advised not to drive or operate machinery.
4.8 Undesirable effects
The main adverse reactions collected from literature were leucopenia in 130 (40.2%) of 323 patients, thrombocytopenia in 75 (24.7%) of 304 patients, anorexia in 58 (21.8%) of 266 patients, nausea/vomiting in 41 (15.4%) of 266 patients, malaise in 15 (5.6%) of 266 patients, weight loss in 18 (5.5%) of 329 patients, bleeding tendency in 12 (3.6%) of 329 patients and anaemia in 10 (3.0%) of 329 patients.
Nausea and vomiting are sometimes experienced immediately after treatment, but these are usually mild and of short duration. Pulmonary toxicities such as pulmonary oedema, interstitial pneumonia and pulmonary fibrosis (accompanied by fever, coughing, dyspnoea, abnormal x-ray findings and eosinophilia) pulmonary hypertension and pulmonary veno-occlusive disease (PVOD) have been reported. If signs of these conditions are observed, discontinue treatment and take appropriate measures.
Skin toxicity may occur in a small proportion of patients, with side effects such as alopecia (although this is less frequent and less severe than with certain other cytotoxic agents). Palmar plantar erythrodysaesthesia (PPE), bleeding, rashes and mouth ulcers have been reported.
Shock or anaphylactoid reaction may occur, patients should be carefully observed. If symptoms such as itching, rash, hot flush, sweating, dyspnoea and decreased blood pressure occur, treatment should be immediately discontinued and appropriate measures should be taken.
Administration related Undesirable Effects
Cystitis, atrophy of the bladder, contracted bladder (pollakiuria, dysuria), calcinosis, bladder necrosis, bladder perforation and penile necrosis have been reported when given by intravesical instillation.
Administration to the hepatic artery may cause liver and biliary tract disorders such as cholecystitis, cholangitis (also sclerosing), biloma, bile duct necrosis and parenchymatous liver disorder. Drug distribution area should be confirmed photographically or by other means, and treatment should be discontinued and appropriate measures taken if any abnormal signs are noted.
The following administration related adverse reactions have also been reported: vascular pain, phlebitis, thrombus, induration or necrosis at the injection site, pain, redness erythema, blisters, erosion and ulceration which may lead to skin/muscle necrosis. Other reported effects, not already described in the text above, include the following:
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Gastrointestinal disorders | |
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Diarrhoea, constipation, abdominal discomfort, stomatitis | |
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Hepatobiliary disorders | |
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Parenchymatous liver disorder, cholecystitis, jaundice | |
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Skin and subcutaneous tissue disorders | |
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Rash, pruritus | |
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Renal and urinary disorders | |
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Acute renal failure, renal disorder, cystitis, haemturia, proteinuria, serious nephropathy, albuminuria | |
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General disorders | |
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Pyrexia, chills, malaise, injection site phlebitis, oedema, generalised weakness and lethargy | |
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Infections and Infestations | |
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Bacterial, viral or fungal infections, sepsis and septic shock | |
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Neoplasms benign and malignant | |
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Myelodysplastic syndrome, acute myeloid leukaemia, acute leukaemia | |
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Blood and lymphatic system disorders | |
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Bone marrow depression, pancytopenia, neutropenia, granulocytopenia, febrile neutropenia, erythropenia, microangiopathic haemolytic anaemia, haemolytic uraemic syndrome, thrombotic thrombocytopenic purpura, eosinophilia. | |
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Immune system disorders | |
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Hypersensitivity | |
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Vascular disorders | |
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Flushing, hypertension | |
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Respiratory and mediastinal disorders | |
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Respiratory disorders such as interstitial lung disease, bronchospasm, pneumonitis | |
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme (www.mhra.gov.uk/yellowcard).
4.9 Overdose
In the unlikely event of accidental overdosage then an increase in the more common side effects should be expected, such as fever, nausea, vomiting and myelosuppression. Appropriate supportive measures should be instituted.
5. PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
ATC Code: L01D
Pharmacotherapeutic group: Other cytotoxic antibiotics Mitomycin-C Kyowa is an antitumour antibiotic that is activated in the tissues to an alkylating agent which disrupts deoxyribonucleic acid (DNA) in cancer cells by forming a complex with DNA and also acts by inhibiting division of cancer cells by interfering with the biosynthesis of DNA.
5.2 Pharmacokinetic properties
In vivo, Mitomycin-C Kyowa is rapidly cleared from the serum after intravenous administration. The time required to reduce the serum concentration by 50% after a 30 mg bolus injection is 17 minutes.
After injection of 30 mg, 20 mg or 10 mg intravenously, the maximal serum concentrations were 2.4 mcg/ml, 1.7 mcg/ml and 0.52 mcg/ml respectively. Clearance is effected primarily by metabolism in the liver, but metabolism occurs in other tissues as well. The rate of clearance is inversely proportional to the maximal serum concentration because, it is thought, of saturation of the degradative pathways. Approximately 10% of a dose of Mitomycin-C Kyowa is excreted unchanged in the urine. Since metabolic pathways are saturated at relatively low doses, the percentage dose excreted in the urine increases with increasing dose. In children, the excretion of intravenously administered Mitomycin-C Kyowa is similar to that in adults.
5.3 Preclinical safety data
There are no preclinical data of relevance to the prescriber which are additional to that already included elsewhere in the SPC.
6. PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Sodium Chloride Ph.Eur.
6.2 Incompatibilities
Not known
6.3 Shelf life
Mitomycin-C Kyowa 2 mg and 10 mg: 4 years Mitomycin-C Kyowa 20 mg: 3 years Mitomycin-C Kyowa 40 mg: 2 years
After reconstitution, the solution is chemically and physically stable for 24 hours when protected from light and stored in a cool place. Do not refrigerate.
From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user.
6.4 Special precautions for storage
Store in the original package.
The reconstituted solution should be protected from light and stored in a cool place (See Section 6.3).
6.5 Nature and contents of container
Mitomycin-C Kyowa is contained within a colourless, type I or III glass vial with a rubber stopper and an aluminium seal.
The 10, 20 and 40 mg vials are packaged into cardboard cartons containing 1 or 5 vials. The 2 mg vials are packaged into cardboard trays with an overwrap containing 10 vials.
6.6 Special precautions for disposal and other handling
Mitomycin-C Kyowa 2 mg: The contents of the vial should be reconstituted with Water for Injection or saline 5 ml for the 2 mg vial. If possible, avoid mixing with injectable solutions which have a low pH.
Mitomycin-C Kyowa 10 mg: The contents of the vial should be reconstituted with Water for Injection or saline at least 10 ml for the 10 mg vial.
Mitomycin-C Kyowa 20 mg, 40 mg: The contents of the vial should be reconstituted with Water for Injection or saline solution at least 20 ml for the 20 mg and at least 40 ml for the 40 mg vial. Mitomycin-C Kyowa should not be allowed to come into contact with the skin. If it does, it should be washed several times with 8.4% sodium bicarbonate solution, followed by soap and water.
Hand creams and emollients should not be used as they may assist the penetration of the drug into the epidermal tissue.
In the event of contact with the eye, it should be rinsed several times with saline solution. It should then be observed for several days for evidence of corneal damage. If necessary, appropriate treatment should be instituted.
7. MARKETING AUTHORISATION HOLDER
Kyowa Kirin Ltd.
Galabank Business Park
Galashiels
TD11QH
UK
8. MARKETING AUTHORISATION NUMBERS PL16508/0042-0045
9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
Date of first authorisation: 26 November 1992 Date of latest renewal: 29 June 2006
10. DATE OF REVISION OF THE TEXT
May 2016
PACKAGE LEAFLET: INFORMATION FOR THE USER
MITOMYCIN-C’ KYOWA®
2, 10, 20 or 40 mg Powder for solution for injection
Mitomycin-C
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
- If you get any of the side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
In this leaflet:
1. What Mitomycin-C Kyowa is and what it is used for
2. What you need to know before you use Mitomycin-C Kyowa
3. How to use Mitomycin-C Kyowa
4. Possible side effects
5. How to store Mitomycin-C Kyowa
6. Contents of the pack and other information
1. WHAT MITOMYCIN-C KYOWA IS AND WHAT IT IS USED FOR
As a single medicine or in a combination with other medicines, Mitomycin-C Kyowa can be used to treat different types of cancers in many different parts of the body as described below:-
• In bladder cancer Mitomycin-C Kyowa can be given by injection or, alternatively introduced directly into the bladder after surgery to reduce the chances of a recurrence of the condition
• Breast cancer and cancer of the neck of the womb (the cervix).
• It shows some activity in cancers of the stomach, pancreas, lung, liver, head and neck, prostate, leukaemia (a disease of the blood) and certain other types of tumours.
• It has a possible role with other anti-cancer medicines in cancer of the lower bowel, skin cancer and sarcomas (cancers of a particular kind of body tissue called connective tissue).
• It has been successfully used in combination with surgery, before operations (in cases of cancer of the upper digestive tract) and after operations (in cases of cancer of the stomach).
• It has been shown to be effective when used in combination with radiotherapy.
2. WHAT YOU NEED TO KNOW BEFORE YOU USE MITOMYCIN-C KYOWA
Do not use Mitomycin-C Kyowa if you:
• are allergic (hypersensitive) to mitomycin or any of the other ingredients of Mitomycin-C Kyowa (listed in section 6).
• have certain types of blood disorders (ask your doctor for advice).
Take special care with Mitomycin-C Kyowa if you:
• have liver or kidney problems; side effects of mitomycin may be more noticeable
• are capable of child-bearing as mitomycin may affect your ability to have children in the future
• have been told that you have bone marrow depression (your bone marrow is not able to make the blood cells that you need); it may be made worse (especially in the elderly); infection (including chickenpox) may be aggravated due to bone marrow depression and may lead to fatal conditions.
Special attention will be paid if this product is given to the elderly or to children due to the possible side effects in these age groups.
You will be given the treatment under the supervision of a healthcare professional who is experienced in this particular branch of medicine to minimise any unwanted side effects in the injection site.
Other medicines and Mitomycin-C Kyowa
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription, or been given other treatments (e.g. radiotherapy).
When given together with certain other cancer treatment there have been some reports of problems related to bone marrow and the occurrence of cancer involving various types of blood cells. Pregnancy and breast-feeding
You should not be given Mitomycin-C Kyowa if you are pregnant, may be pregnant or if you are breast-feeding. Ask your doctor for advice before taking any medicine.
Driving and using machines
A few people have reported that they feel tired or weak after the treatment. Do not drive or use any tools or machines if you are affected.
3. HOW TO USE MITOMYCIN-C KYOWA
Always use the medicine as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Mitomycin-C Kyowa is usually given by injection or as an infusion (with a drip). However in the treatment or the prevention of the recurrence of bladder cancer, a solution of Mitomycin-C Kyowa will be given directly into the bladder through a type of tube called a catheter.
The precise dosage, frequency of dosing and duration of treatment with Mitomycin-C Kyowa will depend on your age, weight, medical condition and whether Mitomycin-C Kyowa is being given in combination with other drug treatment.
LFT-MMC-GB-002
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Kyowa Kirin Limited KYOWA KIRIIll Galabank Business Park,
Galashiels, UK, TD1 1QH Tel: +44 (0) 1896 664 000 Fax: +44 (0) 1896 664 001
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Product No: |
LFT-MMC-GB-002 (Page 2) |
Colours Used | |
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Product Name: |
Mitomycin-C |
■ |
Black |
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Item Description: |
Leaflet |
Technical Info (does not print) | |
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Cutter Ref: |
- |
□ |
Perforation (does not print) |
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Pharmacode |
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Keyline (does not print) | |
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Commodity No: |
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Core Spec Ref: |
42 x297 F Folded | ||
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Market: |
UK | ||
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Language: |
English | ||
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Proof No: |
2 | ||
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Date Issued: |
27-April-16 | ||
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Issued by: |
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Font Size: |
7.6pt | ||
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Font Type: |
Helvetica (TT) & Helvetica LT Std | ||
Reason for Change:
Mock up leaflet