Your treatment with Mitomycin C eye drops 0.02% or 0.04%

You have been prescribed these eye drops specifically for your eye condition. They aim to remove the abnormal cells on the surface of your eye to prevent future problems.

No. Please tell your doctor if you:

• Have had an unusual or allergic reaction to Mitomycin C.
• Are pregnant or trying to become pregnant.
• Are breastfeeding.

As they have a short shelf-life, Moorfields pharmacy does not keep a stock of Mitomycin C eye drops. The drops are specially ordered for you when prescribed by your doctor.

The eye drops will be sent out via courier to your home address before the start of each cycle. As a result, you will receive multiple deliveries. The specialist pharmacist will have organised all the deliveries ahead of time, so it is important to notify them of any changes to your therapy (should they occur), if there will be no one home to receive the delivery, or if you change address.

You may experience common side effects, such as redness, irritation, discomfort, mucous discharge and eye pain. These symptoms may continue whilst using the eye drops but will gradually disappear after you have completed the course of treatment. However, if you experience any of the following side effects, contact the clinic immediately for advice (via the clinic secretaries or nurse).

• Severe redness of the eyes/eyelids.
• Itching/swelling of the eyelids.
• Droopy eyelid.
• Severe sensitivity to light.
• Persistent eye pain lasting for two-three days or more.
• Sharp severe pain not relieved by oral painkillers.

For queries out of working hours (9:00-17:00) please contact the Moorfields switchboard and ask to speak to the oncology fellow on call. Alternatively, if you’re worried, you may wish to attend your local eye unit or A&E (if Moorfields is not your closest). Pharmacy is unable to advise on whether the drops should be discontinued in response to side effects. For this, a doctor’s input is required.

Your eye drops should be stored in the refrigerator (between 2-8°C) in a storage container and in a separate area away from food. Throw away each bottle one week after opening, and if you have multiple bottles, use the bottle with the shorter expiry date first (please note, the bottles may be numbered in the order that they should be used).

Please ensure that you never use the eye drops after the expiry date shown on the bottle, and keep the eye drops out of reach and sight of children. Always read the label and follow the printed instructions before use.

Remember to only open one bottle each week and write the date of opening clearly onto the bottle label.

Mitomycin eye drops are lilac in colour and may cause staining to furniture, clothing and bed linen. If possible, administer eye drops over a sink or basin.

It is very important that anyone who handles or administers these drops follows the precautions below:

1. Remove the bottle of Mitomycin C eye drops from the fridge five minutes before use, to allow it to warm slightly.
2. Wash and dry your hands. It is advisable to wear disposable gloves and apply a barrier cream (e.g. Vaseline, moisturiser cream) on the surrounding skin of your eye and eyelids. This will prevent or lessen skin irritation if the eye drop solution accidentally comes into contact with your skin.
3. Using the dropper, draw up a small amount of liquid from the Mitomycin C bottle. Gently shake off any excess liquid on the dropper back into the bottle.
4. Tilt your head back slightly and gently pull down the lower eyelid to form a pocket. You may find it helpful to hold a clean tissue below the eye to catch any excess and prevent spillage onto your cheek. If any drops fall on your cheek, immediately wipe them away with a tissue and then wash the affected area with warm water and soap.
5. Using the dropper, instil one drop into the pocket. Take care not to touch your eye, the skin around your eye or your fingers with the end of the dropper. Wait a few seconds to allow the drop to be distributed and then release your eyelid. Close your eyes for 30 seconds and press gently on the inner corner of your eye with your finger.
6. Replace the dropper cap and close the bottle before returning it back to the fridge. All used tissues and gloves (turn gloves inside out as you remove them) should be double bagged in plastic bags and then thrown away with household waste. If more than a drop or two has come into contact with the gloves or tissues, dispose of these in the cytotoxic bin.
7. Wash your hands with soap and water.

Should you need to use any other eye drops at the same time of day, remember to leave a five-minute gap between drops to allow the first drop to be absorbed. Otherwise, the second drop will wash the first drop out, causing it to have been ineffective.

For more information on how to accurately put in your eye drops, watch the video tutorial below.

Each bottle of Mitomycin C eye drops should be used for a maximum of one week. 

At the end of each week of treatment, the bottle with its remaining contents should be closed tightly, and then placed into a cytotoxic waste bin. You will be provided with this bin from the Moorfields pharmacy. 

Empty and part used bottles should be placed into this bin. Make sure that you do not close the seal of the bin until you have placed the bottles from every mitomycin cycle into it. The full bins should be disposed of via the waste department of the local council.

Sometimes local GP practices, pharmacies or hospital pharmacies can help to dispose the waste for you. Alternatively, you can return the full bins to Moorfields pharmacy or the eye clinic. Do not throw any remaining liquid down the toilet or sink.

Contact with the skin can cause irritation, so immediately dry the area with tissue and then wash the area with plenty of water. This should be repeated using warm soapy water.

Gently dry the area afterwards. Do not apply any moisturising cream or hand cream to the affected area until the skin has been washed and dried. If redness or irritation lasts for longer than a few hours, contact your GP or clinic.

Any spillages should be dealt with immediately to reduce potential harm to yourself or other people.

Follow the steps below and ensure children and animals are kept away from the spillage area until it has been washed and dried.

• Wear disposable gloves when dealing with a spillage; make sure that the gloves are not damaged or torn.
• Cover the spillage using absorbent paper towels and ensure that all the liquid has been mopped up. Wipe the surface, furniture or floor clean using warm soapy water (i.e. washing up detergent) as soon as possible.
• Repeat this twice to guarantee that the spillage has been thoroughly cleaned.
• Place all used absorbent towels into the cytotoxic bin. If only a drop or two was spilled, the absorbent towels can be double bagged in plastic bags and thrown away with your household waste.

• Wearing a pair of disposable gloves, blot the area dry with a paper towel and remove the dirty clothing/linen immediately.
• Wash the clothes and/or linen separately from other clothing as soon as possible.
• Repeat the wash cycle to make sure all traces of the drug are completely removed.