This is a highly cytotoxic antibiotic with antineoplastic properties.

Indications: IV for upper gastro-intestinal and breast cancers; and by bladder instillation for superficial bladder tumors.

Cautions: hepatic and renal impairment; caution in handling irritant to tissues; renal function should be tested before the beginning of treatment and after each course.

Contra-indications: Patients with impaired renal function or coagulation disorders; pregnancy & breast feeding.

Side effect: prolonged use may result in permanent marrow damage; renal damage and lung fibrosis; fatal haemolytic – uraemic syndrome.