Generic Name: Bleomycin Brand Name(s): .

Uses

What is Bleomycin used for?

Bleomycin is commonly used to treat cancer. It works by slowing or stopping the growth of cancer cells.

This medication may also be used to control the build-up of fluid around the lungs (pleural effusion) caused by tumors that have spread to the lungs. For this condition, bleomycin is placed in the space around the lungs through a chest tube.

How should I take Bleomycin?

This medication is given by injection into a vein, into a muscle, or under the skin by a health care professional usually once or twice a week or as directed by your doctor. When giving this medication into a vein, it is injected slowly over 10 minutes. Tell your health care professional right away if you experience any chest pain. The medication may need to be stopped or injected more slowly. The dosage is based on your medical condition, body size, and response to treatment.

If you are receiving this medication through a chest tube into the space around the lungs, the solution is usually left in place for 4 hours and then drained out through the chest tube. Your doctor may direct you to change positions during the 4 hours to make sure the solution treats all parts of your lungs.

How do I store Bleomycin?

The sterile powder is stable under refrigeration 2°C to 8°C (36°F to 46°F) and should not be used after the expiration date is reached. Bleomycin for Injection is stable for 24 hours at room temperature in Sodium Chloride. If you need to store bleomycin at home, talk with your doctor, nurse, or pharmacist about how to store it.

Precautions & warnings

What should I know before using Bleomycin?

Before using bleomycin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially: immune system problems (e.g., chemotherapy, bone marrow problems), kidney disease, liver disease, lung problems.

This medication may make your lungs more sensitive to oxygen treatment. Therefore, tell your doctor or dentist that you have used this medication before having surgery or any treatment where oxygen may be used.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be at greater risk for side effects (e.g., lung problems) while using this drug.

This medication is not recommended for use during pregnancy. It may harm the unborn baby. Consult your doctor for more details. If you become pregnant or think you may be pregnant, tell your doctor right away.

It is not known whether this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Bleomycin during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Bleomycin. This Bleomycin is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Bleomycin?

Pain/redness at the injection site, fever, chills, vomiting, loss of appetite, weight loss, darkening of the skin, or changes in fingernails/toenails may occur. Changes in diet such as eating several small meals or limiting activity may help lessen some of these effects. In some cases, drug treatment may be necessary to prevent or relieve nausea and vomiting. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Temporary hair loss may occur. Normal hair growth should return after treatment has ended.

People using this medication may have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk ofside effects. Careful monitoring by your doctor may decrease your risk.

Painful sores on the lips, mouth, and throat may occur. To decrease the risk, limit hot foods and drinks, brush your teeth carefully, avoid using mouthwash that contains alcohol, and rinse your mouth frequently with cool water.

Bleomycin can commonly cause skin reactions (e.g., redness, itching, blisters, rash, swelling), usually in the second or third week of treatment. These reactions are not always serious. However, you may not be able to tell them apart from signs of a severe reaction. Therefore, tell your doctor right away if you develop any skin reaction.

Tell your doctor right away if you have any serious side effects, including: dizziness/fainting, fast/pounding heartbeat, numbness/tingling, feeling of coldness in hands/feet, easy bruising/bleeding, pale/bluish skin, coughing up blood, vomit that looks bloody or like coffee grounds, signs of infection (e.g., persistent sore throat), signs of kidney problems (such as change in the amount of urine, pink urine), mental/mood changes (e.g., confusion, aggression), persistent nausea, stomach/abdominal pain, dark urine, yellowing eyes/skin.

Get medical help right away if any of these rare but very serious side effects occur: weakness on one side of the body, vision changes, slurred speech, chest pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: confusion, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Bleomycin?

Some products that may interact with this drug include: brentuximab, digoxin, drugs that may harm the kidneys (e.g., aminoglycosides such as gentamicin, cisplatin), phenytoin.

Bleomycin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Bleomycin?

Bleomycin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Bleomycin?

Bleomycin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Bleomycin.

What is the dose of Bleomycin for an adult?

Usual Adult Dose for Squamous Cell Carcinoma

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

Squamous cell carcinoma sometimes requires as long as 3 weeks before any improvement is noted.

Usual Adult Dose for non-Hodgkin’s Lymphoma

Because of the possibility of an anaphylactic reaction, the manufacturer recommends that lymphoma patients be treated with two units or less for the first two doses. However, there is at least one known case of fatal hyperpyrexia in a patient without lymphoma following an initial dose of 7.5 units. Test doses are controversial in non-lymphoma patients.

Following a 1 unit test dose, the patient should be observed for a reaction for one to two hours if the dose is administered intravenously or two to four hours if the dose is administered intramuscularly. If no acute reaction occurs, then the regular dosage schedule may be followed.

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

Usual Adult Dose for Testicular Cancer

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

Improvement in testicular tumors is prompt and noted within 2 weeks. If no improvement is seen at this time, improvement is unlikely.

Usual Adult Dose for Hodgkin’s Disease

Because of the possibility of an anaphylactic reaction, the manufacturer recommends that lymphoma patients be treated with two units or less for the first two doses. However, there is at least one known case of fatal hyperpyrexia in a patient without lymphoma following an initial dose of 7.5 units. Test doses are controversial in non-lymphoma patients.

Following a 1 unit test dose, the patient should be observed for a reaction for one to two hours if the dose is administered intravenously or two to four hours if the dose is administered intramuscularly. If no acute reaction occurs, then the regular dosage schedule may be followed.

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

After a 50% response, a maintenance dose of 1 unit daily or 5 units weekly intravenously or intramuscularly should be given.

Improvement in Hodgkin’s Disease is prompt and noted within 2 weeks. If no improvement is seen at this time, improvement is unlikely.

Usual Adult Dose for Malignant Pleural Effusion

60 units administered as a single bolus intrapleural injection.

What is the dose of Bleomycin for a child?

Usual Pediatric Dose for Squamous Cell Carcinoma

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

Squamous cell carcinoma sometimes requires as long as 3 weeks before any improvement is noted.

Usual Pediatric Dose for non-Hodgkin’s Lymphoma

Because of the possibility of an anaphylactic reaction, the manufacturer recommends that lymphoma patients be treated with two units or less for the first two doses. However, there is at least one known case of fatal hyperpyrexia in a patient without lymphoma following an initial dose of 7.5 units. Test doses are controversial in non-lymphoma patients.

Following a 1 unit test dose, the patient should be observed for a reaction for one to two hours if the dose is administered intravenously or two to four hours if the dose is administered intramuscularly. If no acute reaction occurs, then the regular dosage schedule may be followed.

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

Usual Pediatric Dose for Testicular Cancer

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

Improvement in testicular tumors is prompt and noted within 2 weeks. If no improvement is seen at this time, improvement is unlikely.

Usual Pediatric Dose for Hodgkin’s Disease

Because of the possibility of an anaphylactic reaction, the manufacturer recommends that lymphoma patients be treated with two units or less for the first two doses. However, there is at least one known case of fatal hyperpyrexia in a patient without lymphoma following an initial dose of 7.5 units. Test doses are controversial in non-lymphoma patients.

Following a 1 unit test dose, the patient should be observed for a reaction for one to two hours if the dose is administered intravenously or two to four hours if the dose is administered intramuscularly. If no acute reaction occurs, then the regular dosage schedule may be followed.

0.25 to 0.50 units/kg (10 to 20 units/m2) intravenously, intramuscularly, or subcutaneously weekly or twice weekly.

After a 50% response, a maintenance dose of 1 unit daily or 5 units weekly intravenously or intramuscularly should be given.

Improvement in Hodgkin’s Disease is prompt and noted within 2 weeks. If no improvement is seen at this time, improvement is unlikely.

Usual Pediatric Dose for Malignant Pleural Effusion

60 units administered as a single bolus intrapleural injection.

Renal Dose Adjustments

The manufacturer recommends the following dose adjustments in patients with renal impairment:

For creatinine clearance of 50 ml/minute or greater: No dose adjustment is required.

For creatinine clearance of 40 to 50 mL/minute: Administer 70% of normal dose.

For creatinine clearance of 30 to 40 mL/minute: Administer 60% of normal dose.

For creatinine clearance of 20 to 30 mL/minute: Administer 55% of normal dose.

For creatinine clearance of 10 to 20 mL/minute: Administer 45% of normal dose.

For creatinine clearance of 5 to 10 mL/minute: Administer 40% of normal dose.

How is Bleomycin available?

Bleomycin is available in the following dosage forms and strengths:

  • Injectable powder for injection

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Bleomycin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 11, 2018 | Last Modified: January 11, 2018

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