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Bleomycin

    Brands

    DEA Class; Rx

    Common Brand Names; Blenoxane

    • Antineoplastics, Antibiotic

    Antibiotic antineoplastic
    Mixture of 13 glycopeptides; active component is the A-2 peptide
    Used for Hodgkin lymphoma, NHL, testicular cancer, squamous cell cancer of the head and neck and cervix, and malignant pleural effusions.

    Indicated for the treatment of Hodgkin lymphoma.

    For the treatment of non-Hodgkin’s lymphoma (NHL).
    For the treatment of cervical cancer, head and neck cancer, or vulvar cancer (specifically squamous cell cancer).
    For the treatment of testicular cancer, including embryonal cell, choriocarcinoma, and teratocarcinoma.
    For the treatment of penile cancer.

    Hypersensitivity

    Concomitant use of bleomycin with brentuximab because of pulmonary toxicity

    • Mucocutaneous toxicity including rash, erythema, hyperpigmentation, urticaria (>50%)
    • Febrile reactions, acute (25-50%)
    • Mucositis (30%)
    • Stomatitis (30%)
    • Interstitial pneumonitis (10%)
    • Pulmonary fibrosis (10%)
    • Anorexia
    • Weight loss
    • Rales
    • Tachypnea
    • Alopecia (1-10%)
    • Fatal pulmonary fibrosis (1%)
    • Confusion
    • Shivering
    • Anphylactoid reactions
    • Onycholysis
    • Pruritus
    • Skin thickening
    • Scleroderma

    Use caution in renal impairment

    Hepatic toxicity reported

    Use caution when administering oxygen during surgery (increases risk of pulmonary toxicity)

    Risk of pulmonary fibrosis (at lower doses if used with other antineoplastics)

    Avoid pregnancy

    Pregnancy Category: D

    Lactation: It is not known whether the drug is excreted in milk. Because of the potential for serious adverse reactions in nursing infants, it is recommended that nursing be discontinued by women receiving bleomycin therapy.

    The suggested maximum tolerated dose (MTD) for bleomycin, which is dependent on performance status, other chemotherapy agents or radiation given in combination, and disease state, is as follows:
     
    NOTE: The correct dose of bleomycin will vary from protocol to protocol. Clinicians should consult the appropriate references to verify the dose.

    Adults

    Maximum lifetime cumulative dosage of bleomycin is 400 units intravenous (IV), intramuscular (IM), or subcutaneous.

    Geriatric

    Maximum lifetime cumulative dosage of bleomycin is 400 units intravenous (IV), intramuscular (IM), or subcutaneous. However, elderly patients may develop pulmonary toxicity at lower cumulative bleomycin doses.

    Adolescents

    Maximum lifetime cumulative dosage of bleomycin is 400 units intravenous (IV), intramuscular (IM), or subcutaneous.

    Children

    Maximum lifetime cumulative dosage of bleomycin is 400 units intravenous (IV), intramuscular (IM), or subcutaneous.

    Bleomycin sulfate

    powder for injection

    • 15unit
    • 30unit