bleomycin

Generic Name: bleomycin (BLEE oh MYE sin)Brand Names: Blenoxane

What is bleomycin?

Bleomycin is a cancer medication. Bleomycin interferes with the growth of cancer cells and slows their growth and spread in the body.

Bleomycin is used to treat squamous cell carcinoma, a skin cancer that can affect the mouth, throat, nose and sinuses, penis, vagina, cervix, and other. Bleomycin is also used to treat Hodgkin's disease and non-Hodgkin's lymphoma, testicular cancer, and malignant pleural effusion (a build-up of fluid in the outer tissues of the lungs, caused by certain types of cancer).

Bleomycin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about bleomycin?

You should not receive bleomycin if you have ever had an allergic reaction to it. Do not receive bleomycin without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Before receiving bleomycin, tell your doctor if you have lung disease or a breathing disorder, kidney disease, or liver disease.

To be sure this medication is not causing harmful effects on your lungs, you may need to have chest X-rays or other lung function tests on a regular basis. Do not miss any follow-up visits to your doctor for X-rays or other tests. If you need to have any type of surgery, tell the surgeon ahead of time that you are being treated with bleomycin. Call your doctor at once if you have a serious side effect such as fever, chills, mouth sores, confusion, weakness, loss of appetite, rapid weight loss, sudden chest pain or discomfort, wheezing, dry cough, feeling short of breath, feeling like you might pass out, unusual hardening or thickening of your skin. or severe skin reaction (redness, itching, rash, blistering, or tenderness).

What should I discuss with my healthcare provider before receiving bleomycin?

You should not receive bleomycin if you have ever had an allergic reaction to it.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before receiving bleomycin, tell your doctor if you have:

• lung disease or a breathing disorder;

• kidney disease; or
• liver disease.

FDA pregnancy category D. Do not receive bleomycin without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether bleomycin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is bleomycin given?

Bleomycin is given as an injection through a needle placed into a vein or muscle, or as a shot given under the skin When treating pleural effusion, bleomycin is given through a chest tube. You will receive this injection in a clinic or hospital setting.

Bleomycin is usually given once or twice per week, depending on the condition being treated. Follow your doctor's instructions.

To be sure this medication is not causing harmful effects on your lungs, you may need to have chest X-rays or other lung function tests on a regular basis. Do not miss any follow-up visits to your doctor for X-rays or other tests. If you need to have any type of surgery, tell the surgeon ahead of time that you are being treated with bleomycin.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your bleomycin injection.

What happens if I overdose?

Since bleomycin is given in a clinical setting by a healthcare professional, an overdose of this medication is not likely to occur.

What should I avoid while receiving bleomycin?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are being treated with bleomycin.

Bleomycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

• fever or chills;

• sudden chest pain or discomfort, wheezing, dry cough or hack;

• feeling short of breath on exertion;

• chest discomfort, wheezing, dry cough or hack;

• confusion, feeling weak or tired, loss of appetite, rapid weight loss;

• feeling like you might pass out;

• white patches or sores inside your mouth or on your lips;

• severe redness, itching, rash, blistering, or tenderness of your skin; or

• unusual hardening or thickening of your skin.

Less serious side effects may include:

• dark streaks or discoloring on your skin;

• fingernail or toenail changes;

• temporary hair loss;

• mild itching;

• vomiting;

• pain near your tumor; or

• redness, warmth, itching, or swelling around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Bleomycin Dosing Information

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.

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.

What other drugs will affect bleomycin?

Tell your doctor about all other cancer treatments you are receiving.

There may be other drugs that can interact with bleomycin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist can provide more information about bleomycin.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 3.02. Revision Date: 11/17/2009 9:56:37 PM.