Bleomycin

Bleomycin is a prescription medication used to treat squamous cell carcinoma, Hodgkin’s disease, non-Hodgkin’s lymphoma, testicular carcinoma, and malignant pleural effusion.

• Bleomycin is available under the following different brand names: Blenoxane

Adult dosage

Powder for injection

• 15unit
• 30unit

Squamous Cell Carcinoma

Adult dosage

• 0.25-0.5 unit/kg (10 to 20 unit/m²) IV/IM/SC every 1-2 Weeks

Hodgkin Disease, Non-Hodgkin Lymphoma

Adult dosage

• 0.25 to 0.5 unit/kg (10 to 20 unit/m²) IV/IM/SC every 1-2 weeks; reduce to a maintenance dose of 1 unit once daily or 5 units every week IV/IM after 50% response

Testicular Carcinoma

Adult dosage

• 0.25-0.5 unit/kg (10 to 20 unit/m²) IV/IM/SC every 1-2 weeks 

Pleural Sclerosing

Adult dosage

• 60 unit in 50-100 mL as single instillation; may repeat dose at intervals of several days if fluid continues to accumulate (mix in 50-100 mL or NS); may add lidocaine 100-200 mg to reduce local discomfort
• Elderly: May limit dose to 40 unit/m²

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Bleomycin include:

• skin redness,
• dark streaks, or discoloration,
• fingernail or toenail changes,
• fever, 
• chills, 
• vomiting, 
• rash,
• itching, and
• hair loss.

Serious side effects of Bleomycin include:

• sudden chest pain, 
• shortness of breath, 
• dry cough, 
• tiredness,
• light-headed feeling, 
• feeling like passing out,
• loss of appetite, 
• weight loss,
• sudden numbness or weakness on one side of the body, 
• problems with vision or speech,
• blisters or ulcers in the mouth, red or swollen gums, trouble swallowing,
• unusual hardening of the skin,
• swelling, numbness, 
• tingling or cold feeling in the fingers, and
• signs of an allergic reaction: hives, fever, chills, confusion, wheezing, difficult breathing, swelling of the face, lips, tongue, or throat.

Rare side effects of Bleomycin include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Bleomycin has severe interactions with the following drug:
  • brentuximab vedotin
• Bleomycin has serious interactions with the following drugs:
  • adenovirus types 4 and 7 live, oral
  • influenza virus vaccine quadrivalent, adjuvanted
  • influenza virus vaccine trivalent, adjuvanted
  • palifermin
• Bleomycin has moderate interactions with the following drugs:
  • cholera vaccine
  • dengue vaccine
  • ethotoin
  • fosphenytoin
  • meningococcal group B vaccine
  • ofatumumab SC
  • olaparib
  • oxaliplatin
  • phenytoin
  • siponimod
  • tenofovir DF
  • trastuzumab
  • trastuzumab deruxtecan
• Bleomycin has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity
• Concomitant use of bleomycin with brentuximab because of pulmonary toxicity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Bleomycin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Bleomycin?”

Cautions

• 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 and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available. Positive evidence of human fetal risk.
• 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.