Bleomycin

Bleomycin Brand Name– Blenoxane

What is Bleomycin

Bleomycin is a cell cycle-phase specific drug from the antibiotic class of antineoplastic drugs.

Bleomycin is a mixture of 13 glycopeptides isolated from the culture broth of the fungus Streptomyces verticillus.

The active component of bleomycin is the A2 peptide, which makes up about 70% of the available formulation.

Clinical uses of bleomycin include treatment of Hodgkin lymphoma; non-Hodgkin’s lymphoma; testicular carcinoma; and squamous cell carcinomas of the head and neck, penis, cervix, and vulva.

Bleomycin also is used as a sclerosing agent to treat pleural effusions.

Bleomycin has been designated an orphan drug by the FDA for the treatment of pancreatic cancer and pleural effusions.

Indications

  1. cervical cancer
  2. head and neck cancer
  3. hemangioma
  4. Hodgkin lymphoma
  5. Kaposi’s sarcoma
  6. malignant ascites
  7. non-Hodgkin’s lymphoma (NHL)
  8. osteogenic sarcoma
  9. penile cancer
  10. pleural effusion
  11. testicular cancer
  12. verruca plantaris
  13. verruca vulgaris
  14. vulvar cancer

Side Effects

  1. alopecia
  2. anorexia
  3. chest pain (unspecified)
  4. chills
  5. confusion
  6. dyspnea
  7. erythema
  8. fever
  9. hemolytic-uremic syndrome
  10. hyperesthesia
  11. hyperkeratosis
  12. hypotension
  13. injection site reaction
  14. malaise
  15. myocardial infarction
  16. nail discoloration
  17. pericarditis
  18. phlebitis
  19. pneumonitis
  20. pruritus
  21. pulmonary fibrosis
  22. pulmonary toxicity
  23. rash
  24. serious hypersensitivity reactions or anaphylaxis
  25. skin hyperpigmentation
  26. stomatitis
  27. striae
  28. stroke
  29. thrombotic microangiopathy
  30. tissue necrosis
  31. urticaria
  32. vomiting
  33. weight loss
  34. wheezing

Monitoring Parameters

  • CBC
  • pulmonary function tests (PFTs)
  • serum creatinine/BUN

Contraindications

  • accidental exposure
  • bleomycin hypersensitivity
  • breast-feeding
  • extravasation
  • fever
  • geriatric
  • idiosyncratic reaction
  • infection
  • intramuscular administration
  • maximum cumulative lifetime dose
  • ocular exposure
  • peripheral vascular disease
  • pregnancy
  • pulmonary disease
  • pulmonary fibrosis
  • pulmonary toxicity
  • radiation therapy
  • Raynaud’s phenomenon
  • renal failure
  • renal impairment
  • requires a specialized care setting
  • requires an experienced clinician
  • serious hypersensitivity reactions or anaphylaxis
  • subcutaneous administration
  • surgery
  • tobacco smoking
  • vaccination

Interactions

  • Alpha interferons
  • Aminoglycosides
  • Antithymocyte Globulin
  • Azelastine; Fluticasone
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Beclomethasone
  • Betamethasone
  • Brentuximab vedotin
  • Budesonide
  • Budesonide; Formoterol
  • Carbamazepine
  • Ciclesonide
  • Cisplatin
  • Clozapine
  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
  • Cyclosporine
  • Deflazacort
  • Dexamethasone
  • Diclofenac
  • Diclofenac; Misoprostol
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Echinacea
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Fludrocortisone
  • Flunisolide
  • Flurbiprofen
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Foscarnet
  • Hydantoins
  • Hydrocodone; Ibuprofen
  • Hydrocortisone
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Influenza Virus Vaccine
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Intranasal Influenza Vaccine
  • Ketoprofen
  • Lansoprazole; Naproxen
  • Live Vaccines
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Methylprednisolone
  • Mometasone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Penicillamine
  • Pentamidine
  • Piroxicam
  • Prednisolone
  • Prednisone
  • Rofecoxib
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Sulindac
  • tobacco
  • Tolmetin
  • Triamcinolone
  • Tuberculin Purified Protein Derivative, PPD
  • Typhoid Vaccine
  • Valdecoxib
  • Vancomycin
  • Varicella-Zoster Virus Vaccine, Live
  • Vitamin C
  • Yellow Fever Vaccine, Live
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