Plicamycin Brand Name– Mithracin
What is Plicamycin
NOTE: This drug is discontinued in the US.
Plicamycin is a parenteral cell cycle-phase nonspecific antineoplastic agent used to manage hypercalcemia of malignancy and to treat testicular cancer (embryonal cell type).
It is a natural substance isolated from Streptomyces plicatus. Currently, its main use is as a third-line agent to treat hypercalcemia. Because of its antineoplastic toxicity, it must be used judiciously.
It is considerably more toxic than other agents used to treat hypercalcemia and is thus reserved for treating refractory cases, particularly those associated with malignancy. A more common name for plicamycin is mithramycin.
Plicamycin was approved by the FDA in 1970. The manufacturer discontinued marketing of plicamycin in the US in March 2000 due to declining demand.
Indications
- hypercalcemia
- Paget’s disease
- testicular cancer
For the treatment of hypercalcemia, particularly when associated with malignancy
Side Effects
- anorexia
- azotemia
- bleeding
- diarrhea
- dysgeusia
- elevated hepatic enzymes
- epistaxis
- esophagitis
- flushing
- GI bleeding
- GI perforation
- hematemesis
- hypercalcemia
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypophosphatemia
- hypoprothrombinemia
- leukopenia
- metallic taste
- nausea
- neutropenia
- platelet dysfunction
- prolonged bleeding time
- proteinuria
- skin hyperpigmentation
- stomatitis
- thrombocytopenia
- thrombosis
- typhlitis
- vomiting
Monitoring Parameters
- CBC
- LDH
- LFTs
- partial thromboplastin time (PTT)
- prothrombin time (PT)
- serum calcium
- serum creatinine/BUN
- serum magnesium
- serum potassium
Contraindications
- accidental exposure
- bleeding
- bone marrow suppression
- breast-feeding
- coagulopathy
- dental disease
- dental work
- hemophilia
- hepatic disease
- herpes infection
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypophosphatemia
- infection
- intramuscular injections
- ocular exposure
- pregnancy
- radiation therapy
- renal disease
- thrombocytopenia
- vaccination
- varicella
- viral infection
Interactions
- Alpha interferons
- Antithymocyte Globulin
- Azelastine; Fluticasone
- Bacillus Calmette-Guerin Vaccine, BCG
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Budesonide; Glycopyrrolate; Formoterol
- Carbamazepine
- Ciclesonide
- Clozapine
- Corticosteroids
- Cortisone
- Deflazacort
- Dexamethasone
- Echinacea
- Febuxostat
- Fludrocortisone
- Flunisolide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocortisone
- Influenza Virus Vaccine
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Intranasal Influenza Vaccine
- Live Vaccines
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Measles/Mumps/Rubella Vaccines, MMR
- Methylprednisolone
- Mometasone
- Palifermin
- Pegfilgrastim
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Penicillamine
- Prednisolone
- Prednisone
- Rotavirus Vaccine
- Rubella Virus Vaccine Live
- Smallpox and Monkeypox Vaccine, Live, Nonreplicating
- Smallpox Vaccine, Vaccinia Vaccine
- Triamcinolone
- Tuberculin Purified Protein Derivative, PPD
- Typhoid Vaccine
- Varicella-Zoster Virus Vaccine, Live
- Yellow Fever Vaccine, Live
