Bleomycin

Indications
 Parenteral
Squamous cell or testicular tumours
Adult: 15,000 IU 3 times a wk or 30,000 IU twice a wk IM/IV, repeated at usual intervals of 3-4 wk up to a total cumulative dose of 500,000 IU.
Elderly: Dose reduction is necessary.
Renal impairment: Dose reduction is necessary.
Intramuscular
Lymphoma
Adult: 15,000 IU once or twice a wk, up to a total cumulative dose of 225,000 IU.
Elderly: Dose reduction is necessary.
Renal impairment: Dose reduction is necessary.
Injection
Malignant effusions
Adult: 60,000 IU in 100 ml of 0.9% sodium chloride instilled into the affected serous cavity, may be repeated up to a total cumulative dose of 500,000 IU.
Elderly: Dose reduction is necessary.
Renal impairment: Dose reduction is necessary.

Incompatibility: Incompatible with solutions of essential amino acids, riboflavin, dexamethasone or furosemide.
Contraindications
 Hypersensitivity. Severe pulmonary disease; pregnancy and lactation.
Warnings / Precautions
 Pulmonary infection, preexisting pulmonary function impairment, renal impairment. Patients who received radiotherapy, particularly to the thorax. Regular chest x-rays should be done. Elderly. Discontinue treatment if chest x-rays show infiltrates or breathlessness occurs.
Adverse Reactions
 Fever, thrombophloebitis (inj). Acute anaphylactoid reactions, hyperpyrexia. Rash, erythema, pruritus, vesiculation, hyperkeratosis, nail changes, alopecia, hyperpigmentation, striae, stomatitis.
Potentially Fatal: Pulmonary toxicity, interstitial pneumonitis, fibrosis, cardiorespiratory collapse in patients with lymphoma.
Drug Interactions
 Lomustine increases severity of leukopenia. Elimination decreased by cisplatin. Decreases plasma levels of digoxin and phenytoin.
Potentially Fatal: Enhanced pulmonary toxicity in patients given with oxygen.
See Below for More bleomycin Drug Interactions
Mechanism of Actions
 Bleomycin causes breakage of single- and double- stranded DNA by binding to DNA and inhibiting DNA synthesis. To a lesser extent, it also inhibits RNA and protein synthesis. It causes very little bone marrow suppression.
Absorption: Poorly absorbed from the GI tract (oral).
Distribution: Crosses the placenta.
Metabolism: Enzymatic degradation in plasma, liver and other organs.
Excretion: Urine (as active drug). Elimination half-life: Initial: 0.5 hr (IV bolus), 1.3 hr (infusion); terminal: 4 hr (IV bolus), 9 hr (infusion).
Storage Conditions
 Injection: Refrigerate at 2-8°C. Intramuscular: Refrigerate at 2-8°C. Parenteral: Refrigerate at 2-8°C.
ATC Classification
 L01DC01 - bleomycin ; Belongs to the class of other cytotoxic antibiotics. Used in the treatment of cancer.
Storage
 Injection: Refrigerate at 2-8°C. Intramuscular: Refrigerate at 2-8°C. Parenteral: Refrigerate at 2-8°C.
Available As
  • Bleomycin 15 mg
  • Bleomycin 30 mg

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