Generic
Bleomycin
2 brands available in the market
At a glance
Bleomycin is an anti-cancer medication used in the treatment of cervical cancer, cancer of the mouth, nasopharynx, paranasal sinuses, larynx, esophagus, and skin cancer. It damages the genetic material (DNA) of cancer cells and stops their growth and multiplication.
Description
Bleomycin is an anti-cancer medication used in the treatment of cervical cancer, cancer of the mouth, nasopharynx, paranasal sinuses, larynx, esophagus, and skin cancer. It may be used alone or with other medicines as part of combination therapy.
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.
The medicine is given under the supervision of a healthcare professional and should not be self-administered.
Indications
- Cervical cancer
- Cancer of the mouth
- Nasopharynx cancer
- Paranasal sinuses cancer
- Larynx cancer
- Esophagus cancer
- Skin cancer
- Squamous cell carcinoma
- Testicular carcinoma
- Hodgkin's disease
- Non-Hodgkin's lymphoma
Therapeutic class
Antineoplastic Agent
Pharmacological class
Cytotoxic Antibiotic
Pharmacology
Bleomycin is a cytotoxic antibiotic that binds to DNA and causes single- and double-stranded DNA breakage, inhibiting DNA synthesis. To a lesser extent, it also inhibits RNA and protein synthesis. It generates oxygen free radicals that cause DNA strand breakage. It causes very little bone marrow suppression, which is an advantage over other chemotherapy agents.
Mechanism of action
Bleomycin binds to DNA and causes single- and double-stranded DNA breakage, inhibiting DNA synthesis. It generates oxygen free radicals that cause DNA strand breakage and induce apoptosis (programmed cell death) of cancer cells. To a lesser extent, it also inhibits RNA and protein synthesis.
Dosage
Squamous Cell Carcinoma and Testicular Carcinoma: 0.25-0.5 unit/kg (10-20 unit/m²) IV/IM/SC every 1-2 weeks.
Hodgkin's Disease and Non-Hodgkin's Lymphoma: Administer test dose of 1-2 units before the first 1-2 doses; monitor vital signs every 15 minutes; wait at least 1 hour before administering remainder of dose; 0.25-0.5 unit/kg (10-20 unit/m²) IV/IM/SC every 1-2 weeks; after 50% response, reduce to maintenance dose of 1 unit daily or 5 units weekly IV/IM.
Children: Not recommended.
Hepatic impairment: Dose adjustment not necessary.
Renal impairment:
CrCl >50 mL/min: No adjustment
CrCl 40-50 mL/min: 70% of normal dose
CrCl 30-40 mL/min: 60% of normal dose
CrCl 20-30 mL/min: 55% of normal dose
CrCl 10-20 mL/min: 45% of normal dose
CrCl 5-10 mL/min: 40% of normal dose
Administration
For IV, IM, or SC administration only. Administered by doctor or nurse. Patient should not self-administer. Given as injection. Follow the dose and schedule as advised by your doctor.
Missed dose
Hospital-only medicine. Administered by doctor or nurse. Patient should not self-administer. Missed dose concept does not apply (hospital-administered).
Side effects
Common side effects:
Fever, loss of appetite, hair loss, weight loss, nausea, nail discoloration, skin pigmentation, stomatitis (inflammation of the mouth), vomiting, rigors, scratch dermatitis, low blood platelets.
Pulmonary: Interstitial pneumonia, pulmonary fibrosis, shortness of breath, cough.
Bone marrow suppression is very minimal compared to other chemotherapy agents.
Precautions & warnings
- Pulmonary toxicity: Seek immediate medical advice if you develop dry cough, breathlessness, rapid breathing, or any other lung problems.
- Inform your doctor if you have severe heart disease, kidney problems, lung problems requiring oxygen use, impaired liver function, chicken pox, or if you are about to undergo surgery.
- May cause weakness or tiredness; avoid driving or operating heavy machinery.
- Avoid alcohol consumption (increases risk of liver damage).
- Do not use during pregnancy and lactation.
- Regular blood tests, X-rays, and physical examinations are required.
Contraindications
- Hypersensitivity to bleomycin
- Severe pulmonary disease
- Pregnancy and lactation
Drug interactions
- Previous or concurrent radiotherapy to the chest: Increased incidence and severity of lung toxicity.
- Combination with vinca alkaloids: May result in Raynaud's syndrome, ischemia leading to necrosis of peripheral parts (fingers, toes, nose tip).
- Phenytoin: May reduce absorption of phenytoin.
- Clozapine: Increased risk of agranulocytosis.
- Oxygen, cisplatin, or brentuximab: Increased pulmonary toxicity (potentially fatal).
Food interactions
It is not known whether it is safe to consume alcohol with Bleomycin. Avoid alcohol consumption (increases risk of liver damage).
Use in pregnancy
Unsafe during pregnancy (Category D). Definite evidence of risk to the developing baby. May be prescribed rarely in life-threatening situations if benefits outweigh risks.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Probably unsafe during breastfeeding. Limited human data suggests the drug may pass into breast milk and harm the baby.
Pediatric use
Not recommended for use in children.
Geriatric use
No specific dose adjustment for elderly, but dose should be based on renal function.
Renal / hepatic impairment
Hepatic impairment: Probably safe; dose adjustment may not be needed. Consult your doctor.
Overdose effects
Overdose may cause increased pulmonary toxicity, severe pulmonary fibrosis, anaphylactic reactions, severe fever, and skin reactions. Seek immediate medical attention if overdose is suspected.
Storage conditions
Store below 30°C, away from light and moisture. Keep out of reach of children.
Chemical structure
Bleomycin (Cytotoxic Antibiotic)