Bleomycin

Indications & Dose:

Palliative and adjuvant to surgery and radiation therapy: Testicular tumour, squamous cell carcinoma of skin, neck and head, genitourinary tract and oesophagus neoplasm, malignancy of cervix. Hodgkin’s and non Hodgkin’s lymphoma. Chorio carcinoma and embroyo-nal cell carcinoma of testis. Brain tumour, glioma.

DOSE

Adults 30mg twice weekly in average cases, otherwise dose can be varied between 15mg daily to 15mg weekly. Total dose: 300-400mg. Small cell cancer 0.25mg-0.5mg/kg i.v, i.m, s.c. once or twice weekly. Hodgkin’s disease 0.25mg-0.5mg/kg i.v, i.m, s.c.

Contraindications:

Pregnancy & breastfeeding. Pre-existing pulmonary disease, hypersensitivity. 

Side Effects:

Cerebrovascular accident stomatitis, interstitial pneumonitis, hyperthermia, & alopecia, hypertrophic skin changes & hyperpigmentation of hands.

Nausea, vomiting, fever, anaphylaxis, skin rash,Ranaud’s phenomenon, stomatitis, pulmonary fibrosis,Renal and hepatic toxicity.

Cautions:

Impaired renal & hepatic functions. Elderly patients.Patients who have received extensive treatment with bleomycin (e.g. cumulative dose more than 100 units) may be at risk of developing respiratory failure if a general anaesthetic is given with high inspired oxygen concentrations. Anaesthetists should be warned of this.
OLD AGE: Use with caution

Precautions:

Interaction:

Drugs

Digoxin: Decreased serum levels of digoxin.

Phenytoin: Decrease serum levels of phenytoin.

Radiotherapy: Enhanced toxicity.

O2 Therapy: Enhanced pulmonary toxicity.

Cisplatin: Toxicity increased by bleomycin.

Vincristine: Debilitation syndrome.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: