Dangerous Drug: Bleomycin Sulfate(blee oh mye’ sin)
PREGNANCY CATEGORY D
Drug Classes
Antibiotic
Antineoplastic
Therapeutic Actions
Inhibits DNA, RNA, and protein synthesis in susceptible cells, preventing cell division; cell cycle phase-specific agent with major effects in G2 and M phases.
Indications
Palliative treatment of squamous cell carcinoma, lymphomas, testicular carcinoma, alone or with other drugs
Treatment of malignant pleural effusion and prevention of recurrent pleural effusions
Unlabeled uses: Mycosis fungoides, osteosarcoma, AIDS-related Kaposi sarcoma, germ cell tumors, sclerosis of pleural effusions, palliative treatment of children with lymphomas, malignant pericardial effusion, malignant peritoneal effusion, warts (intralesional)
Contraindications and Cautions
Contraindicated with allergy to bleomycin sulfate; lactation, pregnancy.
Use cautiously with pulmonary disease; hepatic or renal impairment.
Available Forms
Powder for injection—15, 30 units
Dosages
Adults
Treat lymphoma patients with 2 units or less for the first two doses; if no acute anaphylactoid reaction occurs, use the regular dosage schedule:
Squamous cell carcinoma, non-Hodgkin’s lymphoma, testicular carcinoma: 0.25–0.5 unit/kg IV, IM, or subcutaneously, once or twice weekly.
Hodgkin’s lymphoma: 0.25–0.5 unit/kg IV, IM, or subcutaneously once or twice weekly. After a 50% response, give maintenance dose of 1 unit/day or 5 units/wk, IV or IM. Response should be seen within 2 wk (Hodgkin’s lymphoma, testicular tumors) or 3 wk (squamous cell cancers). If no improvement is seen by then, it is unlikely to occur.
Malignant pleural effusion: 60 units dissolved in 50–100 mL 0.9% saline solution, given via thoracostomy tube.
Pediatric patients
Safety and efficacy not established.
Patients with renal impairment
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