Drug reference
Squamous cell carcinoma | Metastatic germ cell cancer | Non-Hodgkin’s lymphoma ▶BY INTRAMUSCULAR INJECTION, OR BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION, OR BY INTRA- ARTERIAL INFUSION, OR BY LOCAL INFILTRATION ▶Adult: (consult product literature or local protocols) Immune system and malignant disease
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Acute pulmonary infection. significantly reduced lung function
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Caution in handling—irritant to tissues
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To conform to the European Pharmacopoeia vials previously labelled as containing ‘15 units’ of bleomycin are now labelled as containing 15 000 units. The amount of bleomycin in the vial has not changed.
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→Appendix 1: bleomycin
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▶Common or very common Alopecia. angular stomatitis. appetite decreased. chills. fever (after administration). haemorrhage. headache. interstitial pneumonia. leucopenia. malaise. nail discolouration. nail disorder. nausea. pain. pulmonary fibrosis (dose-related). scleroderma. skin reactions. stomatitis. vomiting. weight decreased ▶Uncommon Diarrhoea. dizziness. hepatocellular injury. oliguria. shock. urinary disorders. vein wall hypertrophy. venous stenosis SIDE-EFFECTS, FURTHER INFORMATION Progressive pulmonary fibrosis Progressive pulmonary fibrosis is dose-related, and may occur at lower doses in the elderly. Suspicious chest X-ray changes are an indication to stop therapy with this drug. Pulmonary toxicity Patients who have received bleomycin may be at risk of developing pulmonary toxicity if exposed to high inspired oxygen concentrations, for example peri-operatively, or during lung function testing.
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Contraceptive advice required, see Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Avoid (teratogenic and carcinogenic in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938
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Discontinue breast feeding.
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Dose adjustments Reduce dose by half if serum creatinine 177–354 micromol/litre; reduce dose further if serum- creatinine greater than 354 micromol/litre.
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There can be variation in the licensing of different medicines containing the same drug. Powder for solution for injection ▶Bleo-Kyowa (Kyowa Kirin Ltd) Bleomycin (as Bleomycin sulfate) 15000 unit Bleo-Kyowa 15,000unit powder for solution for injection vials | 10 vial P £190.60
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(consult product literature or local protocols)
First-line fragment. Read the complete Indications and Dose section above.
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