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Bleomycin

Brand and Other Names: Bleomycin
Mechanism of Action:

Inhibits DNA synthesis, causing single- and double-strand breaks; some inhibition of RNA/protein synthesis.

Indications:

Squamous Cell Carcinomas: Head/neck, penis, cervix, vulva, etc.

Lymphomas: Both Hodgkin's and non-Hodgkin's.

Testicular Cancer: Including embryonal cell carcinoma, choriocarcinoma, and teratocarcinoma.

Malignant Pleural Effusion: As a sclerosing agent to prevent recurrence

Route: intramuscular, intravenous, subcutaneous or intrapleural
Dose:

0.25–0.5 units/kg (10–20 units/m²) weekly or biweekly.

Adverse Reactions:

Skin/mucous membrane effects (~50%) — rash, hyperpigmentation, stomatitis.

Contraindication:

Bleomycin for injection is contraindicated in patients who have demonstrated a hypersensitive or an idiosyncratic reaction to it.

Warnings and Precautions:

Pulmonary Toxicity: The most severe risk, occurring in about 10% of patients. Can lead to pneumonitis and potentially fatal pulmonary fibrosis. Risk increases in:

  • Elderly patients (>70 years)

  • Patients receiving >400 units total

Idiosyncratic Reactions: Rare (~1% of lymphoma patients), resembling anaphylaxis — includes fever, chills, hypotension, mental confusion, wheezing.

Renal and Hepatic Impairment: Requires dose adjustment; significant caution recommended due to altered drug clearance.

See package insert for full prescribing information.