Bleomycin belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics called actinomycins. Bleomycin causes the death of cancer cells by interfering with their growth and reproduction.

Bleomycin is used alone or in combination with other antineoplastic medications, radiation, or surgery to treat many types of cancer. These include cervical cancer, head and neck cancer, Skin Cancer, Hodgkin's disease and non-Hodgkins lymphoma, and cancers of the penis, testicles, and vulva. It is also used to control fluid buildup in the lining around the lungs caused by cancer (malignant pleural effusion).

Bleomycin may be available under multiple brand names and/or in several different forms. Any specific brand name of Bleomycin may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Bleomycin may not be used for all of the conditions discussed here.

Your doctor may have suggested Bleomycin for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Bleomycin, speak to your doctor. Do not stop taking Bleomycin without consulting your doctor.

Do not give Bleomycin to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Bleomycin if their doctor has not prescribed it.

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The recommended dose and dosing schedule of bleomycin varies according to the specific disease being treated, the response to therapy, and other drugs or treatments being used. The dose administered is also based on body size.

Bleomycin can be injected into a vein, into a muscle, under the skin, or into the pleura (lining around the lungs). Your doctor will decide the best way to inject the medication depending on the type of cancer and its location.

Bleomycin is always given under the supervision of a doctor. Very careful handling of Bleomycin is required, so it is always given in a hospital or similar setting with access to sterile equipment for preparation.

As well as interfering with the genetic material (DNA) of cancer cells, bleomycin can interfere with some of your normal cells. This can cause a number of side effects. Bleomycin may cause nausea and vomiting, but it is important to keep using Bleomycin even if you feel ill. Your doctor, nurse, or pharmacist can advise you on how to reduce the effects of nausea and vomiting. Keep track of any side effects and report them to your doctor as suggested in the section "What side effects are possible with Bleomycin?"

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Bleomycin exactly as prescribed by your doctor. If you miss an appointment to receive bleomycin, contact your doctor as soon as possible to reschedule your appointment.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Bleomycin. If you are concerned about side effects, discuss the risks and benefits of Bleomycin with your doctor.

The following side effects have been reported by at least 1% of people taking Bleomycin. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• appetite loss or weight loss
• changes in fingernails or toenails
• increased pigmentation of the skin
• nausea and vomiting
• skin rash; itching; coloured bumps; or peeling of fingertips, elbows, or palms
• skin redness or tenderness
• swelling or redness of the hands and feet
• temporary loss of hair

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• signs of infection (symptoms may include Fever or chills, severe Diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• signs of kidney problems (e.g., decreased urination, nausea, vomiting, swelling of the feet and ankles)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of lung inflammation (e.g., cough, shortness of breath, noisy breathing, decreased blood pressure)
• sores in mouth and on lips

Stop taking the medication and seek immediate medical attention if any of the following occur:

• confusion
• fever and chills occurring within 4 to 10 hours of dose; may last up to 48 hours
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• sudden and severe chest pain
• wheezing

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Bleomycin.

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Each vial of sterile lyophilized powder contains bleomycin sulphate equivalent to 15 units of bleomycin. Nonmedicinal ingredients: sulfuric acid or sodium hydroxide may be used as pH adjusters.

Do not use Bleomycin if you are allergic to bleomycin or any ingredients of the medication.

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There may be an interaction between bleomycin and any of the following:

• amphotericin
• BCG
• Digoxin
• echinacea
• Filgrastim
• Fingolimod
• Leflunomide
• Natalizumab
• other cancer medications
• Phenytoin
• Pimecrolimus
• Roflumilast
• Tacrolimus (when applied to the skin)
• Tofacitinib
• vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Bleomycin. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, decongestants, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Bleomycin.

Allergic reactions: In rare cases, some people may develop an allergic reaction to Bleomycin. Signs of an allergic reaction include a severe rash, Hives, swollen face or throat, or difficulty breathing. If these occur, contact your doctor immediately.

Infection: As well as killing cancer cells, Bleomycin can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people who have contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Lung disease: Bleomycin causes lung problems in about 10% of people using the medication. People with lung disease are more likely to be affected by this problem. If you have lung disease, discuss with your doctor how Bleomycin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bleomycin, and whether any special monitoring is needed. If you experience shortness of breath, cough, noisy breathing or chest pain, contact your doctor immediately.

Kidney Disease: Bleomycin is removed from the body by the kidneys. If you have ever had kidney problems, discuss with your doctor how Bleomycin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bleomycin, and whether any special monitoring is needed.

Pregnancy: Studies of Bleomycin have not been done with pregnant women. There is a possibility of birth defects if either the father or mother is using bleomycin at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using Bleomycin. Tell the doctor immediately if you become pregnant while using Bleomycin.

Breast-feeding: It is not known whether bleomycin passes into breast milk. Women should not breast-feed while receiving bleomycin treatment.

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