Bleomycin
Also known as: BLE, Blenoxane, Bleo, Bleomycin A2, Bleomycin B2, Bleomycin sulfate, BLM
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Summary
Bleomycin is a glycopeptide antibiotic used as a chemotherapeutic agent for several malignancies; it induces DNA breaks and is limited by dose‑related pulmonary toxicity.
Mechanism of Action
DNA strand scission via Fe(II)-mediated generation of free radicals causing oxidative damage and cell death
Routes of Administration
Goals & Uses
- Testicular germ cell tumor treatmentOncologyHigh
- Testicular cancerOncologyHigh
- Ovarian germ cell tumor treatmentOncologyModerate
- Hodgkin lymphoma treatmentOncologyHigh
- Cutaneous warts (off‑label)DermatologyLow
- Squamous cell carcinoma of head & neckOncologyModerate
- Squamous cell carcinoma treatmentOncologyModerate
- Malignant pleural effusionOncologyModerate
- Malignant pleural effusion sclerotherapyPalliative OncologyModerate
- Hodgkin lymphomaOncologyHigh
- Non-Hodgkin lymphoma treatmentOncologyModerate
Contraindications
- Severe pulmonary diseaseRespiratoryHigh
- Severe renal impairment (creatinine clearance <30 mL/min)RenalModerate
- Prior severe bleomycin pulmonary toxicityDrug Toxicity HistoryHigh
- Severe renal impairmentOrganModerateKidney function concerns
- PregnancyPopulationHighPotential fetal risk or insufficient safety data
- Hypersensitivity to bleomycinAllergy/immunologyHigh
- Cumulative dose >400 unitsOncology/safetyHigh
- Pre‑existing pulmonary fibrosisRespiratoryHigh
- High‑concentration oxygen therapy (>30% FiO2)RespiratoryHigh
Adverse Effects
- Skin rash / hyperpigmentationDermatologicCommon
- AlopeciaDermatologicUncommonHair loss
- Cutaneous toxicity (skin thickening, hyperpigmentation, alopecia)DermatologicCommon
- Pulmonary fibrosis/pneumonitisRespiratoryUncommon
- Nausea/vomitingGastrointestinalCommon
- Fever and chillsConstitutionalCommon
- Nausea and vomitingGastrointestinalCommon
- MucositisGastrointestinal / MucosalUncommon
- MyelosuppressionHematologicUncommon
- Anaphylactoid/idiosyncratic reactionsImmunologicUncommon
- Pulmonary fibrosisPulmonaryCommon
Drug Interactions
- Radiation therapyHigh
- AmiodaroneModerate
- Supplemental oxygen (high FiO2)High
- DigoxinLow
- PhenytoinModerate
- G‑CSF (filgrastim)Moderate
- CisplatinModerate
- Granulocyte colony-stimulating factors (G-CSF)Moderate
- High inspired oxygenHigh
Population Constraints
- SmokersLifestyleRelative
- Patients with chronic lung diseaseRespiratoryRelative
- Renal impairmentOrgan ImpairmentRelative
- Elderly patients (≥70 years)AgeRelative
- Patients undergoing general anesthesiaPerioperativeRelative
- Children (<12 y)PediatricRelative
- Elderly (>70 y)GeriatricRelative
- Patients with renal impairmentOrgan ImpairmentRelative
- Pregnant womenReproductiveAbsolute
Regulatory Status
- European UnionApprovedApproved: Hodgkin lymphoma, Testicular cancer, Squamous cell carcinomaEMA approval; same safety concerns
- United StatesApprovedApproved: Hodgkin lymphoma, Testicular cancer, Squamous cell carcinoma of head and neck, Malignant pleural effusionFDA‑approved; boxed warning for pulmonary toxicity
- United KingdomApprovedApproved: Hodgkin lymphoma, Testicular cancer, Squamous cell carcinomaMHRA approval; used under specialist supervision
Approved for Hodgkin lymphoma, testicular cancer, and squamous cell carcinoma; contraindicated in patients with pre‑existing pulmonary fibrosis and during high‑concentration oxygen therapy due to risk of severe lung injury.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Bleomycin?
Bleomycin is a glycopeptide antibiotic used as a chemotherapeutic agent for several malignancies; it induces DNA breaks and is limited by dose‑related pulmonary toxicity.
What is Bleomycin used for?
Bleomycin is educationally associated with: Testicular germ cell tumor treatment, Testicular cancer, Ovarian germ cell tumor treatment, Hodgkin lymphoma treatment, Cutaneous warts (off‑label), Squamous cell carcinoma of head & neck, Squamous cell carcinoma treatment, Malignant pleural effusion, Malignant pleural effusion sclerotherapy, Hodgkin lymphoma, Non-Hodgkin lymphoma treatment. Educational only — not medical advice.
How is Bleomycin administered?
Recorded routes of administration: Intralesional, Intramuscular, Intrapleural, Intravenous, Subcutaneous.
What are the potential side effects of Bleomycin?
Reported adverse effects include: Skin rash / hyperpigmentation, Alopecia, Cutaneous toxicity (skin thickening, hyperpigmentation, alopecia), Pulmonary fibrosis/pneumonitis, Nausea/vomiting, Fever and chills, Nausea and vomiting, Mucositis, Myelosuppression, Anaphylactoid/idiosyncratic reactions, Pulmonary fibrosis. This list is not exhaustive — consult a qualified clinician.
Who should avoid Bleomycin?
Recorded contraindications: Severe pulmonary disease, Severe renal impairment (creatinine clearance <30 mL/min), Prior severe bleomycin pulmonary toxicity, Severe renal impairment, Pregnancy, Hypersensitivity to bleomycin, Cumulative dose >400 units, Pre‑existing pulmonary fibrosis, High‑concentration oxygen therapy (>30% FiO2). Consult a qualified clinician before use.