Bleomycin Sulfate (Generic Name)

Other Names: Blenoxane®

About This Drug

Bleomycin sulfate is used to treat cancer. This drug is given intravenously (IV), under the skin by subcutaneous injection (SQ), or as an injection into the space between the two layers that surround the lung (intrapleurally).

Possible Side Effects (More Common)

  • Fever and chills. These symptoms may begin within three to 10 hours after you receive this drug and may last up to 48 hours.
  • Skin redness or tenderness
  • Colored bumps on fingertips, elbows, or palms
  • Raised, red, itchy rash on your arms, legs, back, or chest
  • Darkening of the skin or dark patches on skin. This is usually temporary and will fade when treatment is completed.
  • Darkening or partial loss of fingernail and toenail beds. These effects are usually temporary.
  • Decreased appetite
  • Swelling of the fingers
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Hair loss. Most patients experience scalp and body hair loss. You may notice hair thinning several days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Lung tissue changes may occur with high doses of this drug. Sometimes these changes may not be seen for many years. You may develop a cough or have difficulty catching your breath.

Possible Side Effects (Less Common)

  • Sensitivity to light (photosensitivity). Photosensitivity means that you may become more sensitive to the effects of the sun, sun lamps, and tanning beds. Your eyes may water more, especially in bright light.
  • Mild nausea and vomiting
  • Headache
  • Bone marrow depression is rare. This is a decrease in the number of white blood cells, red blood cells, and platelets.
  • Lightheadedness
  • Sudden weakness in arms and legs
  • Chest pain

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 
    • Breast feeding warning; Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Ask your doctor or nurse about medication to help prevent or lessen nausea and vomiting.
  • Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
  • Use sunscreen with SPF 30 or higher when you are outdoors even for a short time.
  • Avoid sun lamps, tanning booths, and tanning beds.
  • Mouth care is very important. Your mouth care should consist of gently brushing with a very soft tooth brush and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Speak with your nurse about obtaining a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good...Feel Better” program close to where you live. It is a free program where women undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and  skin and nail care.
  • Be careful when cooking, walking, and handling sharp objects and hot liquids.

Food and Drug Interactions

There are no known interactions of Bleomycin with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions 

Serious allergic reactions including anaphylaxis (rare).  Tell your doctor or nurse immediately if you have any of the following symptoms during the time you are receiving this drug:

  • Difficulty catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat rapidly (palpitations)
  • Dizziness or lightheadedness
  • Flushing/itching/rash/hives

When to Call the Doctor

 

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Difficulty catching your breath
  • Rash or itching, dizziness or lightheadedness, or palpitations
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than three times in one day
  • Chest pain
  • Coughing
  • Dizziness or feeling faint

 

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Painful mouth or throat that makes it difficult to eat or drink
  • Nausea unrelieved by prescribed medication
  • Weakness in arms or legs
  • Persistent loss of appetite or weight loss of five pounds or more in one week
  • Extreme tiredness that interferes with normal activities
  • Rash that is bothersome

Revised November 2011

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