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Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: IV/IM Squamous cell or testicular tumours 15,000 IU 3 times/wk or 30,000 IU twice wkly, in 3-4 wkly intervals up to a total cumulative dose of 360,000 IU. IM Lymphoma 15,000 IU once or twice weekly, up to a total dose of 225,000 IU. Max lifetime cumulative dose: 360,000 IU. Intracavitary Malignant effusions60,000 IU in 100 mL NaCl 0.9% instilled into the affected serous cavity, may be repeated up to a lifetime cumulative dose of 360,000 IU, as necessary.
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Contraindications
Acute pulmonary infection or greatly reduced lung function. Concomitant brentuximab, cisplatin or oxygen. Lactation.
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Special Precautions
Patient w/ severe heart disease. Renal impairment. Elderly. Pregnancy. Monitoring Parameters Closely monitor for signs of pulmonary toxicity; take chest radiographs every 1-2 wk. Perform sequential measurement of pulmonary diffusion capacity for carbon monoxide mthly during therapy. Carefully monitor fluid replacement, renal and liver function.
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Adverse Reactions
Rash, erythema, pruritus, vesiculation, hyperkeratosis, nail changes, alopecia, hyperpigmentation, striae, stomatitis, fever, acute anaphylactoid reactions w/ hyperpyrexia and cardioresp collapse, depression of bone marrow, local reactions and thrombophlebitis (site of inj).
Potentially Fatal: Pulmonary toxicity, severe idiosyncratic reactions consisting of hypotension, mental confusion, fever, chills and wheezing; renal toxicity, hepatotoxicity. |
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Drug Interactions
Increased incidence and severity of lung toxicity w/ previous or concurrent radiotherapy to the chest. Combination w/ vinca alkaloids may result to a syndrome corresponding to morbus Raynaud, ischaemia which can lead to necrosis of peripheral parts of the body (fingers, toes, nose tip). May reduce the absorption of phenytoin. Increased risk of agranulocytosis w/ clozapine.
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CIMS Class
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ATC Classification
L01DC01 - bleomycin ; Belongs to the class of other cytotoxic antibiotics. Used in the treatment of cancer.
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