Because of the possibility of an anaphylactoid reaction, lymphoma patients should be treated with 2 units or less for the first two doses. If no acute reaction occurs, then the regular dosage schedule may be followed.
The following dose schedule is recommended: Squamous Cell Carcinoma, Non-Hodgkin's Lymphoma, Testicular Carcinoma: 0.25 to 0.50 units/kg (10 to 20 units/m2) given intravenously, intramuscularly, or subcutaneously weekly or twice weekly.
Hodgkin's Disease: 0.25 to 0.50 units/kg (10 to 20 units/m2) given intravenously, intramuscularly, or subcutaneously weekly or twice weekly. After a 50% response, a maintenance dose of 1 unit daily or 5 units weekly intravenously or intramuscularly should be given. Pulmonary toxicity of BLEOMYCIN SULFATE appears to be dose related with a striking increase when the total dose is over 400 units. Total dose over 400 units should be given with great caution.
Malignant Pleural Effusion: 60 units administered as a single dose bolus intrapleural injection.
Administration: BLEOMYCIN SULFATE may be given by the intramuscular, intravenous, subcutaneous or intrapleural routes.
Intravenous: The contents of the 15 units should be dissolved in 5 mL of Sodium chloride for injection 0.9% and administered slowly over a period of 10 minutes.
Intramuscular or subcutaneous: The BLEOMYCIN SULFATE For Inj. 15 units should be reconstituted with 1-5 mL of sterile water for injection, sodium chloride for injection 0.9%, or sterile bacteriostatic water for injection.
Intrapleural: 60 units of BLEOMYCIN SULFATE is dissolved in 50-100 mL sterile sodium chloride for injection 0.9%. Bleomycin sulfate solutions reconstituted with sodium chloride 0.9% are reported to be stable for four weeks when stored at 2 to 8°C, for two weeks or longer at room temperature, and for 10 days at 37°C.