Bleomycin

Other Names: Blenoxane™

About This Drug

Bleomycin is used to treat cancer. It is given in the vein (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

  • Redness
  • Rash, sometimes with small fluid-filled bumps/blisters
  • Itching
  • Stretch marks
  • Thickening of the skin
  • Darkening of the skin, or changes to the color of your skin
  • Skin tenderness
  • Changes in your nail color, nail loss and/or brittle nail
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin. 
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt. 

Note: Each of the side effects above was reported in 50% or greater of patients treated with bleomycin. Not all possible side effects are included above. 

Warnings and Precautions

  • Thickening and/or inflammation (swelling) of the lung tissues which very rarely can be life-threatening. You may have a dry cough or trouble breathing.
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
  • Heart attack, stroke or other blood vessel problem may rarely occur. Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden bad headache with no known cause.  If you have any of these symptoms for 2 minutes, call 911. 
  • Changes in your kidney function
  • Changes in your liver function, which can very rarely cause liver failure.

Important Information 

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • To help with hair loss, wash your hair with a mild shampoo and avoid washing your hair every day.
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can 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 getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • Moisturize your skin several times day.
  • Avoid sun exposure and apply sunscreen routinely when outside.
  • Keeping your nails moisturized may help with brittleness.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat. 

Food and Drug Interactions

  • There are no known interactions of bleomycin with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with bleomycin. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Pain in your chest
  • Wheezing or trouble breathing
  • Dry cough
  • Confusion
  • A new rash or a rash that is not relieved by prescribed medicines
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Decreased urine
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden bad headache with no known cause.  If you have any of these symptoms for 2 minutes, call 911.
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: It is not known if this drug passes into breast milk, for this reason, women should not breast feed during treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk to your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised November 2017