Bleomycin Sulfate (Generic Name)
Other Names: Blenoxane®
About This Drug
Bleomycin sulfate is used to treat cancer. This drug 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 (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 nails
- Decreased appetite (decreased hunger)
- Swelling of the fingers
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
- Hair loss. You may notice your hair getting thin. Some patients lose their hair. Your hair often grows back when treatment is done.
- Changes in lung tissue may happen with large amounts of this drug. These changes may not last forever, and your lung tissue may go back to normal. Sometimes these changes may not be seen for many years. You may get a cough or have trouble catching your breath.
Possible Side Effects (Less Common)
- Sensitivity to light (photosensitivity). You may become more sensitive to the sun, sun lamps, and tanning beds. Your eyes may water more, mostly in bright light.
- Mild nausea and throwing up (vomiting). These symptoms may happen within a few hours or many hours after your treatment. Medicines are available to stop or lessen these side effects.
- Bone marrow depression is rare. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
- Feeling lightheaded
- Sudden weakness in arms and legs
- Changes in your liver function. Your doctor will check your liver function as needed.
- 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.
While you are getting this drug in your vein (IV), you may have a reaction. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
These reactions may happen for the first 24 hours after you get this drug. Call 911 for emergency care.
Serious allergic reactions including anaphylaxis are rare. While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:
- Trouble catching your breath
- Feeling like your tongue or throat are swelling
- Feeling your heart beat quickly or in a not normal way (palpitations)
- Feeling dizzy or lightheaded
- Flushing, itching, rash, and/or hives
Treating Side Effects
- Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
- Ask your doctor or nurse about medicine to help stop or lessen nausea and throwing up.
- Wear dark sunglasses and use sunscreen with SPF 30 or higher when you are outdoors even for a short time. 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.
- Avoid sun lamps, tanning booths, and tanning beds.
- 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. Avoid alcohol and smoking because they can bother 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. Ask your doctor for medicine if your rash is bothersome.
- Talk with your nurse about getting 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 getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
Food and Drug Interactions
There are no known interactions of bleomycin with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might 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 help.
When to Call the Doctor
Call your doctor or nurse right away if you have any of these symptoms:
- Fever of 100.5 F (38 C) or above
- Bleeding or bruising that is not usual
- Wheezing or trouble breathing
- Rash or itching
- Feeling dizzy or lightheaded
- Feeling that your heart is beating in a fast or not normal way (palpitations)
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
- Blurred vision or other changes in eyesight
- Pain when passing urine; blood in urine
- Pain in your lower back or side
- Confusion or agitation
- Nausea that stops you from eating or drinking
- Throwing up more than 3 times a day
- 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. 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, mostly 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.
- Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or weak, unusual itching, or yellowing of the eyes or skin.
Call your doctor or nurse as soon as possible if any of these symptoms happen:
- Change in hearing, ringing in the ears
- Decreased urine
- Unusual thirst or passing urine often
- Painful mouth or throat that makes it hard to eat or drink
- Nausea not relieved by prescribed medicines
- Rash that is not relieved by prescribed medicines
- Heavy menstrual period lasting longer than normal
- Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
- Trouble walking or changes in the way you walk, clumsiness in buttoning clothes, opening jars, or other routine hand motions
- Swelling of legs, ankles, or feet
- Weight gain of 5 pounds in one week (fluid retention)
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Fatigue that interferes with your daily activities
- Headache that does not go away
- Painful, red, or swollen areas on your hands or feet
- No bowel movement for 3 days or you feel uncomfortable
- Extreme weakness that interferes with normal activities
Sexual Problems and Reproductive Concerns
- Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your therapy. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
- 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 getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
- Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
- 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.
- Breast feeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and badly harm a breast feeding baby.
Revised - July 2014