{"id":3750,"date":"2025-03-31T18:11:48","date_gmt":"2025-03-31T18:11:48","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/bleomycin-txt\/"},"modified":"2025-03-31T18:11:48","modified_gmt":"2025-03-31T18:11:48","slug":"bleomycin-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/bleomycin-txt\/","title":{"rendered":"Bleomycin.txt"},"content":{"rendered":"

Bleomycin<\/h1>\n

CLINICAL USE <\/H3>
\nAntineoplastic agent

DOSE IN NORMAL RENAL FUNCTION <\/H3>Squamous cell carcinoma and testicular teratoma:<\/p>\n
  • range 45\u201360 \u00d7 10 3 IU per week IM\/IV (total cumulative dose up to 500 \u00d7 103 IU)\n
  • OR, continuous IV infusion 15 \u00d7 10 3 IU\/24 hours for up to 10 days\n
  • OR, 30 \u00d7 10 3 IU\/24 hours for up to 5 days\n
  • Malignant lymphomas:15\u201330 \u00d7 10 3 IU\/week IM to total dose of 225 \u00d7 103 IU Lower doses required in combination chemotherapy\n
  • Malignant effusions:60 \u00d7 10 3 IU in 100 mL sodium chloride 0.9% intrapleurally (total cumulative dose of 500 \u00d7 103 IU)

    PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Approximately 1500 <\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :<1 <\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 60\u201370<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.3<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :4 (bolus), 9 (continuous infusion)\/20

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : 75% of normal dose (100% for malignant effusions)
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 50% of normal dose (100% for malignant effusions)

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antipsychotics: avoid concomitant use with clozapine, increased risk of agranulocytosis\n
  • Cytotoxics: increased pulmonary toxicity with cisplatin; in combination with vinca alkaloids can lead to Raynaud\u2019s syndrome and peripheral ischaemia

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\n
  • IM: dissolve required dose in up to 5 mL sodium chloride 0.9% (or 1% solution of lidocaine if pain on injection)\n
  • IV: dissolve dose in 5\u2013200 mL sodium chloride 0.9%\n
  • Intracavitary: 60 \u00d7 10 3 IU in 100 mL sodium chloride 0.9%\n
  • Locally: dissolve in sodium chloride 0.9% to make a 1\u20133 \u00d7103 IU\/mL solution

    Route <\/H4>\n
  • IM, IV, also intra-arterially, intrapleurally, intraperitoneally, locally into tumour

    Rate of Administration <\/H4>\n
  • Give by slow IV injection, or add to reservoir of a running IV infusion

    Comments<\/H4>Avoid direct contact with the skin

    OTHER INFORMATION <\/H4>\n
  • Lesions of skin and oral mucosa common after full course of bleomycin\n
  • Pulmonary toxicity: interstitial pneumonia and fibrosis \u2013 most serious delayed effectIn patients with moderately severe renal impairment less than 20% of the dose is excreted in the urine\n
  • Rapid distribution to body tissues (highest concentration is in skin, lungs, peritoneum and lymph)\n
  • Inactivation takes place primarily in the liver. Approximately 60\u201370% of drug is excreted unchanged in the urine, probably by glomerular filtration
    \n","protected":false},"excerpt":{"rendered":"

    Bleomycin CLINICAL USE Antineoplastic agent DOSE IN NORMAL RENAL FUNCTION<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3750","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3750","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3750"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3750\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3750"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3750"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3750"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}