Bleomycin (Blenoxane)

General information

Class/mechanism: Exact mechanism unknown, but suspected to inhibit DNA synthesis, with some evidence inhibition of RNA and protein synthesis. When administered intrapleurally for malignant pleural effusion, bleomycin acts as a sclerosing agent.
Route: IV, IM, SC, intrapleural
Extravasation: irritant or neutral, depending on reference

• 1 unit of bleomycin = 1 mg of bleomycin

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Carcinoma of unknown primary
• Cutaneous basal cell carcinoma
• Cutaneous squamous cell carcinoma
• Diffuse large B-cell lymphoma
• HIV-associated lymphoma
• Classical Hodgkin lymphoma
• Hodgkin lymphoma, nodular lymphocyte-predominant
• Kaposi sarcoma
• Penile cancer
• Post-transplant lymphoproliferative disorder
• Testicular cancer

Diseases for which it was used

• Follicular lymphoma
• Head and neck cancer
• Osteosarcoma
• Small cell lung cancer

Patient drug information

• Bleomycin (Blenoxane) package insert
• Bleomycin (Blenoxane) patient drug information (Chemocare)
• Bleomycin (Blenoxane) patient drug information (UpToDate)

History of changes in FDA indication

• 1973-07-31: Initial approval
• 2003-03-21 (oldest label available at Drugs @ FDA): has been shown to be useful in the management of the following neoplasms either as a single agent or in proven combinations with other approved chemotherapeutic agents: squamous cell carcinoma of the head and neck (including mouth, tongue, tonsil, nasopharynx, oropharynx, sinus, palate, lip, buccal mucosa, gingivae, epiglottis, skin, larynx); penis; cervix; vulva; Hodgkin’s disease; non-Hodgkin’s lymphoma; testicular cancer (including embryonal cell, choriocarcinoma, and teratocarcinoma). (No supporting studies are cited)

History of changes in EMA indication

• EURD: 1970-03-18

Also known as

• Brand names: Blenoxane, Bleo, Bleocin, Bleocip, Bleopar, Bleowel