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Bleomycin is used to treat cancer and extra fluid surrounding the lungs due to cancer. It slows down the growth of cancer cells by making them less able to create substances they need to multiply, and it decreases the amount of space around the lungs to prevent fluid from building up. Common side effects include lung problems and skin problems. Call your health care provider right away if you have trouble breathing, reduced need to pee, yellowing of your skin or the whites of your eyes, low blood pressure, chest pain, weakness on one side of the body, changes in your fingers or toes, or changes in vision.

Uses

What is bleomycin used for?

Bleomycin is commonly used to treat the following types of cancer.

Bleomycin is also used to treat fluid buildup around the lungs due to cancer (pleural effusion) and helps prevent this extra fluid from coming back.

Bleomycin may also be used for other conditions as determined by your health care provider.

How does bleomycin work (mechanism of action)?

Bleomycin slows down the growth of cancer cells by making them less able to create DNA, RNA, and proteins. When used to treat extra fluid around the lungs due to cancer, bleomycin decreases the amount of space surrounding the lungs, which helps prevent fluid from building up.

How is bleomycin supplied (dosage forms)?

Brands and other names

  • Blenoxane

Dosage forms and strengths

Bleomycin is available in an injectable form that is given by a health care provider.

How should I store bleomycin?

Bleomycin is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of bleomycin?

The most common side effects of bleomycin are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Lung inflammation or scarring (see below)
  • Changes in skin color, including redness or darkening of the skin
  • Blisters, stretch marks, or skin rash
  • Skin tenderness, thickening, or itching
  • Nail changes
  • Hair loss
  • Mouth or lip sores
  • Fever or chills
  • Vomiting
  • Loss of appetite and weight loss
  • General feeling of being unwell, tired, or not having your usual energy

There may be other side effects of bleomycin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of bleomycin?

While less common, the most serious side effects of bleomycin are described below, along with what to do if they happen.

Severe Allergic Reactions. Bleomycin may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever, chills, or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Low blood pressure
  • Confusion

Lung Inflammation or Scarring. Bleomycin can cause inflammation in your lungs, which is called pneumonitis. It can also cause scarring in your lungs, which is called pulmonary fibrosis. These conditions can be serious or even life-threatening. Get emergency help if you have trouble breathing. You may also have a cough, fever, or chest pain. 

Kidney Damage. Kidney damage can happen when using bleomycin. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • A hard time catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using bleomycin. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Heart Attack and Stroke. Bleomycin may increase your risk of a heart attack or stroke that can lead to death. Do not use bleomycin if you have had a recent heart attack or stroke without talking to your health care provider. Get emergency help if you have any of the following symptoms of a heart attack or stroke.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Blood Flow Problems. Bleomycin may cause a condition called Raynaud's disease, which occurs when the blood vessels in your fingers and toes overreact and lead to low blood flow. Bleomycin can also cause thrombotic microangiopathy, which is when blood clots form in small blood vessels. Call your health care provider right away if you have any of the following symptoms.

  • Fingers or toes feeling numb, cool, painful, or sensitive to cold
  • Fingers or toes changing color from pale, to blue, to red
  • Unexplained wounds on fingers or toes
  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Inflammation of the Arteries in the Brain. Bleomycin may cause the arteries in the brain to become inflamed, which is called cerebral arteritis. This condition can be serious and lead to problems including permanent vision loss and stroke. Tell your health care provider right away if you have any of the following symptoms.

  • Changes in vision
  • Scalp tenderness
  • Jaw pain
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Warnings & Precautions

Who should not use bleomycin?

Allergies to Ingredients. People who are allergic to any of the following should not use bleomycin.

  • Blenoxane
  • Bleomycin
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific bleomycin products they stock.

What should I know about bleomycin before using it?

Bleomycin is usually given by a health care provider in a hospital or clinic. 

People who are 70 and older can be at greater risk of some side effects from bleomycin. Talk to your health care provider about your risks if you are in this age group.

Keep all appointments to have your blood work and chest X-ray checked.

Women of childbearing age should use effective birth control to avoid becoming pregnant while receiving bleomycin. Talk to your health care provider if you have any questions about birth control.

What should I tell my health care provider before using bleomycin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if bleomycin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Lung problems
  • Kidney or liver problems
  • Heart attack or stroke
  • Blood flow problems, such as Raynaud's phenomenon

Other Medicines and Supplements. Bleomycin may interact with other medicines and supplements. Before using bleomycin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Vaccines. Talk with your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while using bleomycin. Tell your health care provider about any vaccines you have recently received or have scheduled.

Pregnancy. Bleomycin may cause harm to an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. 

Breastfeeding. It is not known if bleomycin passes into breast milk. You should not breastfeed while receiving bleomycin. Tell your health care provider if you are breastfeeding or plan to breastfeed. 

Interactions

Does bleomycin interact with foods or drinks?

There are no known interactions between bleomycin and foods or drinks.

There are no known interactions between bleomycin and alcohol, but heavy drinking can slow your immune response and make it harder for your body to fight cancer. 

Does bleomycin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using bleomycin.

  • Amphotericin B (Abelcet, AmBisome), which is a medicine used to treat fungal infections
  • Cisplatin, which is a medicine used to treat some cancers
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine to suppress your immune system
  • Vancomycin, which is an antibiotic used to treat various infections
  • An aminoglycoside, such as amikacin, gentamicin, or tobramycin, which is an antibiotic used to treat various infections
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A medicine called a granulocyte colony stimulating factor, such as filgrastim (Granix, Neuopogen, Nivestym, Nypozi, Releuko, Zarzio), which helps increase neutrophil counts

This may not be a complete list of medicines that can interact with bleomycin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much bleomycin?

If you or someone else has used too much bleomycin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of bleomycin?

Bleomycin is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving bleomycin as scheduled.

If you miss an appointment to get your bleomycin dose, call to make another appointment as soon as possible.