#高警訊藥品

頭、頸部癌、皮膚癌 (包括陰莖、陰囊及婦女外陰癌等)、睪丸癌、肺癌、何杰金氏病
Squamous cell carcinoma of neck and head, cervix vulvovaginal area, skin, penis and rectum; Hodgkin's and non-Hodgkin's lymphoma; Testicular tumor; Lung cancer

Antineoplastic Agent
Bleomycin inhibits synthesis of DNA; binds to DNA leading to single- and double-strand breaks; also inhibits (to a lesser degree) RNA and protein synthesis

Absorption:
1. IM, SubQ, and intrapleural administration: 100%, 70%, and 45%, respectively, of IV serum concentrations
2. Time to peak: 30 to 60 minutes
Distribution:
Vd: 17.5 L/m2; Protein binding: 1%
Metabolism:
1. Enzymatic inactivation by bleomycin hydrolase, a cytosolic cysteine proteinase enzyme; bleomycin hydrolase is widely distributed in normal tissues (except for the skin and lungs)
2. Half-life elimination: 2 hours
Excretion:
Urine (~65% [IV], 40% [Intrapleural])

1. Hypersensitivity to bleomycin or any component of the formulation
2. Lymphomas, renal impairment, pulmonary disease

D.

Infant risk can not be ruled out.

Stomatitis, alopecia, edema fingers, skin hyperpigmentation, lung fibrosis, thrombophlebitis, anorexia.

IV 0.25 to 0.5 units/kg (10 to 20 units/m2) given once or twice a week

1. CrCl ≥50 mL/minute: No dosage adjustment necessary
2. CrCl 40-50 mL/minute: Reduce to 70% of normal dose
3. CrCl 30 to 40 mL/minute: Reduce to 60% of normal dose
4. CrCl 20 to 30 mL/minute: Reduce to 55% of normal dose
5. CrCl 10 to 20 mL/minute: Reduce to 45% of normal dose
6. CrCl 5 to 10 mL/minute: Reduce to 40% of normal dose

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied)

1. Reconstitute: 15-units vial with 5 mL NS (Do not reconstitute or dilute bleomycin with D5W)
2. Administration: IV slowly over a 10-minute period
3. Storage: Once diluted in NS, may store for up to 24 hours at room temperature