Monograph
L01DC01 - Bleomycin |
Not porphyrinogenic |
NP |
Rationale
Non-CYP-metabolism. However side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Bleomycin sulphat is an antineoplastic antibiotic consisting of a mixture of glucopeptides isolated from Streptomyces verticillusor.
Therapeutic characteristics
Bleomycin is used in combination with other forms of chemotherapy in the treatment of epithelial carinomas at different locations, malignant lymphomass, testistumors, malignant pleura effusions. It is administered intravenously or as intramuscular injection. Common adverse reactions of bleomycin that can be confused with an acute porphyric attack are nausea and vomiting. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Hepatic exposure
Probably not significant.
Metabolism and pharmacokinetics
Bleomycin is primarily metabolised by enzymatic degradation, 60-70% is excreted in unchanged form in urine. No reports of CYP interactions. Not listed as CYP substrate, inhibitor or inducer. Baumhakel (2002) found no inhibitory effect of bleomycin on CYP3A4.
Published experience
Used uneventfully in the treatment of testicular cancer in man with AIP. (Arbus, 1981).
References
| # | Citation details | PMID |
|---|---|---|
| * | Scientific articles | |
| 1. | Relationship between porphyria and the use of antineoplastics.
Arbus MH. Am J Hosp Pharm. 1981;38(5):631. |
7282689 |
| 2. | Screening for inhibitory effects of antineoplastic agents on CYP3A4 in human liver microsomes.
Baumhäkel M, Kasel D, et al. Int J Clin Pharmacol Ther. 2001 Dec;39(12):517-28. |
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| * | Drug reference publications | |
| 3. | McEvoy GK, editor. Bleomycin. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (07.05.10).
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| 4. | Sweetman SC, editor. Martindale: The complete drug reference. Bleomycin). Pharmaceutical Press 2009.
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| * | Summary of Product Characteristics | |
| 5. | Norwegian medicines agency. Summary of Product Characteristics (SPC). Bleomycin Baxter.
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