Bleocin Injection 15 unit

✔️ Dosage & Administration

• Initial Testing Dose (Lymphoma): ≤2 units for the first two doses to monitor for anaphylactoid reactions.
• Standard Regimen (Squamous Cell Carcinoma, Testicular Cancer, Non-Hodgkin’s Lymphoma):
  0.25–0.50 units/kg (10–20 units/m²) via IV, IM, or SC weekly or twice weekly.
• Hodgkin’s Disease:
  Same initial dosing; if 50% response is achieved, continue with 1 unit daily or 5 units weekly (IV or IM) as maintenance.

Malignant Pleural Effusion:
60 units via single-dose intrapleural bolus.

⚠️ Cumulative doses exceeding 400 units significantly increase the risk of pulmonary toxicity and must be administered with caution, especially in combination regimens.

Pediatrics: Safety and efficacy not established.

Geriatrics: Higher incidence of pulmonary toxicity in patients >70 yea

✔️ Overdose Management

Symptoms include hypotension, fever, tachycardia, and shock-like symptoms. Treatment is symptomatic; respiratory complications should be addressed with corticosteroids and broad-spectrum antibiotics.

✔️ Side Effects

• Common: Injection site reactions, fever, chills, nausea, appetite and weight loss, skin discoloration, nail changes, and tumor-site pain.
• Serious: Pulmonary fibrosis, particularly with high cumulative doses.

✔️ Reconstitution Guidelines

• IM/SC: Add 1–5 mL (15 IU) or 2–10 mL (30 IU) of sterile water, NaCl 0.9%, or bacteriostatic water to achieve 3–15 IU/mL.
• IV: Reconstitute with 5 mL (15 IU) or 10 mL (30 IU) of NaCl 0.9% for ≤3 IU/mL. Administer slowly over 10 minutes.
• Intrapleural: Dissolve 60 IU in 50–100 mL of NaCl 0.9%.

✔️ Drug Interactions

• Increased pulmonary toxicity when used before or after chest radiotherapy.
• Vinca alkaloids may precipitate Raynaud 's-like ischemia, potentially leading to peripheral necrosis.
• May impair phenytoin absorption.
• Co-administration with clozapine increases the risk of agranulocytosis.

✔️ Contraindications

• Acute pulmonary infections or severely impaired lung function.
• Concomitant use with brentuximab, cisplatin, or high-concentration oxygen therapy.
• Breastfeeding is contraindicated.

✔️ Use in Pregnancy & Lactation

Pregnancy Category D: Known risk to the fetus.

Unknown if excreted in breast milk. Due to potential risks, breastfeeding should be avoided during treatment.

✔️ Precautions & Warnings

Use with caution in patients with renal impairment, cardiovascular disease, the elderly, or those who are pregnant.

✔️ Storage

Store at 2–8°C.

Protect from light and do not use beyond the expiration date.