Bleomycin is a cytotoxic antibiotic that is used as an anticancer agent in the therapy of testicular and germ cell cancers, Hodgkin disease, lymphomas, and tumors of the head and neck. Therapy with bleomycin in combination with other agents is often associated with mild-to-moderate serum enzyme elevations but is a rare cause of clinically apparent liver injury.
Bleomycin A2 is the primary bleomycin species in bleomycin sulfate, a mixture of the sulfate salts of several basic glycopeptide antineoplastic antibiotics isolated from Streptomyces verticillus. Bleomycin A2 forms complexes with iron that reduce molecular oxygen to superoxide and hydroxyl radicals which cause single- and double-stranded breaks in DNA; these reactive oxygen species also induce lipid peroxidation, carbohydrate oxidation, and alterations in prostaglandin synthesis and degradation. (NCI04)
Bleomycin Sulfate is a mixture of the sulfate salts of basic glycopeptide antineoplastic antibiotics isolated from Streptomyces verticillus. Bleomycin sulfate forms complexes with iron that reduce molecular oxygen to superoxide and hydroxyl radicals which cause single- and double-stranded breaks in DNA; these reactive oxygen species also induce lipid peroxidation, carbohydrate oxidation, and alterations in prostaglandin synthesis and degradation.
Mechanism of Action
Although the exact mechanism of action of bleomycin is unknown, available evidence would seem to indicate that the main mode of action is the inhibition of DNA synthesis with some evidence of lesser inhibition of RNA and protein synthesis. As evident in _in vitro_ studies, the DNA-cleaving actions of bleomycin are dependent on oxygen and metal ions. It is believed that bleomycin chelates metal ions (primarily iron) producing a pseudonym that reacts with oxygen to produce superoxide and hydroxide free radicals that cleave DNA.
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The cytotoxic action of bleomycin results from its ability to cause fragmentation of DNA. Studies in vitro indicate that bleomycin causes the accumulation of cells in the G2 phase of the cell cycle, and many of these cells display chromosomal aberrations, incl chromatid breaks, gaps, and fragments, as well as translocations. Bleomycin appears to cause the scission of DNA by interacting with oxygen and iron(2+). In the presence of oxygen and a reducing agent, such as dithiothreitol, the metallobleomycin complex becomes activated and functions mechanistically as a ferrous oxidase, transferring electrons from iron(2) to molecular oxygen to produce activated species of oxygen. It has also been shown that metallobleomycin complexes can be activated by a reaction with the flavin enzyme, NADPH-cytochrome p450 reductase. Bleomycin binds to DNA through its amino-terminal peptide, and the activated complex generates free radicals that are responsible for the scission of the DNA chain.
Indications
- For palliative treatment in the management of malignant neoplasm (trachea, bronchus, lung), squamous cell carcinoma, and lymphomas.
- Lymphoma, Hodgkins
- Non-Hodgkin’s Lymphoma (NHL)
- Pleural Effusion, Malignant
- Squamous Cell Carcinoma (SCC)
- Teratocarcinoma
- Testicular Choriocarcinoma
- Testicular Embryonal Carcinoma
Use in Cancer
Bleomycin sulfate is approved to be used alone or with other drugs as palliative treatment of:
- Hodgkin lymphoma.
- Non-Hodgkin lymphoma (NHL).
- Squamous cell carcinoma of the penis.
- Squamous cell carcinoma of the cervix.
- Squamous cell carcinoma of the head and neck (SCCHN).
- Squamous cell carcinoma of the vulva.
- Testicular cancer.
Bleomycin sulfate is also approved to treat malignant pleural effusion and keep it from recurring (coming back).
Bleomycin sulfate is also being studied in the treatment of other types of cancer.
Contraindication
- Hypersensitivity to the active component or any of the ingredients
- a type of inflammation of the lung called interstitial pneumonitis
- a condition where there is a formation of fibrous tissue in the lung called pulmonary fibrosis
- pregnancy
- a patient who is producing milk and breastfeeding
- chronic obstructive pulmonary disease
- chronic kidney disease stage 3A (moderate)
- chronic kidney disease stage 3B (moderate)
- chronic kidney disease stage 4 (severe)
- chronic kidney disease stage 5 (failure)
- kidney disease with likely reduction in kidney function
Dosage
Strengths: 15 units; 30 units; 15,000 intl units
Squamous Cell Carcinoma
- 0.25 to 0.5 units/kg (10 to 20 units/m2) IV, IM, or subcutaneously 1 to 2 times a week
- Squamous cell carcinoma sometimes requires 3 weeks before any improvement is noted.
- When this drug is used in combination with other antineoplastic agents, pulmonary toxicities may occur at lower doses.
Non-Hodgkin’s Lymphoma
- 0.25 to 0.5 units/kg (10 to 20 units/m2) IV, IM, or subcutaneously 1 to 2 times a week
- Because of the possibility of an anaphylactic reaction, the manufacturer recommends that lymphoma patients be treated with 2 units or less for the first 2 doses. If no acute reaction occurs, then the regular dosage schedule may be followed.
Testicular Cancer
- 0.25 to 0.5 units/kg (10 to 20 units/m2) IV, IM, or subcutaneously 1 to 2 times a weekHodgkin’s Disease
- 0.25 to 0.5 units/kg (10 to 20 units/m2) IV, IM, or subcutaneously 1 to 2 times a week; after a 50% response, a maintenance dose of 1 unit daily or 5 units weekly IV or IM should be given
Malignant Pleural Effusion
- 60 units administered as a single bolus intrapleural injection
- When this drug is used in combination with other antineoplastic agents, pulmonary toxicities may occur at lower doses.
Renal Dose Adjustments
The manufacturer recommends the following dose adjustments in patients with renal impairment:
- CrCl 50 mL/minute or greater: No adjustment is recommended.
- CrCl 40 to 50 mL/minute: Administer 70% of the normal dose.
- CrCl 30 to 40 mL/minute: Administer 60% of the normal dose.
- CrCl 20 to 30 mL/minute: Administer 55% of the normal dose.
- CrCl 10 to 20 mL/minute: Administer 45% of the normal dose.
- CrCl 5 to 10 mL/minute: Administer 40% of the normal dose.
Side Effects
The Most Common
- redness, blistering, tenderness, or thickening of the skin
- darkened skin color
- rash
- hair loss
- sores on the mouth or tongue
- vomiting
- loss of appetite
- weight loss
- sudden numbness or weakness of the face, arm, or leg on one side of the body
- sudden confusion or trouble speaking or understanding
- sudden dizziness. loss of balance or coordination
- sudden severe headache
- chest pain
- decreased urination
More Common
- appetite loss or weight loss
- changes in fingernails or toenails
- increased pigmentation of the skin
- nausea and vomiting
- skin rash; itching; colored bumps; or peeling of fingertips, elbows, or palms
- sudden chest pain, shortness of breath, dry cough, tiredness;
- a light-headed feeling, feeling like you might pass out;
- loss of appetite, weight loss;
- sudden numbness or weakness on one side of the body, problems with vision or speech;
- blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;
- unusual hardening of your skin; or
- swelling, numbness, tingling or cold feeling in your fingers.
- skin redness or tenderness
- swelling or redness of the hands and feet
- temporary loss of hair
Rare
- signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
- signs of kidney problems (e.g., decreased urination, nausea, vomiting, swelling of the feet and ankles)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- signs of lung inflammation (e.g., cough, shortness of breath, noisy breathing, decreased blood pressure)
- sores in mouth and on lips
- confusion
- fever and chills occurring within 4 to 10 hours of dose; may last up to 48 hours
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- sudden and severe chest pain
- wheezing
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abacavir | Bleomycin may decrease the excretion rate of Abacavir which could result in a higher serum level. |
| Abatacept | The risk or severity of adverse effects can be increased when Bleomycin is combined with Abatacept. |
| Aceclofenac | Aceclofenac may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Acemetacin | Acemetacin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Acetaminophen | Bleomycin may decrease the excretion rate of Acetaminophen which could result in a higher serum level. |
| Acetazolamide | Acetazolamide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Acetyldigitoxin | Acetyldigitoxin may decrease the cardiotoxic activities of Bleomycin. |
| Acetylsalicylic acid | Acetylsalicylic acid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Aclidinium | Bleomycin may decrease the excretion rate of Aclidinium which could result in a higher serum level. |
| Acrivastine | Bleomycin may decrease the excretion rate of Acrivastine which could result in a higher serum level. |
| Acyclovir | Acyclovir may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Adalimumab | The risk or severity of adverse effects can be increased when Adalimumab is combined with Bleomycin. |
| Adefovir dipivoxil | Adefovir dipivoxil may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Adenovirus type 7 | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Bleomycin. |
| Albutrepenonacog alfa | Bleomycin may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level. |
| Alclofenac | Alclofenac may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Bleomycin. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Bleomycin. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bleomycin. |
| Allogeneic processed | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Bleomycin. |
| Allopurinol | Bleomycin may decrease the excretion rate of Allopurinol which could result in a higher serum level. |
| Almasilate | Bleomycin may decrease the excretion rate of Almasilate which could result in a higher serum level. |
| Almotriptan | Bleomycin may decrease the excretion rate of Almotriptan which could result in a higher serum level. |
| Alogliptin | Bleomycin may decrease the excretion rate of Alogliptin which could result in a higher serum level. |
| Alprazolam | Bleomycin may decrease the excretion rate of Alprazolam which could result in a higher serum level. |
| Altretamine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Altretamine. |
| Amantadine | Bleomycin may decrease the excretion rate of Amantadine which could result in a higher serum level. |
| Amikacin | Bleomycin may decrease the excretion rate of Amikacin which could result in a higher serum level. |
| Amiloride | Amiloride may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Aminophenazone | Aminophenazone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Amitriptyline | Bleomycin may decrease the excretion rate of Amitriptyline which could result in a higher serum level. |
| Ammonium chloride | Bleomycin may decrease the excretion rate of Ammonium chloride which could result in a higher serum level. |
| Amoxicillin | Bleomycin may decrease the excretion rate of Amoxicillin which could result in a higher serum level. |
| Amphetamine | Amphetamine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Amphotericin B | Amphotericin B may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ampicillin | Bleomycin may decrease the excretion rate of Ampicillin which could result in a higher serum level. |
| Amrinone | Bleomycin may decrease the excretion rate of Amrinone which could result in a higher serum level. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Bleomycin. |
| Anakinra | The risk or severity of adverse effects can be increased when Anakinra is combined with Bleomycin. |
| Anastrozole | The risk or severity of cardiotoxicity can be increased when Bleomycin is combined with Anastrozole. |
| Ancestim | Bleomycin may decrease the excretion rate of Ancestim which could result in a higher serum level. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Anifrolumab. |
| Anthrax immune | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Bleomycin. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Bleomycin. |
| Antihemophilic | Bleomycin may decrease the excretion rate of Antihemophilic factor (recombinant), PEGylated which could result in a higher serum level. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Bleomycin is combined with Antilymphocyte immunoglobulin (horse). |
| Antipyrine | Antipyrine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Antithrombin III | Bleomycin may decrease the excretion rate of Antithrombin III human which could result in a higher serum level. |
| Antithymocyte | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Bleomycin. |
| Antrafenine | Antrafenine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Apalutamide | Bleomycin may decrease the excretion rate of Apalutamide which could result in a higher serum level. |
| Apremilast | The risk or severity of adverse effects can be increased when Bleomycin is combined with Apremilast. |
| Arformoterol | Bleomycin may decrease the excretion rate of Arformoterol which could result in a higher serum level. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Arsenic trioxide. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Articaine. |
| Ascorbic acid | The therapeutic efficacy of Bleomycin can be decreased when used in combination with Ascorbic acid. |
| COVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Bleomycin. |
| Atazanavir | Atazanavir may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Atomoxetine | Atomoxetine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Auranofin | Bleomycin may decrease the excretion rate of Auranofin which could result in a higher serum level. |
| Aurothioglucose | Bleomycin may decrease the excretion rate of Aurothioglucose which could result in a higher serum level. |
| Azacitidine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Azacitidine. |
| Azathioprine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Azathioprine. |
| Azelaic acid | Bleomycin may decrease the excretion rate of Azelaic acid which could result in a higher serum level. |
| Aztreonam | Bleomycin may decrease the excretion rate of Aztreonam which could result in a higher serum level. |
| Bacillus antigen | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Bleomycin. |
| Bacillus calmette- | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Bleomycin. |
| Bacillus | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Bleomycin. |
| Bacitracin | Bacitracin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Baclofen | Baclofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Balsalazide | Balsalazide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Baricitinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Bleomycin. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Bleomycin. |
| Beclomethasone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Beclomethasone dipropionate. |
| Belatacept | The risk or severity of adverse effects can be increased when Bleomycin is combined with Belatacept. |
| Belimumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Belimumab. |
| Belinostat | The risk or severity of adverse effects can be increased when Bleomycin is combined with Belinostat. |
| Belumosudil | The risk or severity of adverse effects can be increased when Bleomycin is combined with Belumosudil. |
| Bendamustine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Bendamustine. |
| Bendroflumethiazide | Bendroflumethiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Benorilate | Benorilate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Benoxaprofen | Benoxaprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Benserazide | Bleomycin may decrease the excretion rate of Benserazide which could result in a higher serum level. |
| Benzatropine | Benzatropine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Benznidazole | Bleomycin may decrease the excretion rate of Benznidazole which could result in a higher serum level. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Benzocaine. |
| Benzthiazide | Benzthiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Benzydamine | Benzydamine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Benzyl alcohol. |
| Bepotastine | Bleomycin may decrease the excretion rate of Bepotastine which could result in a higher serum level. |
| Betamethasone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Betamethasone. |
| Bevacizumab | The risk or severity of cardiotoxicity can be increased when Bevacizumab is combined with Bleomycin. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bleomycin is combined with Bexarotene. |
| Bicisate | Bleomycin may decrease the excretion rate of Bicisate which could result in a higher serum level. |
| Bimekizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Bimekizumab. |
| Bismuth subgallate | Bleomycin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level. |
| Bisoprolol | Bleomycin may decrease the excretion rate of Bisoprolol which could result in a higher serum level. |
| Bisoxatin | Bleomycin may decrease the excretion rate of Bisoxatin which could result in a higher serum level. |
| Blinatumomab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Blinatumomab. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Bleomycin. |
| Bosutinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Bosutinib. |
| Brentuximab vedotin | The risk or severity of pulmonary toxicity can be increased when Brentuximab vedotin is combined with Bleomycin. |
| Brivaracetam | Bleomycin may decrease the excretion rate of Brivaracetam which could result in a higher serum level. |
| Brodalumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Brodalumab. |
| Bromazepam | Bleomycin may decrease the excretion rate of Bromazepam which could result in a higher serum level. |
| Bromotheophylline | Bromotheophylline may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Budesonide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Budesonide. |
| Bumadizone | Bumadizone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Bumetanide | Bumetanide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Bupivacaine. |
| Bupropion | Bleomycin may decrease the excretion rate of Bupropion which could result in a higher serum level. |
| Buspirone | Bleomycin may decrease the excretion rate of Buspirone which could result in a higher serum level. |
| Busulfan | The risk or severity of adverse effects can be increased when Bleomycin is combined with Busulfan. |
| Butabarbital | Butabarbital may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Bleomycin is combined with Cabazitaxel. |
| Calcium ascorbate | The therapeutic efficacy of Bleomycin can be decreased when used in combination with Calcium ascorbate. |
| Canagliflozin | Canagliflozin may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Canakinumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Canakinumab. |
| Canrenoic | Canrenoic acid may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Capecitabine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Capecitabine. |
| Capreomycin | Bleomycin may decrease the excretion rate of Capreomycin which could result in a higher serum level. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Capsaicin. |
| Carbamazepine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Carbamazepine. |
| Carbidopa | Carbidopa may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Carboplatin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Carboplatin. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Carfilzomib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Bleomycin. |
| Carprofen | Carprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefaclor | Cefaclor may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefadroxil | Cefadroxil may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefalotin | Cefalotin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefamandole | Cefamandole may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefapirin | Cefapirin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefazolin | Cefazolin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefdinir | Bleomycin may decrease the excretion rate of Cefdinir which could result in a higher serum level. |
| Cefditoren | Cefditoren may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefepime | Cefepime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefmenoxime | Cefmenoxime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefmetazole | Cefmetazole may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefonicid | Cefonicid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefoperazone | Cefoperazone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceforanide | Ceforanide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefotaxime | Cefotaxime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefotetan | Cefotetan may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefotiam | Cefotiam may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefoxitin | Cefoxitin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefpiramide | Cefpiramide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefpirome | Cefpirome may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefpodoxime | Cefpodoxime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefprozil | Cefprozil may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefradine | Cefradine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceftaroline fosamil | Ceftaroline fosamil may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceftazidime | Ceftazidime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceftibuten | Ceftibuten may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceftizoxime | Ceftizoxime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceftobiprole | Ceftobiprole may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ceftolozane | Bleomycin may decrease the excretion rate of Ceftolozane which could result in a higher serum level. |
| Ceftriaxone | Ceftriaxone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cefuroxime | Cefuroxime may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Celecoxib | Celecoxib may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cephalexin | Cephalexin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cephaloglycin | Cephaloglycin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Certolizumab pegol | The risk or severity of adverse effects can be increased when Bleomycin is combined with Certolizumab pegol. |
| Cetirizine | Bleomycin may decrease the excretion rate of Cetirizine which could result in a higher serum level. |
| Cevimeline | Cevimeline may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Chloral hydrate | Bleomycin may decrease the excretion rate of Chloral hydrate which could result in a higher serum level. |
| Chlorambucil | The risk or severity of adverse effects can be increased when Bleomycin is combined with Chlorambucil. |
| Chloramphenicol | The risk or severity of adverse effects can be increased when Bleomycin is combined with Chloramphenicol. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Chloroprocaine. |
| Chloroquine | Bleomycin may decrease the excretion rate of Chloroquine which could result in a higher serum level. |
| Chlorothiazide | Chlorothiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Chloroxylenol | Bleomycin may decrease the excretion rate of Chloroxylenol which could result in a higher serum level. |
| Chlorpromazine | Bleomycin may decrease the excretion rate of Chlorpromazine which could result in a higher serum level. |
| Chlorpropamide | Bleomycin may decrease the excretion rate of Chlorpropamide which could result in a higher serum level. |
| Chlorthalidone | Chlorthalidone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Chlorzoxazone | Bleomycin may decrease the excretion rate of Chlorzoxazone which could result in a higher serum level. |
| Choline C 11 | Bleomycin may decrease the excretion rate of Choline C 11 which could result in a higher serum level. |
| Choline magnesium trisalicylate | Choline magnesium trisalicylate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Choline salicylate | Bleomycin may decrease the excretion rate of Choline salicylate which could result in a higher serum level. |
| Chondroitin sulfate | Bleomycin may decrease the excretion rate of Chondroitin sulfate which could result in a higher serum level. |
| Chromic chloride | Bleomycin may decrease the excretion rate of Chromic chloride which could result in a higher serum level. |
| Chromic nitrate | Bleomycin may decrease the excretion rate of Chromic nitrate which could result in a higher serum level. |
| Chromium | Bleomycin may decrease the excretion rate of Chromium which could result in a higher serum level. |
| Chromium gluconate | Bleomycin may decrease the excretion rate of Chromium gluconate which could result in a higher serum level. |
| Chromium nicotinate | Bleomycin may decrease the excretion rate of Chromium nicotinate which could result in a higher serum level. |
| Chromous sulfate | Bleomycin may decrease the excretion rate of Chromous sulfate which could result in a higher serum level. |
| Ciclesonide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ciclesonide. |
| Cidofovir | Cidofovir may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cilostazol | Bleomycin may decrease the excretion rate of Cilostazol which could result in a higher serum level. |
| Cimetidine | Bleomycin may decrease the excretion rate of Cimetidine which could result in a higher serum level. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Cinchocaine. |
| Ciprofloxacin | Bleomycin may decrease the excretion rate of Ciprofloxacin which could result in a higher serum level. |
| Cisplatin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Cisplatin. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Bleomycin. |
| Clevidipine | Bleomycin may decrease the excretion rate of Clevidipine which could result in a higher serum level. |
| Clobazam | Bleomycin may decrease the excretion rate of Clobazam which could result in a higher serum level. |
| Clobetasol propionate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Clobetasol propionate. |
| Clofarabine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Clofarabine. |
| Clomipramine | Bleomycin may decrease the excretion rate of Clomipramine which could result in a higher serum level. |
| Clonazepam | Bleomycin may decrease the excretion rate of Clonazepam which could result in a higher serum level. |
| Clorazepic acid | Bleomycin may decrease the excretion rate of Clorazepic acid which could result in a higher serum level. |
| Clostridium tetani | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Bleomycin. |
| Clove oil | Bleomycin may decrease the excretion rate of Clove oil which could result in a higher serum level. |
| Clozapine | Bleomycin may decrease the excretion rate of Clozapine which could result in a higher serum level. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Cocaine. |
| Colchicine | Bleomycin may decrease the excretion rate of Colchicine which could result in a higher serum level. |
| Colistimethate | Colistimethate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Colistin | Bleomycin may decrease the excretion rate of Colistin which could result in a higher serum level. |
| Conivaptan | Conivaptan may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Conjugated estrogens | Conjugated estrogens may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Corifollitropin alfa | Bleomycin may decrease the excretion rate of Corifollitropin alfa which could result in a higher serum level. |
| Corticotropin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Corticotropin. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Cortisone acetate. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Bleomycin. |
| Cyanocobalamin | Cyanocobalamin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Cyclopenthiazide | Cyclopenthiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Cyclophosphamide. |
| Cyclosporine | Bleomycin may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | Cyclothiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Cytarabine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Cytarabine. |
| Dabigatran etexilate | Bleomycin may decrease the excretion rate of Dabigatran etexilate which could result in a higher serum level. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dacarbazine. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dactinomycin. |
| Dalfampridine | Bleomycin may decrease the excretion rate of Dalfampridine which could result in a higher serum level. |
| Dapagliflozin | Dapagliflozin may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Daptomycin | Daptomycin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Bleomycin. |
| Dasatinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dasatinib. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Daunorubicin. |
| Decitabine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Decitabine. |
| Deferiprone | Bleomycin may decrease the excretion rate of Deferiprone which could result in a higher serum level. |
| Deflazacort | The risk or severity of adverse effects can be increased when Bleomycin is combined with Deflazacort. |
| Delafloxacin | Bleomycin may decrease the excretion rate of Delafloxacin which could result in a higher serum level. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Bleomycin. |
| Desipramine | Bleomycin may decrease the excretion rate of Desipramine which could result in a higher serum level. |
| Deslanoside | Deslanoside may decrease the cardiotoxic activities of Bleomycin. |
| Desmopressin | Desmopressin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Desoximetasone. |
| Desvenlafaxine | Bleomycin may decrease the excretion rate of Desvenlafaxine which could result in a higher serum level. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Deucravacitinib. |
| Deutetrabenazine | Bleomycin may decrease the excretion rate of Deutetrabenazine which could result in a higher serum level. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dexamethasone. |
| Dexibuprofen | Dexibuprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Dexketoprofen | Dexketoprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Dexmedetomidine | Bleomycin may decrease the excretion rate of Dexmedetomidine which could result in a higher serum level. |
| Dexpanthenol | Bleomycin may decrease the excretion rate of Dexpanthenol which could result in a higher serum level. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dexrazoxane. |
| Dextran | Bleomycin may decrease the excretion rate of Dextran which could result in a higher serum level. |
| Diatrizoate | Diatrizoate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Diazepam | Bleomycin may decrease the excretion rate of Diazepam which could result in a higher serum level. |
| Dichlorobenzyl alcohol | Bleomycin may decrease the excretion rate of Dichlorobenzyl alcohol which could result in a higher serum level. |
| Diclofenac | Diclofenac may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Diclofenamide | Diclofenamide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Dicyclomine | Bleomycin may decrease the excretion rate of Dicyclomine which could result in a higher serum level. |
| Didanosine | Bleomycin may decrease the excretion rate of Didanosine which could result in a higher serum level. |
| Dienogest | Bleomycin may decrease the excretion rate of Dienogest which could result in a higher serum level. |
| Diflunisal | Diflunisal may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Difluocortolone. |
| Digitoxin | Digitoxin may decrease the cardiotoxic activities of Bleomycin. |
| Digoxin | Bleomycin may decrease the excretion rate of Digoxin which could result in a higher serum level. |
| Dihydrostreptomycin | Dihydrostreptomycin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Dimercaprol | Bleomycin may decrease the excretion rate of Dimercaprol which could result in a higher serum level. |
| Dimethyl fumarate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dimethyl fumarate. |
| Dimethyl sulfoxide | Bleomycin may decrease the excretion rate of Dimethyl sulfoxide which could result in a higher serum level. |
| Dinutuximab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Dinutuximab. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Diphenhydramine. |
| Diroximel fumarate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Diroximel fumarate. |
| Disopyramide | Disopyramide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| DL-Methylephedrine | Bleomycin may decrease the excretion rate of DL-Methylephedrine which could result in a higher serum level. |
| Dobutamine | Bleomycin may decrease the excretion rate of Dobutamine which could result in a higher serum level. |
| Docetaxel | The risk or severity of adverse effects can be increased when Bleomycin is combined with Docetaxel. |
| Dopamine | Bleomycin may decrease the excretion rate of Dopamine which could result in a higher serum level. |
| Doripenem | Bleomycin may decrease the excretion rate of Doripenem which could result in a higher serum level. |
| Doxacurium | Bleomycin may decrease the excretion rate of Doxacurium which could result in a higher serum level. |
| Doxepin | Bleomycin may decrease the excretion rate of Doxepin which could result in a higher serum level. |
| Doxorubicin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Doxorubicin. |
| Doxycycline | Doxycycline may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Drospirenone | Drospirenone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Droxidopa | Bleomycin may decrease the excretion rate of Droxidopa which could result in a higher serum level. |
| Duloxetine | Bleomycin may decrease the excretion rate of Duloxetine which could result in a higher serum level. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Dyclonine. |
| Dyphylline | Bleomycin may decrease the excretion rate of Dyphylline which could result in a higher serum level. |
| Ebola | The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Bleomycin. |
| Eculizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Eculizumab. |
| Edoxaban | Bleomycin may decrease the excretion rate of Edoxaban which could result in a higher serum level. |
| Edrophonium | Bleomycin may decrease the excretion rate of Edrophonium which could result in a higher serum level. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Bleomycin. |
| Emapalumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Emapalumab. |
| Enalaprilat | Bleomycin may decrease the excretion rate of Enalaprilat which could result in a higher serum level. |
| Enzalutamide | Bleomycin may decrease the excretion rate of Enzalutamide which could result in a higher serum level. |
| Epirubicin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Epirubicin. |
| Eplerenone | Eplerenone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Epoprostenol | Bleomycin may decrease the excretion rate of Epoprostenol which could result in a higher serum level. |
| Eribulin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Eribulin. |
| Ertapenem | Bleomycin may decrease the excretion rate of Ertapenem which could result in a higher serum level. |
| Ertugliflozin | Ertugliflozin may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Estradiol | Bleomycin may decrease the excretion rate of Estradiol which could result in a higher serum level. |
| Estradiol acetate | Bleomycin may decrease the excretion rate of Estradiol acetate which could result in a higher serum level. |
| Estradiol cypionate | Bleomycin may decrease the excretion rate of Estradiol cypionate which could result in a higher serum level. |
| Estradiol dienanthate | Bleomycin may decrease the excretion rate of Estradiol dienanthate which could result in a higher serum level. |
| Estradiol valerate | Bleomycin may decrease the excretion rate of Estradiol valerate which could result in a higher serum level. |
| Estramustine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Estramustine. |
| Estrone sulfate | Bleomycin may decrease the excretion rate of Estrone sulfate which could result in a higher serum level. |
| Eszopiclone | Bleomycin may decrease the excretion rate of Eszopiclone which could result in a higher serum level. |
| Etacrynic acid | Etacrynic acid may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Etafedrine | Bleomycin may decrease the excretion rate of Etafedrine which could result in a higher serum level. |
| Etanercept | The risk or severity of adverse effects can be increased when Etanercept is combined with Bleomycin. |
| Ethambutol | Bleomycin may decrease the excretion rate of Ethambutol which could result in a higher serum level. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Etidocaine. |
| Etodolac | Etodolac may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Etomidate | Bleomycin may decrease the excretion rate of Etomidate which could result in a higher serum level. |
| Etonogestrel | Bleomycin may decrease the excretion rate of Etonogestrel which could result in a higher serum level. |
| Etoposide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Etoposide. |
| Etoricoxib | Etoricoxib may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Eucalyptus oil | Bleomycin may decrease the excretion rate of Eucalyptus oil which could result in a higher serum level. |
| Everolimus | The risk or severity of adverse effects can be increased when Bleomycin is combined with Everolimus. |
| Ezogabine | Bleomycin may decrease the excretion rate of Ezogabine which could result in a higher serum level. |
| Fenbufen | Fenbufen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Fenofibrate | Bleomycin may decrease the excretion rate of Fenofibrate which could result in a higher serum level. |
| Fenofibric acid | Bleomycin may decrease the excretion rate of Fenofibric acid which could result in a higher serum level. |
| Fenoldopam | Bleomycin may decrease the excretion rate of Fenoldopam which could result in a higher serum level. |
| Fenoprofen | Fenoprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Fentanyl | Bleomycin may decrease the excretion rate of Fentanyl which could result in a higher serum level. |
| Fesoterodine | Bleomycin may decrease the excretion rate of Fesoterodine which could result in a higher serum level. |
| Filgotinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Filgotinib. |
| Filgrastim | The risk or severity of pulmonary toxicity can be increased when Filgrastim is combined with Bleomycin. |
| Finerenone | Finerenone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Fingolimod | Bleomycin may increase the immunosuppressive activities of Fingolimod. |
| Flavoxate | Bleomycin may decrease the excretion rate of Flavoxate which could result in a higher serum level. |
| Floctafenine | Floctafenine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Florbetaben (18F) | Bleomycin may decrease the excretion rate of Florbetaben (18F) which could result in a higher serum level. |
| Florbetapir (18F) | Bleomycin may decrease the excretion rate of Florbetapir (18F) which could result in a higher serum level. |
| Floxuridine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Floxuridine. |
| Fluconazole | Fluconazole may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Flucytosine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Flucytosine. |
| Fludarabine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fludarabine. |
| Fludeoxyglucose (18F) | Bleomycin may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fludrocortisone. |
| Flumazenil | Bleomycin may decrease the excretion rate of Flumazenil which could result in a higher serum level. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Bleomycin. |
| Fluocinolone acetonide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluocinolone acetonide. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluocinonide. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluocortolone. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluorometholone. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluorouracil. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluprednisolone. |
| Flurazepam | Bleomycin may decrease the excretion rate of Flurazepam which could result in a higher serum level. |
| Flurbiprofen | Flurbiprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Flutamide | Bleomycin may decrease the excretion rate of Flutamide which could result in a higher serum level. |
| Fluticasone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluticasone. |
| Fluticasone furoate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluticasone furoate. |
| Fluticasone propionate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Fluticasone propionate. |
| Fluvoxamine | Fluvoxamine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Folic acid | Folic acid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Fomepizole | Bleomycin may decrease the excretion rate of Fomepizole which could result in a higher serum level. |
| Fondaparinux | Bleomycin may decrease the excretion rate of Fondaparinux which could result in a higher serum level. |
| Formestane | Bleomycin may decrease the excretion rate of Formestane which could result in a higher serum level. |
| Foscarnet | Foscarnet may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Fosfomycin | Bleomycin may decrease the excretion rate of Fosfomycin which could result in a higher serum level. |
| Fosinopril | Bleomycin may decrease the excretion rate of Fosinopril which could result in a higher serum level. |
| Fosphenytoin | The serum concentration of Fosphenytoin can be decreased when it is combined with Bleomycin. |
| Framycetin | Framycetin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Furosemide | Furosemide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Gabapentin enacarbil | Bleomycin may decrease the excretion rate of Gabapentin enacarbil which could result in a higher serum level. |
| Gadobenic acid | Bleomycin may decrease the excretion rate of Gadobenic acid which could result in a higher serum level. |
| Gadodiamide | Gadodiamide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Gadofosveset trisodium | Bleomycin may decrease the excretion rate of Gadofosveset trisodium which could result in a higher serum level. |
| Gadopentetic acid | Bleomycin may decrease the excretion rate of Gadopentetic acid which could result in a higher serum level. |
| Gadoteric acid | Bleomycin may decrease the excretion rate of Gadoteric acid which could result in a higher serum level. |
| Gadoteridol | Bleomycin may decrease the excretion rate of Gadoteridol which could result in a higher serum level. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Gallium nitrate. |
| Ganciclovir | Bleomycin may decrease the excretion rate of Ganciclovir which could result in a higher serum level. |
| Gemcitabine | The risk or severity of pulmonary toxicity can be increased when Gemcitabine is combined with Bleomycin. |
| Gemfibrozil | Bleomycin may decrease the excretion rate of Gemfibrozil which could result in a higher serum level. |
| Gemtuzumab ozogamicin | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Bleomycin. |
| Gentamicin | Bleomycin may decrease the excretion rate of Gentamicin which could result in a higher serum level. |
| Gimeracil | Bleomycin may decrease the excretion rate of Gimeracil which could result in a higher serum level. |
| Givosiran | Givosiran may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Glatiramer | The risk or severity of adverse effects can be increased when Bleomycin is combined with Glatiramer. |
| Glipizide | Bleomycin may decrease the excretion rate of Glipizide which could result in a higher serum level. |
| Glycerol phenylbutyrate | Bleomycin may decrease the excretion rate of Glycerol phenylbutyrate which could result in a higher serum level. |
| Golimumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Golimumab. |
| Golodirsen | Bleomycin may decrease the excretion rate of Golodirsen which could result in a higher serum level. |
| Goserelin | Goserelin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Guanethidine | Bleomycin may decrease the excretion rate of Guanethidine which could result in a higher serum level. |
| Guanfacine | Bleomycin may decrease the excretion rate of Guanfacine which could result in a higher serum level. |
| Guselkumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Guselkumab. |
| Iopromide | Bleomycin may decrease the excretion rate of Iopromide which could result in a higher serum level. |
| Iothalamic acid | Bleomycin may decrease the excretion rate of Iothalamic acid which could result in a higher serum level. |
| Ioversol | Bleomycin may decrease the excretion rate of Ioversol which could result in a higher serum level. |
| Ioxilan | Bleomycin may decrease the excretion rate of Ioxilan which could result in a higher serum level. |
| Ipecac | Bleomycin may decrease the excretion rate of Ipecac which could result in a higher serum level. |
| Ipilimumab | Bleomycin may decrease the excretion rate of Ipilimumab which could result in a higher serum level. |
| Irinotecan | The risk or severity of adverse effects can be increased when Bleomycin is combined with Irinotecan. |
| Isoniazid | Bleomycin may decrease the excretion rate of Isoniazid which could result in a higher serum level. |
| Isosorbide | Isosorbide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Isosorbide mononitrate | Bleomycin may decrease the excretion rate of Isosorbide mononitrate which could result in a higher serum level. |
| Isosulfan blue | Bleomycin may decrease the excretion rate of Isosulfan blue which could result in a higher serum level. |
| Isotretinoin | Bleomycin may decrease the excretion rate of Isotretinoin which could result in a higher serum level. |
| Isoxicam | Isoxicam may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Isradipine | Isradipine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ixabepilone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ixabepilone. |
| Ixazomib | Bleomycin may decrease the excretion rate of Ixazomib which could result in a higher serum level. |
| Ixekizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ixekizumab. |
| COVID-19 Vaccine | The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Bleomycin. |
| Japanese encephalitis | The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Bleomycin. |
| Kanamycin | Bleomycin may decrease the excretion rate of Kanamycin which could result in a higher serum level. |
| Ketamine | Bleomycin may decrease the excretion rate of Ketamine which could result in a higher serum level. |
| Ketazolam | Bleomycin may decrease the excretion rate of Ketazolam which could result in a higher serum level. |
| Ketoprofen | Ketoprofen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ketorolac | Ketorolac may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Labetalol | Bleomycin may decrease the excretion rate of Labetalol which could result in a higher serum level. |
| Lamivudine | Bleomycin may decrease the excretion rate of Lamivudine which could result in a higher serum level. |
| Lamotrigine | Bleomycin may decrease the excretion rate of Lamotrigine which could result in a higher serum level. |
| Latamoxef | Latamoxef may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ledipasvir | Bleomycin may decrease the excretion rate of Ledipasvir which could result in a higher serum level. |
| Leflunomide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Leflunomide. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Lenalidomide. |
| Lesinurad | Bleomycin may decrease the excretion rate of Lesinurad which could result in a higher serum level. |
| Leuprolide | Leuprolide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Levobupivacaine. |
| Levocarnitine | Bleomycin may decrease the excretion rate of Levocarnitine which could result in a higher serum level. |
| Levocetirizine | Bleomycin may decrease the excretion rate of Levocetirizine which could result in a higher serum level. |
| Levofloxacin | Bleomycin may decrease the excretion rate of Levofloxacin which could result in a higher serum level. |
| Levomilnacipran | Bleomycin may decrease the excretion rate of Levomilnacipran which could result in a higher serum level. |
| Levosalbutamol | Bleomycin may decrease the excretion rate of Levosalbutamol which could result in a higher serum level. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Lidocaine. |
| Linezolid | The risk or severity of adverse effects can be increased when Bleomycin is combined with Linezolid. |
| Liothyronine | Liothyronine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Lisinopril | Bleomycin may decrease the excretion rate of Lisinopril which could result in a higher serum level. |
| Lithium carbonate | Bleomycin may decrease the excretion rate of Lithium carbonate which could result in a higher serum level. |
| Lithium citrate | Lithium citrate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Meperidine | Bleomycin may decrease the excretion rate of Meperidine which could result in a higher serum level. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mepolizumab. |
| Meprednisone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mercaptopurine. |
| Meropenem | Bleomycin may decrease the excretion rate of Meropenem which could result in a higher serum level. |
| Mesalazine | Mesalazine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Metamfetamine | Bleomycin may decrease the excretion rate of Metamfetamine which could result in a higher serum level. |
| Metamizole | Metamizole may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Metaxalone | Bleomycin may decrease the excretion rate of Metaxalone which could result in a higher serum level. |
| Metformin | Bleomycin may decrease the excretion rate of Metformin which could result in a higher serum level. |
| Methadone | Bleomycin may decrease the excretion rate of Methadone which could result in a higher serum level. |
| Methazolamide | Methazolamide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Methimazole | The risk or severity of adverse effects can be increased when Bleomycin is combined with Methimazole. |
| Methotrexate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Methotrexate. |
| Methoxsalen | Bleomycin may decrease the excretion rate of Methoxsalen which could result in a higher serum level. |
| Methoxy polyethylene | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Bleomycin. |
| Methyldopa | Bleomycin may decrease the excretion rate of Methyldopa which could result in a higher serum level. |
| Methylene blue | Bleomycin may decrease the excretion rate of Methylene blue which could result in a higher serum level. |
| Methylnaltrexone | Bleomycin may decrease the excretion rate of Methylnaltrexone which could result in a higher serum level. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Methylprednisolone. |
| Methyltestosterone | Bleomycin may decrease the excretion rate of Methyltestosterone which could result in a higher serum level. |
| Meticrane | Meticrane may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoclopramide | Bleomycin may decrease the excretion rate of Metoclopramide which could result in a higher serum level. |
| Metolazone | Metolazone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoprolol | Metoprolol may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Metyrapone | Bleomycin may decrease the excretion rate of Metyrapone which could result in a higher serum level. |
| Midazolam | Bleomycin may decrease the excretion rate of Midazolam which could result in a higher serum level. |
| Migalastat | Bleomycin may decrease the excretion rate of Migalastat which could result in a higher serum level. |
| Milnacipran | Bleomycin may decrease the excretion rate of Milnacipran which could result in a higher serum level. |
| Milrinone | Milrinone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Mirabegron | Bleomycin may decrease the excretion rate of Mirabegron which could result in a higher serum level. |
| Mitomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mitomycin. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mitoxantrone. |
| COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Bleomycin. |
| vaccinia Ankara | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Bleomycin. |
| Mometasone furoate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mometasone furoate. |
| Monomethyl fumarate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Monomethyl fumarate. |
| Mosunetuzumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mosunetuzumab. |
| Moxisylyte | Bleomycin may decrease the excretion rate of Moxisylyte which could result in a higher serum level. |
| Mumps virus strain B | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Bleomycin. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Bleomycin. |
| Muzolimine | Muzolimine may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Mycophenolate mofetil | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mycophenolate mofetil. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Bleomycin is combined with Mycophenolic acid. |
| N-acetyltyrosine | Bleomycin may decrease the excretion rate of N-acetyltyrosine which could result in a higher serum level. |
| Nabumetone | Nabumetone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Nadolol | Bleomycin may decrease the excretion rate of Nadolol which could result in a higher serum level. |
| Naldemedine | Bleomycin may decrease the excretion rate of Naldemedine which could result in a higher serum level. |
| Nalmefene | Bleomycin may decrease the excretion rate of Nalmefene which could result in a higher serum level. |
| Naloxone | Bleomycin may decrease the excretion rate of Naloxone which could result in a higher serum level. |
| Naproxen | Naproxen may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Natalizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Natalizumab. |
| Nateglinide | Bleomycin may decrease the excretion rate of Nateglinide which could result in a higher serum level. |
| Nedaplatin | Bleomycin may decrease the excretion rate of Nedaplatin which could result in a higher serum level. |
| Nedocromil | Bleomycin may decrease the excretion rate of Nedocromil which could result in a higher serum level. |
| Nefazodone | Bleomycin may decrease the excretion rate of Nefazodone which could result in a higher serum level. |
| Nelarabine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Nelarabine. |
| Neomycin | Bleomycin may decrease the excretion rate of Neomycin which could result in a higher serum level. |
| Netilmicin | Bleomycin may decrease the excretion rate of Netilmicin which could result in a higher serum level. |
| Niacinamide | The therapeutic efficacy of Bleomycin can be decreased when used in combination with Niacinamide ascorbate. |
| Nicorandil | Bleomycin may decrease the excretion rate of Nicorandil which could result in a higher serum level. |
| Nifedipine | Bleomycin may decrease the excretion rate of Nifedipine which could result in a higher serum level. |
| Nilotinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Nilotinib. |
| Nilutamide | Bleomycin may decrease the excretion rate of Nilutamide which could result in a higher serum level. |
| Nimesulide | Nimesulide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Nisoldipine | Bleomycin may decrease the excretion rate of Nisoldipine which could result in a higher serum level. |
| Nitric Oxide | Bleomycin may decrease the excretion rate of Nitric Oxide which could result in a higher serum level. |
| Nitrofurantoin | Bleomycin may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Obinutuzumab. |
| Ocrelizumab | Ocrelizumab may increase the immunosuppressive activities of Bleomycin. |
| Octinoxate | Bleomycin may decrease the excretion rate of Octinoxate which could result in a higher serum level. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ofatumumab. |
| Olaparib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Olaparib. |
| Olsalazine | Olsalazine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Opium | Bleomycin may decrease the excretion rate of Opium which could result in a higher serum level. |
| Oseltamivir | Oseltamivir may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Ouabain | Ouabain may decrease the cardiotoxic activities of Bleomycin. |
| Oxacillin | Bleomycin may decrease the excretion rate of Oxacillin which could result in a higher serum level. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Oxaliplatin. |
| Oxaprozin | Oxaprozin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Oxazepam | Bleomycin may decrease the excretion rate of Oxazepam which could result in a higher serum level. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Oxetacaine. |
| Oxybenzone | Bleomycin may decrease the excretion rate of Oxybenzone which could result in a higher serum level. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Oxybuprocaine. |
| Oxyphenbutazone | Oxyphenbutazone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Oxyquinoline | Bleomycin may decrease the excretion rate of Oxyquinoline which could result in a higher serum level. |
| Ozanimod | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Bleomycin is combined with Paclitaxel. |
| Palbociclib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Palbociclib. |
| Paliperidone | Bleomycin may decrease the excretion rate of Paliperidone which could result in a higher serum level. |
| Palonosetron | Bleomycin may decrease the excretion rate of Palonosetron which could result in a higher serum level. |
| Pamidronic acid | Pamidronic acid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Panobinostat | The risk or severity of adverse effects can be increased when Bleomycin is combined with Panobinostat. |
| Pantoprazole | Pantoprazole may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Parecoxib | Parecoxib may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Paromomycin | Paromomycin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Patent Blue | Bleomycin may decrease the excretion rate of Patent Blue which could result in a higher serum level. |
| Pazopanib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pazopanib. |
| Pegaptanib | Bleomycin may decrease the excretion rate of Pegaptanib which could result in a higher serum level. |
| Pegaspargase | The risk or severity of adverse effects can be increased when Pegaspargase is combined with Bleomycin. |
| Pegcetacoplan | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pegcetacoplan. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Bleomycin. |
| Peginterferon alfa-2a | The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Bleomycin. |
| Peginterferon alfa-2b | The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Bleomycin. |
| Peginterferon beta-1a | The risk or severity of adverse effects can be increased when Bleomycin is combined with Peginterferon beta-1a. |
| Pemetrexed | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pemetrexed. |
| Penbutolol | Bleomycin may decrease the excretion rate of Penbutolol which could result in a higher serum level. |
| Penicillamine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Penicillamine. |
| Pentaerythritol tetranitrate | Bleomycin may decrease the excretion rate of Pentaerythritol tetranitrate which could result in a higher serum level. |
| Pentamidine | Pentamidine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Pentastarch | Bleomycin may decrease the excretion rate of Pentastarch which could result in a higher serum level. |
| Pentetic acid | Bleomycin may decrease the excretion rate of Pentetic acid which could result in a higher serum level. |
| Pentobarbital | Bleomycin may decrease the excretion rate of Pentobarbital which could result in a higher serum level. |
| Pentostatin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pentostatin. |
| Pentoxifylline | Bleomycin may decrease the excretion rate of Pentoxifylline which could result in a higher serum level. |
| Perindopril | Bleomycin may decrease the excretion rate of Perindopril which could result in a higher serum level. |
| Permethrin | Bleomycin may decrease the excretion rate of Permethrin which could result in a higher serum level. |
| Pertussis vaccine | The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Bleomycin. |
| Pertuzumab | The risk or severity of cardiotoxicity can be increased when Bleomycin is combined with Pertuzumab. |
| Phenazopyridine | Phenazopyridine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Phenelzine | Bleomycin may decrease the excretion rate of Phenelzine which could result in a higher serum level. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Phenol. |
| Phentolamine | Bleomycin may decrease the excretion rate of Phentolamine which could result in a higher serum level. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Bleomycin. |
| Phenylbutazone | Phenylbutazone may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Phenytoin | The serum concentration of Phenytoin can be decreased when it is combined with Bleomycin. |
| Pholcodine | Bleomycin may decrease the excretion rate of Pholcodine which could result in a higher serum level. |
| Phosphoric acid | Bleomycin may decrease the excretion rate of Phosphoric acid which could result in a higher serum level. |
| Phylloquinone | Bleomycin may decrease the excretion rate of Phylloquinone which could result in a higher serum level. |
| Picosulfuric acid | Bleomycin may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Bleomycin. |
| Pindolol | Bleomycin may decrease the excretion rate of Pindolol which could result in a higher serum level. |
| Piperacillin | Bleomycin may decrease the excretion rate of Piperacillin which could result in a higher serum level. |
| Piracetam | Bleomycin may decrease the excretion rate of Piracetam which could result in a higher serum level. |
| Piretanide | Piretanide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pirfenidone. |
| Piroxicam | Piroxicam may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Pitolisant | Bleomycin may decrease the excretion rate of Pitolisant which could result in a higher serum level. |
| Plazomicin | Bleomycin may decrease the excretion rate of Plazomicin which could result in a higher serum level. |
| Plerixafor | Bleomycin may decrease the excretion rate of Plerixafor which could result in a higher serum level. |
| Polythiazide | Polythiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pomalidomide. |
| Ponatinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ponatinib. |
| Ponesimod | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ponesimod. |
| Potassium | Potassium may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium acetate | Bleomycin may decrease the excretion rate of Potassium acetate which could result in a higher serum level. |
| Potassium bicarbonate | Bleomycin may decrease the excretion rate of Potassium bicarbonate which could result in a higher serum level. |
| Potassium cation | Potassium cation may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium chloride | Bleomycin may decrease the excretion rate of Potassium chloride which could result in a higher serum level. |
| Potassium citrate | Potassium citrate may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium nitrate | Bleomycin may decrease the excretion rate of Potassium nitrate which could result in a higher serum level. |
| Potassium perchlorate | Bleomycin may decrease the excretion rate of Potassium perchlorate which could result in a higher serum level. |
| Potassium sulfate | Bleomycin may decrease the excretion rate of Potassium sulfate which could result in a higher serum level. |
| Pralatrexate | The risk or severity of adverse effects can be increased when Bleomycin is combined with Pralatrexate. |
| Pralidoxime | Bleomycin may decrease the excretion rate of Pralidoxime which could result in a higher serum level. |
| Pramipexole | Bleomycin may decrease the excretion rate of Pramipexole which could result in a higher serum level. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Pramocaine. |
| Prasugrel | Bleomycin may decrease the excretion rate of Prasugrel which could result in a higher serum level. |
| Prednisolone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Prednisolone. |
| Prednisone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Prednisone. |
| Pregabalin | Pregabalin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Procarbazine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Procarbazine. |
| Promethazine | Bleomycin may decrease the excretion rate of Promethazine which could result in a higher serum level. |
| Propantheline | Bleomycin may decrease the excretion rate of Propantheline which could result in a higher serum level. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Proparacaine. |
| Propiverine | Bleomycin may decrease the excretion rate of Propiverine which could result in a higher serum level. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Propoxycaine. |
| Propranolol | Bleomycin may decrease the excretion rate of Propranolol which could result in a higher serum level. |
| Propylthiouracil | The risk or severity of adverse effects can be increased when Bleomycin is combined with Propylthiouracil. |
| Prucalopride | Bleomycin may decrease the excretion rate of Prucalopride which could result in a higher serum level. |
| Pyrantel | Bleomycin may decrease the excretion rate of Pyrantel which could result in a higher serum level. |
| Pyrazinamide | Bleomycin may decrease the excretion rate of Pyrazinamide which could result in a higher serum level. |
| Pyridoxine | Pyridoxine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Pyrithione | Bleomycin may decrease the excretion rate of Pyrithione which could result in a higher serum level. |
| Quetiapine | Bleomycin may decrease the excretion rate of Quetiapine which could result in a higher serum level. |
| Quinethazone | Quinethazone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Quinidine | Bleomycin may decrease the excretion rate of Quinidine which could result in a higher serum level. |
| Rabeprazole | Bleomycin may decrease the excretion rate of Rabeprazole which could result in a higher serum level. |
| Rabies immune | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Bleomycin. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Bleomycin. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Bleomycin. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Bleomycin is combined with Raltitrexed. |
| Ramelteon | Bleomycin may decrease the excretion rate of Ramelteon which could result in a higher serum level. |
| Ranitidine | Bleomycin may decrease the excretion rate of Ranitidine which could result in a higher serum level. |
| Ranolazine | Ranolazine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Rasagiline | Bleomycin may decrease the excretion rate of Rasagiline which could result in a higher serum level. |
| Ravulizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ravulizumab. |
| Reserpine | Reserpine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Resorcinol | Bleomycin may decrease the excretion rate of Resorcinol which could result in a higher serum level. |
| Ribavirin | Bleomycin may decrease the excretion rate of Ribavirin which could result in a higher serum level. |
| Ribostamycin | Bleomycin may decrease the excretion rate of Ribostamycin which could result in a higher serum level. |
| Rilonacept | The risk or severity of adverse effects can be increased when Bleomycin is combined with Rilonacept. |
| Risankizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Risankizumab. |
| Rituximab | The risk or severity of adverse effects can be increased when Rituximab is combined with Bleomycin. |
| Rivaroxaban | Bleomycin may decrease the excretion rate of Rivaroxaban which could result in a higher serum level. |
| Rizatriptan | Bleomycin may decrease the excretion rate of Rizatriptan which could result in a higher serum level. |
| Rofecoxib | Rofecoxib may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Roflumilast | Roflumilast may increase the immunosuppressive activities of Bleomycin. |
| Ropeginterferon | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ropeginterferon alfa-2b. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Ropivacaine. |
| Rosiglitazone | Bleomycin may decrease the excretion rate of Rosiglitazone which could result in a higher serum level. |
| Rotavirus vaccine | The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Bleomycin. |
| Rubella virus vaccine | The risk or severity of infection can be increased when Rubella virus vaccine is combined with Bleomycin. |
| Ruxolitinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ruxolitinib. |
| Sacubitril | Bleomycin may decrease the excretion rate of Sacubitril which could result in a higher serum level. |
| Salbutamol | Bleomycin may decrease the excretion rate of Salbutamol which could result in a higher serum level. |
| Salicylamide | Salicylamide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Salicylic acid | Salicylic acid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Salmon calcitonin | Salmon calcitonin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Salsalate | Salsalate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Sargramostim | The risk or severity of adverse effects can be increased when Sargramostim is combined with Bleomycin. |
| Sarilumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Sarilumab. |
| Satralizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Satralizumab. |
| Saxagliptin | Bleomycin may decrease the excretion rate of Saxagliptin which could result in a higher serum level. |
| Secobarbital | Bleomycin may decrease the excretion rate of Secobarbital which could result in a higher serum level. |
| Secukinumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Secukinumab. |
| Selenious acid | Bleomycin may decrease the excretion rate of Selenious acid which could result in a higher serum level. |
| Selenium | Bleomycin may decrease the excretion rate of Selenium which could result in a higher serum level. |
| Sibutramine | Bleomycin may decrease the excretion rate of Sibutramine which could result in a higher serum level. |
| Siltuximab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Siltuximab. |
| Siponimod | The risk or severity of adverse effects can be increased when Bleomycin is combined with Siponimod. |
| Sipuleucel-T | The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Bleomycin. |
| Sirolimus | The risk or severity of adverse effects can be increased when Bleomycin is combined with Sirolimus. |
| Sitagliptin | Bleomycin may decrease the excretion rate of Sitagliptin which could result in a higher serum level. |
| Smallpox (Vaccinia) | The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Bleomycin. |
| Sodium acetate | Bleomycin may decrease the excretion rate of Sodium acetate which could result in a higher serum level. |
| Sodium ascorbate | The therapeutic efficacy of Bleomycin can be decreased when used in combination with Sodium ascorbate. |
| Sodium aurothiomalate | Bleomycin may decrease the excretion rate of Sodium aurothiomalate which could result in a higher serum level. |
| Sodium fluoride | Bleomycin may decrease the excretion rate of Sodium fluoride which could result in a higher serum level. |
| Sodium sulfate | Bleomycin may decrease the excretion rate of Sodium sulfate which could result in a higher serum level. |
| Sofosbuvir | Bleomycin may decrease the excretion rate of Sofosbuvir which could result in a higher serum level. |
| Solriamfetol | Bleomycin may decrease the excretion rate of Solriamfetol which could result in a higher serum level. |
| Sorafenib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Sorafenib. |
| Sorbitol | Bleomycin may decrease the excretion rate of Sorbitol which could result in a higher serum level. |
| Spesolimab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Spesolimab. |
| Spironolactone | Spironolactone may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Stiripentol | Bleomycin may decrease the excretion rate of Stiripentol which could result in a higher serum level. |
| Streptomycin | Bleomycin may decrease the excretion rate of Streptomycin which could result in a higher serum level. |
| Streptozocin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Streptozocin. |
| Strontium chloride | Bleomycin may decrease the excretion rate of Strontium chloride which could result in a higher serum level. |
| Sucralfate | Bleomycin may decrease the excretion rate of Sucralfate which could result in a higher serum level. |
| Sulbactam | Bleomycin may decrease the excretion rate of Sulbactam which could result in a higher serum level. |
| Sulfadiazine | Bleomycin may decrease the excretion rate of Sulfadiazine which could result in a higher serum level. |
| Sulfamethoxazole | The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Bleomycin. |
| Sulfasalazine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Sulfasalazine. |
| Sulindac | Sulindac may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Sumatriptan | Bleomycin may decrease the excretion rate of Sumatriptan which could result in a higher serum level. |
| Sunitinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Sunitinib. |
| Estrogens, A | Bleomycin may decrease the excretion rate of Synthetic Conjugated Estrogens, A which could result in a higher serum level. |
| Conjugated Estrogens, B | Bleomycin may decrease the excretion rate of Synthetic Conjugated Estrogens, B which could result in a higher serum level. |
| Tacrolimus | Tacrolimus may increase the immunosuppressive activities of Bleomycin. |
| Tadalafil | Bleomycin may decrease the excretion rate of Tadalafil which could result in a higher serum level. |
| Tamoxifen | The risk or severity of cardiotoxicity can be increased when Bleomycin is combined with Tamoxifen. |
| Tamsulosin | Bleomycin may decrease the excretion rate of Tamsulosin which could result in a higher serum level. |
| Tasimelteon | Bleomycin may decrease the excretion rate of Tasimelteon which could result in a higher serum level. |
| Telavancin | Bleomycin may decrease the excretion rate of Telavancin which could result in a higher serum level. |
| Temazepam | Temazepam may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Temozolomide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Temozolomide. |
| Temsirolimus | The risk or severity of adverse effects can be increased when Bleomycin is combined with Temsirolimus. |
| Teniposide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Teniposide. |
| Tenofovir alafenamide | Tenofovir alafenamide may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Tenofovir disoproxil | Tenofovir disoproxil may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Tenoxicam | Tenoxicam may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Teprotumumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Teprotumumab. |
| Terbutaline | Bleomycin may decrease the excretion rate of Terbutaline which could result in a higher serum level. |
| Teriflunomide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Teriflunomide. |
| Testolactone | Bleomycin may decrease the excretion rate of Testolactone which could result in a higher serum level. |
| Testosterone | Bleomycin may decrease the excretion rate of Testosterone which could result in a higher serum level. |
| Testosterone cypionate | Bleomycin may decrease the excretion rate of Testosterone cypionate which could result in a higher serum level. |
| Testosterone enanthate | Bleomycin may decrease the excretion rate of Testosterone enanthate which could result in a higher serum level. |
| Testosterone propionate | Bleomycin may decrease the excretion rate of Testosterone propionate which could result in a higher serum level. |
| Testosterone undecanoate | Bleomycin may decrease the excretion rate of Testosterone undecanoate which could result in a higher serum level. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Bleomycin is combined with Tetracaine. |
| Tetracycline | Bleomycin may decrease the excretion rate of Tetracycline which could result in a higher serum level. |
| Tetradecyl hydrogen | Bleomycin may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level. |
| Thalidomide | The risk or severity of adverse effects can be increased when Bleomycin is combined with Thalidomide. |
| Thiabendazole | Bleomycin may decrease the excretion rate of Thiabendazole which could result in a higher serum level. |
| Thiethylperazine | Bleomycin may decrease the excretion rate of Thiethylperazine which could result in a higher serum level. |
| Thiotepa | The risk or severity of adverse effects can be increased when Bleomycin is combined with Thiotepa. |
| Tiaprofenic acid | Tiaprofenic acid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| encephalitis vaccine | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Bleomycin. |
| Ticlopidine | Ticlopidine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Tiludronic acid | Bleomycin may decrease the excretion rate of Tiludronic acid which could result in a higher serum level. |
| Timolol | Bleomycin may decrease the excretion rate of Timolol which could result in a higher serum level. |
| Tinidazole | Bleomycin may decrease the excretion rate of Tinidazole which could result in a higher serum level. |
| Tioguanine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Tioguanine. |
| Tiopronin | Bleomycin may decrease the excretion rate of Tiopronin which could result in a higher serum level. |
| Tiotropium | Bleomycin may decrease the excretion rate of Tiotropium which could result in a higher serum level. |
| Tirofiban | Bleomycin may decrease the excretion rate of Tirofiban which could result in a higher serum level. |
| Tixocortol | The risk or severity of adverse effects can be increased when Bleomycin is combined with Tixocortol. |
| Tobramycin | Bleomycin may decrease the excretion rate of Tobramycin which could result in a higher serum level. |
| Tocilizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Tocilizumab. |
| Tocopherol | Bleomycin may decrease the excretion rate of Tocopherol which could result in a higher serum level. |
| Tofacitinib | Bleomycin may increase the immunosuppressive activities of Tofacitinib. |
| Tolazamide | Bleomycin may decrease the excretion rate of Tolazamide which could result in a higher serum level. |
| Tolbutamide | Bleomycin may decrease the excretion rate of Tolbutamide which could result in a higher serum level. |
| Tolcapone | Bleomycin may decrease the excretion rate of Tolcapone which could result in a higher serum level. |
| Tolfenamic acid | Tolfenamic acid may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Tolmetin | Tolmetin may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Tolterodine | Bleomycin may decrease the excretion rate of Tolterodine which could result in a higher serum level. |
| Tolvaptan | Tolvaptan may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Topiramate | Topiramate may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Topotecan | The risk or severity of adverse effects can be increased when Bleomycin is combined with Topotecan. |
| Torasemide | Torasemide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Bleomycin. |
| Trabectedin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Trabectedin. |
| Tramadol | Tramadol may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Trametinib | Bleomycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Bleomycin. |
| Trastuzumab emtansine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Trastuzumab emtansine. |
| Tretinoin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Tretinoin. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Bleomycin is combined with Triamcinolone. |
| Triamterene | Triamterene may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Triazolam | Bleomycin may decrease the excretion rate of Triazolam which could result in a higher serum level. |
| Trichlormethiazide | Trichlormethiazide may increase the excretion rate of Bleomycin which could result in a lower serum level and potentially a reduction in efficacy. |
| Triethylenetetramine | Bleomycin may decrease the excretion rate of Triethylenetetramine which could result in a higher serum level. |
| Trifluridine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Trifluridine. |
| Trilostane | The risk or severity of adverse effects can be increased when Bleomycin is combined with Trilostane. |
| Trimebutine | Bleomycin may decrease the excretion rate of Trimebutine which could result in a higher serum level. |
| Trimethoprim | Bleomycin may decrease the excretion rate of Trimethoprim which could result in a higher serum level. |
| Trimetrexate | Bleomycin may decrease the excretion rate of Trimetrexate which could result in a higher serum level. |
| Tropisetron | Bleomycin may decrease the excretion rate of Tropisetron which could result in a higher serum level. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Bleomycin. |
| Typhoid Vaccine Live | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Bleomycin. |
| polysaccharide vaccine | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Bleomycin. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Bleomycin is combined with Upadacitinib. |
| Vaborbactam | Bleomycin may decrease the excretion rate of Vaborbactam which could result in a higher serum level. |
| Valaciclovir | Valaciclovir may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Valbenazine | Bleomycin may decrease the excretion rate of Valbenazine which could result in a higher serum level. |
| Valdecoxib | Valdecoxib may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Valganciclovir | Bleomycin may decrease the excretion rate of Valganciclovir which could result in a higher serum level. |
| Valproic acid | The serum concentration of Valproic acid can be decreased when it is combined with Bleomycin. |
| Vancomycin | Bleomycin may decrease the excretion rate of Vancomycin which could result in a higher serum level. |
| Varenicline | Bleomycin may decrease the excretion rate of Varenicline which could result in a higher serum level. |
| Varicella zoster | The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Bleomycin. |
| Varicella zoster | The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Bleomycin. |
| Vedolizumab | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vedolizumab. |
| Venlafaxine | Venlafaxine may decrease the excretion rate of Bleomycin which could result in a higher serum level. |
| Verapamil | Bleomycin may decrease the excretion rate of Verapamil which could result in a higher serum level. |
| Vibrio cholerae | The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Bleomycin. |
| Vilanterol | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vilanterol. |
| Viloxazine | Bleomycin may decrease the excretion rate of Viloxazine which could result in a higher serum level. |
| Vinblastine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vinblastine. |
| Vincristine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vincristine. |
| Vindesine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vindesine. |
| Vinorelbine | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vinorelbine. |
| Voclosporin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Voclosporin. |
| Vorinostat | The risk or severity of adverse effects can be increased when Bleomycin is combined with Vorinostat. |
| Vortioxetine | Bleomycin may decrease the excretion rate of Vortioxetine which could result in a higher serum level. |
| Warfarin | Bleomycin may decrease the excretion rate of Warfarin which could result in a higher serum level. |
Pregnancy and Lactation
FDA Pregnancy Category D
Pregnancy
Studies of this medication have not been done with pregnant women. There is a possibility of birth defects if either the father or mother is using bleomycin at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using this medication. Tell the doctor immediately if you become pregnant while using this medication.
Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence. Although no data are available to determine an appropriate period to withhold breastfeeding, the drug’s terminal half-life of 4 hours with normal kidney function suggests that withholding breastfeeding for at least 24 hours may be sufficient. This period may be longer in patients with impaired kidney function. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breast milk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.
How should this medicine be used?
Bleomycin comes as a powder to be mixed with liquid and injected intravenously (into a vein), intramuscularly (into a muscle), or subcutaneously (under the skin) by a doctor or nurse in a medical office or hospital outpatient department. It is usually injected once or twice a week. When bleomycin is used to treat pleural effusions, it is mixed with liquid and placed in the chest cavity through a chest tube (plastic tube that is placed in the chest cavity through a cut in the skin).
What special precautions should I follow?
Before taking bleomycin,
- tell your doctor and pharmacist if you are allergic to bleomycin or any of the ingredients in bleomycin injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements, you are taking or plan to take. Your doctor may need to monitor you carefully for side effects.
- tell your doctor if you have or have ever had kidney or lung disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not become pregnant while you are receiving bleomycin injections. If you become pregnant while receiving bleomycin, call your doctor. Bleomycin may harm the fetus.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving bleomycin.
References
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