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Blenoxane Side Effects

Generic name: bleomycin

Medically reviewed by Last updated on Aug 23, 2023.

Note: This document contains side effect information about bleomycin. Some dosage forms listed on this page may not apply to the brand name Blenoxane.

Applies to bleomycin: injection powder for solution.


Injection route (Powder for Solution)

Pulmonary fibrosis is the most severe toxicity for bleomycin and its most frequent presentation is pneumonitis occasionally progressing to pulmonary fibrosis. Its occurrence is higher in elderly patients and in those receiving greater than 400 units total dose, but pulmonary toxicity has been observed in young patients and those treated with low doses. A severe idiosyncratic reaction consisting of hypotension, mental confusion, fever, chills, and wheezing has been reported in lymphoma patients treated with bleomycin.

Serious side effects of Blenoxane

Along with its needed effects, bleomycin (the active ingredient contained in Blenoxane) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor immediately if any of the following side effects occur while taking bleomycin:

More common

Less common


Check with your doctor as soon as possible if any of the following side effects occur while taking bleomycin:

More common

Other side effects of Blenoxane

Some side effects of bleomycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

Bleomycin may cause a temporary loss of hair in some people. After treatment has ended, normal hair growth should return, although it may take several months.

Side effects that affect your lungs (for example, cough and shortness of breath) may be more likely to occur if you smoke.

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, Check with your doctor immediately if you notice the following side effects:

For Healthcare Professionals

Applies to bleomycin: injectable powder for injection.


Very common (10% or more): Interstitial pneumonia (10%), pulmonary fibrosis (10%)

Common (1% to 10%): Wheezing[Ref]


Skin toxicity is a relatively late manifestation, usually developing in the 2nd and 3rd week of treatment, after a cumulative dose of 150 to 200 units.[Ref]

Very common (10% or more): Sclerosis of the skin (41%), pigmentation disorder (41%), alopecia (30%), nail deformation (11%), nail discoloration, skin hypertrophy, flagellate dermatitis

Common (1% to 10%): Rash, urticaria, exfoliative dermatitis[Ref]


Very common (10% or more): Nausea (15%), vomiting (15%), stomatitis (13%)

Common (1% to 10%): Angular cheilitis

Uncommon (0.1% to 1%): Diarrhea[Ref]


Uncommon (0.1% to 1%): Shock, vein wall hypertrophy, venous stenosis

Frequency not reported: Myocardial infarction, hypotension, Raynaud's phenomenon, embolism, thrombosis, peripheral ischemia, cerebral infarction, chest pain[Ref]


Very common (10% or more): Fever/pyrexia (40%), malaise (16%)[Ref]


Uncommon (0.1% to 1%): Injection site induration

Frequency not reported: Injection site thrombosis (IV), injection site pain[Ref]


The most frequent mutations produced in mammalian cells are large multilocus deletions, which probably arise by misrepair of (DNA) double strand breaks.[Ref]

Uncommon (0.1% to 1%): Tumor pain[Ref]


Common (1% to 10%): Hemorrhage

Uncommon (0.1% to 1%): Leucopenia

Frequency not reported: Pancytopenia, thrombocytopenia, anemia, neutropenia

Postmarketing reports:


Frequency not reported: Sepsis


Very common (10% or more): Scleroderma, chills


Very common (10% or more): Anorexia (29%), weight loss (29%)


Common (1% to 10%): Mental confusion


Uncommon (0.1% to 1%): Oliguria, dysuria, pollakiuria, urinary retention, polyuria, feeling of residual urine


Uncommon (0.1% to 1%): Hepatocellular injury

Nervous system

Very common (10% or more): Rigors (40%)

Common (1% to 10%): Headache

Uncommon (0.1% to 1%): Dizziness


1. Chisholm RA, Dixon AK, Williams MV, Oliver RTD (1992) "Bleomycin lung: the effect of different chemotherapeutic regimens." Cancer Chemother Pharmacol, 30, p. 158-60

2. Wolkowicz J, Sturgeon J, Rawji M, Chan CK (1992) "Bleomycin-induced pulmonary function abnormalities." Chest, 101, p. 97-101

3. Khansur T, Little D, Tavassoli M (1984) "Fulminant and fatal angioedema caused by bleomycin treatment." Arch Intern Med, 144, p. 2267

4. McLeod BF, Lawrence HJ, Smith DW, Vogt PJ, Gandara DR (1987) "Fatal bleomycin toxicity from a low cumulative dose in a patient with renal insufficiency." Cancer, 60, p. 2617-20

5. Hartmann LC, Frytak S, Richardson RL, Coles DT, Cupps RE (1990) "Life-threatening bleomycin pulmonary toxicity with ultimate reversibility." Chest, 98, p. 497-9

6. Brown WG, Hasan FM, Barbee RA (1978) "Reversibility of severe bleomycin-induced pneumonitis." JAMA, 239, p. 2012-4

7. Bechard DE, Fairman RP, DeBlois GG, Via CT (1987) "Fatal pulmonary fibrosis from low-dose bleomycin therapy." South Med J, 80, p. 646-9

8. Jones AW (1978) "Bleomycin lung damage: the pathology and nature of the lesion." Br J Dis Chest, 72, p. 321-6

9. Doll DC (1986) "Fatal pneumothorax associated with bleomycin-induced pulmonary fibrosis." Cancer Chemother Pharmacol, 17, p. 294-5

10. Bennett WM, Pastore L, Houghton DC (1980) "Fatal pulmonary bleomycin toxicity in cisplatin-induced acute renal failure." Cancer Treat Rep, 64, p. 921-4

11. Leeser JE, Carr D (1985) "Fatal pneumothorax following bleomycin and other cytotoxic drugs." Cancer Treat Rep, 69, p. 344-5

12. Zucker PK, Khouri NF, Rosenshein NB (1987) "Bleomycin-induced pulmonary nodules: a variant of bleomycin pulmonary toxicity." Gynecol Oncol, 28, p. 284-91

13. Wilson KS, Worth A, Richards AG, Ford HS (1982) "Low-dose bleomycin lung." Med Pediatr Oncol, 10, p. 283-8

14. Maher J, Daly PA (1993) "Severe bleomycin lung toxicity: reversal with high dose corticosteroids." Thorax, 48, p. 92-4

15. Dalgleish AG, Woods RL, Levi JA (1984) "Bleomycin pulmonary toxicity: its relationship to renal dysfunction." Med Pediatr Oncol, 12, p. 313-7

16. (2001) "Product Information. Blenoxane (bleomycin)." Bristol-Myers Squibb

17. Sleijfer S (2001) "Bleomycin-induced pneumonitis." Chest, 120, 617+

18. Arseculeratne G, Berroeta L, Meiklejohn D, et al. (2007) "Bleomycin-induced "flagellate dermatitis"." Arch Dermatol, 143, p. 1461-2

19. Kerr LD, Spiera H (1992) "Scleroderma in association with the use of bleomycin: a report of 3 cases." J Rheumatol, 19, p. 294-6

20. "Multum Information Services, Inc. Expert Review Panel"

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.