Bleomycin Side Effects
Medically reviewed by Drugs.com. Last updated on Jan 31, 2022.
Commonly reported side effects of bleomycin include: pulmonary toxicity. See below for a comprehensive list of adverse effects.
For the Consumer
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.
Side effects requiring immediate medical attention
Along with its needed effects, bleomycin 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:
- Fever and chills (occurring within 3 to 6 hours after a dose)
- Chest pain (sudden severe)
- weakness in arms or legs (sudden)
Check with your doctor as soon as possible if any of the following side effects occur while taking bleomycin:
- shortness of breath
- sores in mouth and on lips
Side effects not requiring immediate medical attention
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:
- Darkening or thickening of skin
- dark stripes on skin
- itching of skin
- skin rash or colored bumps on fingertips, elbows, or palms
- skin redness or tenderness
- swelling of fingers
- vomiting and loss of appetite
- Changes in fingernails or toenails
- weight loss
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:
- shortness of breath
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]
Very common (10% or more): Sclerosis of the skin (41%), pigmentation disorder (41%), alopecia (30%), nail deformation (11%), nail discoloration, skin hypertrophy, flagellate dermatitis
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]
Common (1% to 10%): Angular cheilitis
Uncommon (0.1% to 1%): Shock, vein wall hypertrophy, venous stenosis
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: 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%): Hepatocellular injury
Very common (10% or more): Rigors (40%)
Common (1% to 10%): Headache
Uncommon (0.1% to 1%): Dizziness
More about bleomycin
- Drug interactions
- Dosage information
- During pregnancy or Breastfeeding
- Compare alternatives
- Pricing & coupons
- En español
- Drug class: antibiotics/antineoplastics
- Other brands
Related treatment guides
1. Chisholm RA, Dixon AK, Williams MV, Oliver RTD "Bleomycin lung: the effect of different chemotherapeutic regimens." Cancer Chemother Pharmacol 30 (1992): 158-60
2. Wolkowicz J, Sturgeon J, Rawji M, Chan CK "Bleomycin-induced pulmonary function abnormalities." Chest 101 (1992): 97-101
3. Khansur T, Little D, Tavassoli M "Fulminant and fatal angioedema caused by bleomycin treatment." Arch Intern Med 144 (1984): 2267
4. McLeod BF, Lawrence HJ, Smith DW, Vogt PJ, Gandara DR "Fatal bleomycin toxicity from a low cumulative dose in a patient with renal insufficiency." Cancer 60 (1987): 2617-20
5. Hartmann LC, Frytak S, Richardson RL, Coles DT, Cupps RE "Life-threatening bleomycin pulmonary toxicity with ultimate reversibility." Chest 98 (1990): 497-9
6. Brown WG, Hasan FM, Barbee RA "Reversibility of severe bleomycin-induced pneumonitis." JAMA 239 (1978): 2012-4
7. Bechard DE, Fairman RP, DeBlois GG, Via CT "Fatal pulmonary fibrosis from low-dose bleomycin therapy." South Med J 80 (1987): 646-9
8. Jones AW "Bleomycin lung damage: the pathology and nature of the lesion." Br J Dis Chest 72 (1978): 321-6
9. Doll DC "Fatal pneumothorax associated with bleomycin-induced pulmonary fibrosis." Cancer Chemother Pharmacol 17 (1986): 294-5
10. Bennett WM, Pastore L, Houghton DC "Fatal pulmonary bleomycin toxicity in cisplatin-induced acute renal failure." Cancer Treat Rep 64 (1980): 921-4
11. Leeser JE, Carr D "Fatal pneumothorax following bleomycin and other cytotoxic drugs." Cancer Treat Rep 69 (1985): 344-5
12. Zucker PK, Khouri NF, Rosenshein NB "Bleomycin-induced pulmonary nodules: a variant of bleomycin pulmonary toxicity." Gynecol Oncol 28 (1987): 284-91
13. Wilson KS, Worth A, Richards AG, Ford HS "Low-dose bleomycin lung." Med Pediatr Oncol 10 (1982): 283-8
14. Maher J, Daly PA "Severe bleomycin lung toxicity: reversal with high dose corticosteroids." Thorax 48 (1993): 92-4
15. Dalgleish AG, Woods RL, Levi JA "Bleomycin pulmonary toxicity: its relationship to renal dysfunction." Med Pediatr Oncol 12 (1984): 313-7
16. "Product Information. Blenoxane (bleomycin)." Bristol-Myers Squibb, Princeton, NJ.
17. Sleijfer S "Bleomycin-induced pneumonitis." Chest 120 (2001): 617+
18. Arseculeratne G, Berroeta L, Meiklejohn D, et al. "Bleomycin-induced "flagellate dermatitis"." Arch Dermatol 143 (2007): 1461-2
19. Kerr LD, Spiera H "Scleroderma in association with the use of bleomycin: a report of 3 cases." J Rheumatol 19 (1992): 294-6
20. "Multum Information Services, Inc. Expert Review Panel"
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.