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Mithracin Side Effects

Generic Name: plicamycin

Note: This page contains information about the side effects of plicamycin. Some of the dosage forms included on this document may not apply to the brand name Mithracin.

For the Consumer

Applies to plicamycin: intravenous powder for solution

In addition to its needed effects, some unwanted effects may be caused by plicamycin (the active ingredient contained in Mithracin). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking plicamycin:

Less common:
  • Muscle and abdominal cramps
Symptoms of overdose:
  • Bloody or black, tarry stools
  • flushing or redness or swelling of face
  • nosebleed
  • skin rash or small red spots on skin
  • sore throat and fever
  • unusual bleeding or bruising
  • vomiting of blood
  • yellow eyes or skin

Minor Side Effects

Some of the side effects that can occur with plicamycin may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Diarrhea
  • irritation or soreness of mouth
  • loss of appetite
  • nausea or vomiting—may occur 1 to 2 hours after the injection is started and continue for 12 to 24 hours
Less common:
  • Drowsiness
  • fever
  • headache
  • mental depression
  • pain, redness, soreness, or swelling at place of injection
  • unusual tiredness or weakness

Side Effects: Post Treatment

After you stop taking this drug, it is possible that you may still experience side effects that need medical attention. If you notice any of the following side effects check with your doctor immediately:

  • Bloody or black, tarry stools
  • nosebleed
  • sore throat and fever
  • unusual bleeding or bruising
  • vomiting of blood

For Healthcare Professionals

Applies to plicamycin: intravenous powder for injection

Hematologic

The hemorrhagic syndrome may start with an episode of hematemesis which may progress to more widespread hemorrhage in the gastrointestinal tract or to a more generalized bleeding tendency. This may be due to abnormalities in multiple clotting factors. The hemorrhagic syndrome has been dose related.

If severe thrombocytopenia occurs, infusion of platelet concentrates of platelet-rich plasma may of help in elevating the platelet count.

Laboratory abnormalities have generally been upon discontinuation of therapy.[Ref]

Hematologic effects including a bleeding syndrome which usually begins with an episode of epistaxis, comprise the major form of toxicity associated with the use of plicamycin. Thrombocytopenia which is sometime rapid in onset, may occur at any time during therapy or within several days following the last dose. Depression of platelet count, white count, hemoglobin, and prothrombin time, elevation of clotting and bleeding times, and abnormal clot retraction have been reported. Leukopenia (6%) has been reported. Depression in levels of serum calcium, phosphorus, and potassium have also been reported.[Ref]

Gastrointestinal

Gastrointestinal effects including anorexia, nausea, vomiting, diarrhea, and stomatitis are among the most common effects reported with the use of plicamycin (the active ingredient contained in Mithracin) [Ref]

General

General effects including fever, weakness, lethargy, malaise, and drowsiness have been reported.[Ref]

Nervous system

Nervous system effects including headache have been reported.[Ref]

Psychiatric

Psychiatric effects including depression have been reported.[Ref]

Cardiovascular

Cardiovascular effects including phlebitis have been reported. A case has also been reported of multiple arterial occlusive episodes in association the courses of drug therapy.[Ref]

Dermatologic

Dermatologic effects including facial flushing an skin rash have been reported. A case of toxic epidermal necrolysis have also been reported.[Ref]

Hepatic

Laboratory abnormalities have generally been reported to be reversible upon discontinuation of therapy.[Ref]

Hepatic effects including increased levels of serum glutamic oxalacetic transaminase, serum glutamic pyruvic transaminase, lactic dehydrogenase, alkaline phosphatase, serum bilirubin, ornithine carbamyl transferase, isocitric dehydrogenase, an increased retention of bromsulphalein have been reported.[Ref]

Genitourinary

Genitourinary effects including increased blood urea nitrogen, increased serum creatinine, and proteinuria have been reported.[Ref]

Laboratory abnormalities have generally been reported to be reversible upon discontinuation of therapy.[Ref]

References

1. Ahr DJ, Scialla SJ, Kimbali DB Jr "Acquired platelet dysfunction following mithramycin therapy." Cancer 41 (1978): 448-54

2. "Product Information. Mithracin (plicamycin)." Bayer, West Haven, CT.

3. Yamreudeewong W, Henann NE, Fazio A, Rangaraj U "Possible severe thrombocytopenia associated with a single dose of plicamycin." Ann Pharmacother 26 (1992): 1369-73

4. Margileth DA, Smith FE, Lane M "Sudden arterial occlusion associated with mithramycin therapy." Cancer 31 (1973): 708-12

5. Purpora D, Ahern MJ, Silverman N "Toxic epidermal necrolysis after mithramycin [letter]." N Engl J Med 299 (1978): 1412

Not all side effects for Mithracin may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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