Skip to main content

Mithracin Side Effects

Generic name: plicamycin

Medically reviewed by Last updated on Aug 4, 2023.

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

Applies to plicamycin: intravenous powder for injection.


Plicamycin should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Serious side effects have been reported with the use of plicamycin including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; fever or chills; or signs of infection such as fever; chills, or sore throat); severe nausea, vomiting, diarrhea, and loss of appetite; and others. Talk to your doctor about the possible side effects from treatment with plicamycin.

Plicamycin should not be used in women who are or may become pregnant.

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

Other less serious side effects may be more likely to occur. Talk to your doctor if you experience:

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

For Healthcare Professionals

Applies to plicamycin: intravenous powder for injection.


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 (the active ingredient contained in Mithracin) 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]

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]


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

Nervous system

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


Psychiatric effects including depression have been reported.[Ref]


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

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


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]


1. (2001) "Product Information. Mithracin (plicamycin)." Bayer

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

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

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

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

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.