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Plicamycin Side Effects

For the Consumer

Applies to plicamycin: intravenous powder for solution

As well as its needed effects, plicamycin may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking plicamycin, check with your doctor immediately:

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 plicamycin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

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


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 effects including anorexia, nausea, vomiting, diarrhea, and stomatitis are among the most common effects reported with the use of plicamycin.[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]


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

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

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

It is possible that some side effects of plicamycin may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.