Clorexine may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Chlorhexidine is reported as an ingredient of Clorexine in the following countries:
International Drug Name Search
Lansoprazol Mabo may be available in the countries listed below.
Lansoprazole is reported as an ingredient of Lansoprazol Mabo in the following countries:
International Drug Name Search
Fluconazole Dakota Pharm may be available in the countries listed below.
Fluconazole is reported as an ingredient of Fluconazole Dakota Pharm in the following countries:
International Drug Name Search
Naloxone Hydrochloride Injection may be available in the countries listed below.
Naloxone hydrochloride (a derivative of Naloxone) is reported as an ingredient of Naloxone Hydrochloride Injection in the following countries:
International Drug Name Search
Psibeter may be available in the countries listed below.
Buspirone hydrochloride (a derivative of Buspirone) is reported as an ingredient of Psibeter in the following countries:
International Drug Name Search
Vagisten may be available in the countries listed below.
Estriol is reported as an ingredient of Vagisten in the following countries:
International Drug Name Search
Ecuzol may be available in the countries listed below.
Secnidazole is reported as an ingredient of Ecuzol in the following countries:
International Drug Name Search
Fenoximetilpenicilina may be available in the countries listed below.
Phenoxymethylpenicillin is reported as an ingredient of Fenoximetilpenicilina in the following countries:
International Drug Name Search
Galtes may be available in the countries listed below.
Gliclazide is reported as an ingredient of Galtes in the following countries:
International Drug Name Search
Actisuny may be available in the countries listed below.
Diclofenac sodium salt (a derivative of Diclofenac) is reported as an ingredient of Actisuny in the following countries:
International Drug Name Search
Piroxicam Vannier may be available in the countries listed below.
Piroxicam is reported as an ingredient of Piroxicam Vannier in the following countries:
International Drug Name Search
Rid A Lint may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Praziquantel is reported as an ingredient of Rid A Lint in the following countries:
International Drug Name Search
Carboprost Trometamol may be available in the countries listed below.
Carboprost Trometamol (BANM) is known as Carboprost in the US.
International Drug Name Search
Glossary
| BANM | British Approved Name (Modified) |
Pamiray may be available in the countries listed below.
Iopamidol is reported as an ingredient of Pamiray in the following countries:
International Drug Name Search
Methylprednisolone-Mayne may be available in the countries listed below.
Methylprednisolone is reported as an ingredient of Methylprednisolone-Mayne in the following countries:
International Drug Name Search
Generic Name: olmesartan (OL me SAR tan)
Brand Names: Benicar
Olmesartan is in a group of drugs called angiotensin II receptor antagonists. Olmesartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.
Olmesartan is used to treat high blood pressure (hypertension) in adults and children who are at least 6 years old. It is sometimes given together with other blood pressure medications.
Olmesartan may also be used for purposes not listed in this medication guide.
Your blood pressure will need to be checked often. Visit your doctor regularly.
Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.
To make sure you can safely take olmesartan, tell your doctor if you have any of these other conditions:
congestive heart failure; or
if you are dehydrated.
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results.
You may take olmesartan with or without food.
Your blood pressure will need to be checked often. Visit your doctor regularly.
Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.
See also: Olmesartan dosage (in more detail)
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include extreme dizziness, fast or slow heartbeat, or fainting.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
feeling like you might pass out;
urinating less than usual or not at all;
chest pain, fast heart rate; or
swelling in your hands or feet.
Less serious side effects may include:
dizziness;
joint or muscle pain;
back pain;
stomach pain, nausea, diarrhea;
mild itching or skin rash; or
weakness.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Hypertension:
Initial dose: 20 mg orally once a day.
Maintenance dose: May increase to 40 mg/day if further blood pressure reduction is necessary after 2 weeks. Diuretics or other antihypertensive agents may be added.
Usual Pediatric Dose for Hypertension:
6 to 16 years of age:
20 to less than 35 kg (44 to 77 pounds): Initial: 10 mg orally once daily; Maximum: if the initial response is inadequate after 2 weeks, dose may be increased to a maximum of 20 mg/day.
Greater than or equal to 35 kg (greater than or equal to 77 pounds): 20 mg orally once daily; Maximum: if the initial response is inadequate after 2 weeks, dose may be increased to a maximum of 40 mg/day.
Tell your doctor about all other medicines you use, especially:
blood pressure medications such as a diuretic (water pill); or
an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.
There may be other drugs that can interact with olmesartan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
See also: olmesartan side effects (in more detail)
Bicalinn may be available in the countries listed below.
Bicalutamide is reported as an ingredient of Bicalinn in the following countries:
International Drug Name Search
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Bupropion Extended-Release Tablets outweigh the risks.
Bupropion Extended-Release Tablets has the same ingredient in it that is in Zyban, a medicine used to help certain patients stop smoking. Some patients using bupropion to help them stop smoking have also developed depression and certain other mental or mood problems, including suicidal thoughts or actions.
Family and caregivers must closely watch patients who take Bupropion Extended-Release Tablets. It is important to keep in close contact with the patient's doctor. Contact the doctor at once if new, worsened, or sudden symptoms such as agitation, hostility, depressed mood, or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur. Discuss any questions with the patient's doctor.
Treating depression and seasonal affective disorder (SAD). It may also be used for other conditions as determined by your doctor.
Bupropion Extended-Release Tablets are an antidepressant. It works in the brain to treat depression. Exactly how it works is not known.
Contact your doctor or health care provider right away if any of these apply to you.
Treatments for depression are getting better everyday and there are things you can start doing right away.
Some medical conditions may interact with Bupropion Extended-Release Tablets. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
Some MEDICINES MAY INTERACT with Bupropion Extended-Release Tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:
This may not be a complete list of all interactions that may occur. Ask your health care provider if Bupropion Extended-Release Tablets may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Use Bupropion Extended-Release Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Bupropion Extended-Release Tablets.
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Constipation; dizziness; drowsiness; dry mouth; flushing; gas; headache; increased sweating; increased urination; loss of appetite; nausea; nervousness; restlessness; ringing in the ears; stomach pain; taste changes; trouble sleeping; vomiting; weakness; weight changes.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue, unusual hoarseness); chest pain; confusion; dark urine; delusions; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; hearing problems or ringing in the ears; menstrual changes; new or worsening mental or mood changes (eg, concentration problems, depression, panic attacks, aggressiveness, agitation, anxiety, impulsiveness, irritability, hostility, exaggerated feeling of well-being, inability to sit still); pale stools; red, swollen, blistered, or peeling skin; seizures; severe headache or dizziness; severe or persistent joint or muscle pain; severe or persistent nausea, vomiting, or stomach pain; severe or persistent nervousness, restlessness, or trouble sleeping; shortness of breath; suicidal thoughts or attempts; tremor; unusual swelling; vision changes; worsening depression; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
See also: Bupropion side effects (in more detail)
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include chest pain; fainting; fast, slow, or irregular heartbeat; fever; hallucinations; loss of consciousness; rigid or painful muscles; seizures; severe dizziness; slow or difficult breathing.
Store Bupropion Extended-Release Tablets at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tight, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Bupropion Extended-Release Tablets out of the reach of children and away from pets.
This information is a summary only. It does not contain all information about Bupropion Extended-Release Tablets. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
Gluconato de Calcio Sanderson may be available in the countries listed below.
Calcium Gluconate is reported as an ingredient of Gluconato de Calcio Sanderson in the following countries:
International Drug Name Search
Nipolen may be available in the countries listed below.
Chlorphenamine maleate (a derivative of Chlorphenamine) is reported as an ingredient of Nipolen in the following countries:
International Drug Name Search
Lydium may be available in the countries listed below.
Hyaluronic Acid sodium salt (a derivative of Hyaluronic Acid) is reported as an ingredient of Lydium in the following countries:
International Drug Name Search
Bisoprolol-CT may be available in the countries listed below.
Bisoprolol fumarate (a derivative of Bisoprolol) is reported as an ingredient of Bisoprolol-CT in the following countries:
International Drug Name Search
Flutide Diskus may be available in the countries listed below.
Fluticasone propionate (a derivative of Fluticasone) is reported as an ingredient of Flutide Diskus in the following countries:
International Drug Name Search
Preventing or treating symptoms of hay fever and other upper respiratory allergies or the common cold, such as runny nose, sneezing, itching of the nose and throat, and itchy, watery eyes, and relieving cough. It may also relieve itching of the skin and allergic skin reactions. It is also used to treat and prevent motion sickness. It may also be used for other conditions as determined by your doctor.
Benadryl Allergy Ultratabs is an antihistamine and anticholinergic. It works by blocking the action of histamine, reducing the symptoms of an allergic reaction. It also works in the brain to cause sedation.
Contact your doctor or health care provider right away if any of these apply to you.
Some medical conditions may interact with Benadryl Allergy Ultratabs. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
Some MEDICINES MAY INTERACT with Benadryl Allergy Ultratabs. Tell your health care provider if you are taking any other medicines, especially any of the following:
This may not be a complete list of all interactions that may occur. Ask your health care provider if Benadryl Allergy Ultratabs may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Use Benadryl Allergy Ultratabs as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Benadryl Allergy Ultratabs.
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Dizziness; drowsiness; dry mouth, throat, and nose; excitability; thickening of mucus in nose or throat.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); convulsions; fast heartbeat or pounding in the chest; decreased alertness; hallucinations; tremor; wheezing.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
See also: Benadryl Allergy Ultratabs side effects (in more detail)
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include coma; excitement; hallucinations; loss of consciousness; muscle twitching; seizures; tremor; weakness.
Store Benadryl Allergy Ultratabs at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), or according to directions on the package label. Store in the original package or container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Benadryl Allergy Ultratabs out of the reach of children and away from pets.
This information is a summary only. It does not contain all information about Benadryl Allergy Ultratabs. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
In some countries, this medicine may only be approved for veterinary use.
Amprolium is reported as an ingredient of Chick Grower Developer in the following countries:
International Drug Name Search
Cefixim Hexal may be available in the countries listed below.
Cefixime trihydrate (a derivative of Cefixime) is reported as an ingredient of Cefixim Hexal in the following countries:
International Drug Name Search
Generic Name: chlorpheniramine, dextromethorphan, and phenylephrine (klor feh NEER a meen, dex troe meh THOR fan, and feh nill EH frin)
Brand Names: Alka-Seltzer Plus Cold and Cough, C-Phen DM, C-Phen DM Drops, Cardec DM, Cardec DM Drops, Ceron-DM, Ceron-DM Drops, Cerose DM, Corfen-DM, CP Dec DM, CP Dec-DM Drops, De-Chlor DM, De-Chlor DR, Dec-Chlorphen DM, Dex PC, DM-PE-Chlor, Donatussin DM Drops, Ed A-Hist DM, HistadecDM, Maxiphen ADT, Mintuss DR, Nasohist-DM, Neo DM Drops, Nohist-DMX, Norel DM, P Chlor DM, PD-Cof, PD-Cof Drops, Poly-Tussin DM, Quartuss DM, Reme Tussin DM, Rondec-DM, Rondec-DM Drops, Rondex-DM, Rondex-DM Drops, Sildec-PE DM, Sildec-PE DM Drops, Tri-Vent DPC, Trital DM, Tussplex DM, Zotex-12D
Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.
Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.
Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
Chlorpheniramine, dextromethorphan, and phenylephrine is used to treat sneezing, cough, runny or stuffy nose, itchy or watery eyes, hives, skin rash, itching, and other symptoms of allergies and the common cold.
Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.
Chlorpheniramine, dextromethorphan, and phenylephrine may also be used for other purposes not listed in this medication guide.
Before taking this medication, tell your doctor if you are allergic to chlorpheniramine, dextromethorphan, or phenylephrine, or if you have:
diabetes;
glaucoma;
heart disease or high blood pressure;
diabetes;
a thyroid disorder;
a stomach ulcer or a stomach obstruction,
emphysema or chronic bronchitis; or
an enlarged prostate or urination problems.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.
Artificially-sweetened liquid forms of cough-and-cold medications may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.
Use this medication exactly as directed on the label or as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.
Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.
If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.
Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include feeling restless or nervous, nausea, vomiting, stomach pain, dizziness, drowsiness, dry mouth, warmth or tingly feeling, or seizure (convulsions).
Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.
fast, pounding, or uneven heartbeat;
confusion, hallucinations, unusual thoughts or behavior;
severe dizziness, anxiety, restless feeling, or nervousness;
increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
confusion, hallucinations;
slow, shallow breathing;
urinating less than usual or not at all;
easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
blurred vision;
dry mouth;
nausea, stomach pain, constipation;
mild loss of appetite, stomach upset;
warmth, tingling, or redness under your skin;
feeling excited or restless;
sleep problems (insomnia);
restless or excitability (especially in children);
skin rash or itching;
dizziness, drowsiness;
problems with memory or concentration; or
ringing in your ears.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Before taking this medication, tell your doctor if you are using any of the following drugs:
an antidepressant;
a diuretic (water pill);
medication to treat irritable bowel syndrome;
celecoxib (Celebrex);
cinacalcet (Sensipar);
imatinib (Gleevec);
quinidine (Quinaglute, Quinidex);
ranolazine (Ranexa)
ritonavir (Norvir);
sibutramine (Meridia);
terbinafine (Lamisil);
medicines to treat high blood pressure;
aspirin or salicylates (such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others);
bladder or urinary medications such as darifenacin (Enablex), oxybutynin (Ditropan, Oxytrol) or tolterodine (Detrol); or
a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others.
This list is not complete and there may be other drugs that can interact with chlorpheniramine, dextromethorphan, and phenylephrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
See also: Dex PC side effects (in more detail)
The following drugs and medications are in some way related to, or used in the treatment of Thrombocytopenia Idiopathic. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
Micromedex Care Notes:
Ampi-Kur may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Ampicillin is reported as an ingredient of Ampi-Kur in the following countries:
Cloxacillin sodium salt (a derivative of Cloxacillin) is reported as an ingredient of Ampi-Kur in the following countries:
International Drug Name Search
The following drugs and medications are in some way related to, or used in the treatment of Chronic Myelogenous Leukemia. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
Micromedex Care Notes:
Medical Encyclopedia:
Atorvox may be available in the countries listed below.
Atorvastatin is reported as an ingredient of Atorvox in the following countries:
Atorvastatin calcium (a derivative of Atorvastatin) is reported as an ingredient of Atorvox in the following countries:
International Drug Name Search
Leukichtan Salbe may be available in the countries listed below.
Ichthammol sodium salt (a derivative of Ichthammol) is reported as an ingredient of Leukichtan Salbe in the following countries:
International Drug Name Search
Docetaxel Rontag may be available in the countries listed below.
Docetaxel is reported as an ingredient of Docetaxel Rontag in the following countries:
International Drug Name Search
Generic Name: benzocaine and trimethobenzamide (rectal) (BENZ o kain and try meth o BENZ uh myd)
Brand names: Tigan Adult, Tigan Pediatric, Navogan, Tebamide, Triban, Tebamide Pediatric
Benzocaine and trimethobenzamide affects the areas of the brain that stimulate nausea and vomiting.
Benzocaine and trimethobenzamide is used to treat nausea and vomiting.
Benzocaine and trimethobenzamide may also be used for purposes other than those listed in this medication guide.
Before using this medication, tell your doctor if you have:
an enlarged prostate;
difficulty urinating;
bladder problems;
glaucoma;
asthma; or
heart disease or a heart rhythm disorder.
If you have any of these conditions, you may not be able to use benzocaine and trimethobenzamide, or you may need a dosage adjustment or special tests during treatment.
Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor.
Unwrap the suppository when you are ready to insert it. You may wet the tip of the suppository with cold water. Lie down on your side and use your finger to insert the suppository into your rectum. Hold in the suppository and remain lying down for a few minutes while the medicine dissolves.
Benzocaine and trimethobenzamide is normally used three or four times a day. You may also be using the medicine only as needed. Follow your doctor's instructions.
Do not take more of this medication than is prescribed for you.
Since benzocaine and trimethobenzamide is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.
Symptoms of a benzocaine and trimethobenzamide overdose may include drowsiness, uncontrollable movements, muscle spasms, blurred vision, seizures or convulsions, difficulty breathing, and death.
jaundice (yellowing of the skin or eyes);
seizure (convulsions); or
easy bruising or bleeding, unusual weakness;
tremor (uncontrolled shaking); or
muscle cramps, severe muscle spasms.
Other less serious side effects are more likely to occur. Continue using benzocaine and trimethobenzamide and talk with your doctor if you have any of these less serious side effects:
drowsiness or dizziness;
headache;
feeling depressed or disoriented; or
blurred vision.
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.
Usual Adult Dose for Nausea/Vomiting:
200 mg rectally 3 to 4 times a day as needed.
Usual Pediatric Dose for Nausea/Vomiting:
1 to 12 years: 15 to 20 mg/kg/day (400 to 500 mg/m2/day) rectally administered in equally divided doses 3 to 4 times a day as needed.
Alternatively:
1 to 12 years:
13.6 to 41 kg (30 to 90 lbs): 100 to 200 mg rectally 3 to 4 times a day as needed.
Benzocaine and trimethobenzamide may increase the side effects of other drugs that make you sleepy (such as alcohol, cold medicine, pain medication, muscle relaxants, and medicine for seizures, depression or anxiety). Before using benzocaine and trimethobenzamide, tell your doctor if you are using any of these medicines.
There may be other drugs that can affect benzocaine and trimethobenzamide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Benzocaine and trimethobenzamide is available with a prescription generically and under the brand name Tigan. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
Generic Name: Bleomycin Sulfate
Class: Antineoplastic Agents
VA Class: AN200
CAS Number: 9041-93-4
Administer only under supervision of qualified clinicians experienced in use of cytotoxic therapy and only in a setting where adequate diagnostic and treatment facilities are readily available.121
Risk of developing pulmonary toxicity (e.g., pneumonitis, pulmonary fibrosis), particularly in geriatric patients >70 years of age and in patients receiving total bleomycin dosage >400 units.121 (See Pulmonary Toxicity under Cautions.)
Risk of severe idiosyncratic reaction (e.g., hypotension, mental confusion, fever, chills, wheezing) in patients with Hodgkin’s or non-Hodgkin’s disease.121 (See Sensitivity Reactions under Cautions.)
Antineoplastic agent; mixture of basic cytotoxic glycopeptide antibiotics produced by Streptomyces verticillus (bleomycin A2 and bleomycin B2 are the major components).121
Treatment of Hodgkin’s disease.121 122 142 143 144 217
Combination therapy for induction of remissions is superior to single-drug therapy.142 143 144
Various combination regimens are used.142 143 144
Commonly used in combination with doxorubicin, vinblastine, and dacarbazine (ABVD regimen).121 122 142 143 144 217
Has been used for treatment of non-Hodgkin’s lymphoma.121 122
Second- or third-generation combination regimens containing bleomycin no more effective than the standard CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone) for the treatment of advanced intermediate-grade or high-grade non-Hodgkin’s lymphoma.235 236 237 238 239
Treatment of testicular embryonal cell carcinoma, choriocarcinoma, and teratocarcinoma.121 123 126 127 128 129 130 132 140
Combination chemotherapy with bleomycin, cisplatin, and etoposide is a regimen of choice for the treatment of advanced nonseminomatous testicular carcinoma.122 123 126 127 128 129 130 132
Combination chemotherapy with bleomycin, cisplatin, and etoposide is used for the treatment of disseminated seminoma testis.123 128 129 131 132 140
Intracavitary injection as a sclerosing agent for intrapleural management and prevention of recurrent pleural effusions (pleurodesis) caused by metastatic tumors.121
At least as effective and possibly better tolerated than intrapleural tetracycline.121 147 148 149 151 154 155 156
Intrapleural talc may be preferred because of cost considerations.c d e f g
Has been used for intrapleural management of pneumothorax† associated with AIDS Pneumocystis jiroveci (Pneumocystis carinii) pneumonia.108 112
Palliative treatment of squamous cell carcinomas of the head and neck (including mouth, tongue, tonsils, nasopharynx, oropharynx, sinuses, palate, lip, buccal mucosa, gingiva, epiglottis, larynx, skin).121
Poorer response to bleomycin in patients who have received prior radiation therapy for the treatment of head and neck cancer.121
Combination chemotherapy with cisplatin, methotrexate, and vincristine for advanced head and neck cancer.122 225
Has been used for palliative treatment of squamous cell carcinoma of the cervix.121
Not considered a drug of choice for the treatment of advanced cervical cancer.232
Palliative treatment of squamous cell carcinomas of the penis and vulva (in combination with other antineoplastic agents).121 234
Has been used for the palliative treatment of AIDS-related Kaposi’s sarcoma† (alone or in combination with doxorubicin, and a vinca alkaloid).122 146 172 173 174 175 176 177
Has been used as monotherapy for palliative treatment of early-stage disease.146 169 170 171
Bleomycin combination chemotherapy has been considered a regimen of choice for advanced disease,122 146 175 177 but a liposomal anthracycline currently considered first-line therapy.146 185
Has been used for the treatment of ovarian germ cell tumors† (in combination with cisplatin and etoposide).122 216
Has been used for the treatment of intracranial germ cell tumors† (in combination with cisplatin and vinblastine).122 178
Individualize dosage carefully according to individual requirements and response.121
Consult specialized references for procedures for proper handling and disposal of antineoplastics.121
Risk of anaphylactoid reactions in lymphoma patients (e.g., those with Hodgkin’s and non-Hodgkin’s disease).121
Administer 2 test doses (i.e., ≤2 units of bleomycin) before initiating full-dose therapy.121
After each test dose, monitor carefully for severe idiosyncratic reactions (see Boxed Warning).121 If no acute reaction occurs, recommended dosage regimen may then be administered.121
Take precautions to treat potential allergic reactions.121
Intrapleural injection of local anesthetics or systemic administration of opiates prior to the intrapleural procedure may relieve pain associated with pleurodesis104 120 153 160 163 164 166 but generally are not considered necessary.121
Administer by IV, IM, sub-Q, or intrapleural (intracavitary) injection.121
Administer by IV injection once or twice weekly.121
For solution and drug compatibility information, see Compatibility under Stability.
Add a minimum of 5 or 10 mL of 0.9% sodium chloride injection to the vial labeled as containing 15 or 30 units, respectively, to provide a solution containing not more than 3 units/mL.121
Administer IV slowly over a 10-minute period.121
Administer by IM injection once or twice weekly.121
Add 1–5 or 2–10 mL of sterile water for injection, 0.9% sodium chloride injection, or bacteriostatic water for injection to the vial containing 15 or 30 units, respectively, to provide solutions containing 3–15 units/mL.121
Administer by sub-Q injection once or twice weekly.121
Add 1–5 or 2–10 mL of sterile water for injection, 0.9% sodium chloride injection, or bacteriostatic water for injection to the vial containing 15 or 30 units, respectively, to provide solutions containing 3–15 units/mL.121
Administer as a single bolus dose by intrapleural (intracavitary) injection through a thoracostomy tube.121
Drain pleural fluid via the thoracostomy by gravity or suction prior to instillation;102 103 104 110 118 119 120 121 confirmation of complete expansion of the lungs is recommended.121 148 153
Initiate therapy when chest tube drainage <100 mL in a 24 hour period or 100–300 mL in 24 hours under certain special circumstances.121
Dissolve 60 units in 50–100 mL of 0.9% sodium chloride injection.121
Available as bleomycin sulfate; dosage expressed in terms of bleomycin.121
Consult published protocols for the dosage of bleomycin and other chemotherapeutic agents and the method and sequence of administration.121
Increased sensitivity risk in lymphomas; administer test doses.121 (See Sensitivity Testing under Dosage and Administration.)
0.25–0.5 units/kg (10–20 units/m2) once or twice weekly.121
Following a 50% regression of tumor size, a maintenance dose of 1 unit daily or 5 units weekly can be given.121
Improvement unlikely to occur if not evident by week 2 of therapy.121
Increased sensitivity risk in lymphomas; administer test doses.121 (See Sensitivity Testing under Dosage and Administration.)
0.25–0.5 units/kg (10–20 units/m2) once or twice weekly.121
0.25–0.5 units/kg (10–20 units/m2) once or twice weekly.121
Improvement in testicular cancer disease unlikely to occur if not evident by week 2 of therapy.121
0.25–0.5 units/kg (10–20 units/m2) once or twice weekly.121
Improvement in squamous cell carcinomas may not be evident for 3 weeks after initiation of therapy.121
50–60 units diluted and instilled into the chest through a thoracostomy tube followed by clamping of the tube, periodic rotation (optional)148 149 of the patient during the next 4 hours, and subsequent removal of the fluid.101 104 105 107 110 113 118 119 120 121
Length of time the chest tube remains in the pleural space after instillation of the drug should be individualized depending on the clinical status of the patient;121 allowing the chest tube to remain for at least 4 days after instillation may prevent pneumothorax.153
Pulmonary: |
Clinical manifestations or radiologic evidence of pulmonary toxicity unless drug excluded as cause |
Pulmonary diffusion capacity for carbon monoxide (DLco) <30–35% of the pretreatment value |
Cardiovascular: |
Intractable pain or ECG changes suggestive of pericarditis |
Dermatologic: |
Mucocutaneous toxicity (e.g., erythema, rash, striae, vesiculation, hyperpigmentation, and skin tenderness) |
Pulmonary: |
Rapid decline in forced vital capacity |
Cardiovascular: |
Acute chest pain syndrome suggestive of pleuropericarditis |
Further courses of bleomycin therapy do not appear to be contraindicated, but careful evaluation of the patient must precede continuation of therapy.121 |
Pulmonary toxicity: Administer cumulative dosages >400 units with great caution.121
When bleomycin is used in conjunction with other antineoplastic agents, pulmonary toxicity may occur at lower cumulative dosages of bleomycin.121
Generally, maximum of 1 unit/kg or 40 units/m2 in geriatric patients.b
No dosage adjustment established by manufacturer for mild to moderate renal impairment; use with extreme caution in severe renal impairment.121
Known hypersensitivity or idiosyncrasy to bleomycin or any ingredient in the formulation.121
Has a low therapeutic index; monitor patients carefully and frequently during and after therapy.121
Potentially life-threatening, severe idiosyncratic (anaphylactoid) reactions (see Boxed Warning);121 may be immediate or delayed for several hours, and usually occurs after the first or second dose.121 Monitor carefully.121 (See Sensitivity Testing under Dosage and Administration.)
Treatment of anaphylactoid reactions is supportive and symptomatic and may include volume expansion, vasopressor therapy, antihistamines, and corticosteroids.121
Risk of dose- and age-related pulmonary toxicity (see Boxed Warning); use with extreme caution in compromised pulmonary function.121
Most severe toxicity.121
Pneumonitis can progress to potentially fatal pulmonary fibrosis.121
Most frequently with total dosages >400 units, but can occur with lower dosages.121
Risk may be increased with filgrastim or other cytokines.121
Dyspnea and fine rales are early manifestations.121
Perform chest radiographs every 1–2 weeks and sequential measurement of pulmonary diffusion capacity for carbon monoxide (DLco) monthly during therapy.121
Dosage modification or drug discontinuance may be necessary.121 (See Dosage Modification for Toxicity under Dosage and Administration.)
Risk of pleuropericarditis and/or vascular toxicities (e.g., MI, cerebrovascular accident, thrombotic microangiography, cerebral arteritis).121
Sudden onset of acute chest pain may be first sign of pleuropericarditis.121
Dosage modification may be necessary in patients experiencing acute chest pain syndrome suggestive of pleuropericarditis.121 133
Raynaud's phenomenon, possibly due to bleomycin, combination therapy (e.g., vinblastine, cisplatin), underlying cancer or vascular compromise, or combination of factors.121 134 135 136 137
Risk of developing dose-related adverse mucocutaneous effects (e.g., erythema, rash, striae, vesiculation, hyperpigmentation, skin tenderness, and less commonly hyperkeratosis, nail changes, alopecia, pruritus, stomatitis).121
Usually occurs during the second or third week of bleomycin therapy after a cumulative dose of 150–200 units.121
Most frequent toxicity, occurring in 50% of patients.121
Discontinuance of bleomycin may be necessary.121
Begins as deterioration in renal or liver function tests; may occur anytime after bleomycin initiation.121
Fever and chills are frequent, mainly with large single doses within a few hours of administration and persisting for 4–12 hours.b
Sensitizes lung tissue to damaging effects of oxygen administered during surgery; lung damage can occur at Fl O2 concentrations that are usually considered safe.121
Maintain Fl O2 at concentrations approximating that of room air (25%) during surgery and the postoperative period and monitor carefully fluid replacement, focusing more on colloid administration rather than crystalloid.121
Rarely, pulmonary toxicity.121
Local pain.121
Hypotension, which may require treatment.121
Very rarely, death, but patients were very seriously ill prior to treatment.121
Category D.121
Not known whether bleomycin is distributed into milk.121 Use not recommended.121
Safety and efficacy not established in pediatric patients.121
Greater risk of pulmonary toxicity in patients >70 years of age than in younger patients.240
Titrate dosage carefully.240
Use with extreme caution in patients with clinically important renal impairment.121
With IV administration, fever, chills, vomiting, and anorexia/weight loss (which may persist long after discontinuance of therapy).121 Mucocutaneous and dermatologic effects are most common and pulmonary toxicity is most serious.121 (See Major Toxicities under Cautions.)
With intracavitary administration into the pleural space, chest pain and fever.104 121 147 148 150 153 159 160 161 166
Drug | Interaction | Comments |
|---|---|---|
Antineoplastic agents | Increased risk of bleomycin-induced pulmonary toxicity121 | Use with caution; pulmonary toxicity possible at lower total bleomycin dosages121 |
Filgrastim and other cytokines | Increased risk of bleomycin-induced pulmonary toxicity121 | Use with caution; pulmonary toxicity possible at lower total bleomycin dosages121 |
Vitamins (e.g., vitamin C, riboflavin) | Bleomycin shown to be inactivated in vitro by ascorbic acid and riboflavin233 |
Not appreciably absorbed orally; must be administered parenterally for systemic effect.121
Following intrapleural administration, systemic absorption is about 45%.121 150 153
Improvement in Hodgkin’s disease or testicular cancer usually evident within 2 weeks.121
Improvement in squamous cell carcinoma usually evident within 3 weeks.121
Distributed mainly into skin, lungs, kidneys, peritoneum, and lymphatics in animals.121
Concentrations higher in tumor cells of skin and lungs relative to hematopoietic tissue.b
Metabolic fate not determined.b
Excreted principally in urine (60–70%) as active drug.b
Clcr>35 mL/minute: serum or plasma terminal half-life of about 2 hours.121
Clcr<35 mL/minute: terminal half-life inversely related to creatinine clearance.121
Moderately severe renal impairment (Clcr <35 mL/minute) decreases renal clearance; accumulation may occur with severe renal impairment.112 121
2–8°C; do not use after the expiration date is reached.121
Use reconstituted solutions stored at room temperature within 24 hours.121 b
Although stable for 2 weeks at room temperature or 4 weeks at 2–8°C, reconstituted solutions contain no preservatives; discard within 24 hours of reconstitution.b
For information on systemic interactions resulting from concomitant use, see Interactions.
Inactivated by agents containing sulfhydryl groups, hydrogen peroxide, and ascorbic acid.b
Forms Schiff base-type adducts with dextrose.106
CompatibleHID 121 |
|---|
Sodium chloride 0.9% |
Incompatible106 121 |
Dextrose 5% in water |
Compatible |
|---|
Amikacin sulfate |
Dexamethasone sodium phosphate |
Diphenhydramine HCl |
Fluorouracil |
Gentamicin sulfate |
Heparin sodium |
Hydrocortisone sodium phosphate |
Streptomycin sulfate |
Tobramycin sulfate |
Vinblastine sulfate |
Vincristine sulfate |
Incompatible |
Aminophylline |
Ascorbic acid injection |
Cefazolin sodium |
Diazepam |
Hydrocortisone sodium succinate |
Methotrexate |
Mitomycin |
Nafcillin sodium |
Penicillin G sodium |
Terbutaline sulfate |
Compatible |
|---|
Allopurinol sodium |
Amifostine |
Aztreonam |
Cefepime HCl |
Cisplatin |
Cyclophosphamide |
Doxorubicin HCl |
Doxorubicin HCl liposome injection |
Droperidol |
Etoposide phosphate |
Filgrastim |
Fludarabine phosphate |
Fluorouracil |
Gemcitabine HCl |
Granisetron HCl |
Heparin sodium |
Leucovorin calcium |
Melphalan HCl |
Methotrexate sodium |
Metoclopramide HCl |
Mitomycin |
Ondansetron HCl |
Paclitaxel |
Piperacillin sodium–tazobactam sodium |
Sargramostim |
Teniposide |
Thiotepa |
Vinblastine sulfate |
Vincristine sulfate |
Vinorelbine tartrate |
Antineoplastic antibiotic; active against gram-positive and gram-negative bacteria and fungi, but its cytotoxicity precludes its use as an anti-infective agent.b
Precise mechanism(s) of action not fully known but may involve inhibition of DNA synthesis and to a lesser extent inhibition of RNA and protein synthesis.121
Inhibits incorporation of thymidine into DNA.b
Exhibits no immunosuppressive activity.b
Advise patients about risk of pulmonary toxicity and to report any changes in pulmonary function (e.g., wheezing) to their clinician.b 121
Advise lymphoma patients of risk of severe idiosyncratic reactions (hypotension, mental confusion, fever, chills, wheezing).121
Advise patients to report any sudden onset of chest pain to their clinician.b 121
Advise patients of dermatologic and mucocutaneous effects and that they may not be apparent for several weeks after 100–200 units have been given.b 121
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.121
Importance of women informing clinicians if they are or plan to become pregnant or to breast-feed.121
Importance of informing patients of other important precautionary information.121 (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Parenteral | For injection | 15 units (of bleomycin)* | Blenoxane | Bristol-Myers Squibb |
Bleomycin Sulfate for Injection | Bedford, Mayne, Sicor | |||
30 units (of bleomycin)* | Blenoxane | Bristol-Myers Squibb | ||
Bleomycin Sulfate for Injection | Bedford, Mayne, Sicor |
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions August 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
† Use is not currently included in the labeling approved by the US Food and Drug Administration.
Only references cited for selected revisions after 1984 are available electronically.
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