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Plicamycin (Intravenous route)

Pronunciation:

plye-ka-MYE-sin

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic—

Antibiotic

Uses of This Medicine:

Plicamycin belongs to the group of medicines known as antineoplastics. It may be used to treat certain types of cancer. It is also used to treat hypercalcemia or hypercalciuria (too much calcium in the blood or urine) that may occur with some types of cancer.

Plicamycin may also be used for other conditions as determined by your doctor.

Plicamycin is to be administered by or under the immediate care of your doctor. It was available only with a prescription.

The manufacturer discontinued plicamycin in 2000 .

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, plicamycin is used in certain patients with the following medical condition:

  • Paget's disease of the bone

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Plicamycin is a very strong medicine. In addition to its helpful effects in treating your medical problem, it has side effects that could be very serious. Before you receive this medicine, be sure that you have discussed its use with your doctor.

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Studies on this medicine have not been done in children; however, plicamycin can cause serious side effects in any patient. Therefore, it is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it.

Older adults—

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of plicamycin in the elderly with use in other age groups.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersXStudies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Yellow Fever Vaccine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems—Use of plicamycin may increase the risk of bleeding.
  • Blood disease or
  • Kidney disease or
  • Liver disease—Use of plicamycin may make these conditions worse.
  • Chickenpox (including recent exposure) or
  • Herpes zoster (shingles)—Use of plicamycin may make your reaction to either of these conditions worse.

Proper Use of This Medicine:

Plicamycin sometimes causes nausea, vomiting, and loss of appetite. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. If you have any questions about this, check with your doctor.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • To treat cancer:
      • Adults and children—The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's weight, and whether or not other medicines are also being taken. If you are receiving plicamycin at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of plicamycin, ask your doctor.
    • To treat hypercalcemia or hypercalciuria (too much calcium in the blood or urine):
      • Adults—The dose is based on body weight and must be determined by your doctor. At first, the usual dose is 15 to 25 micrograms (mcg) per kg (6.8 to 11.4 mcg per pound) of body weight a day, injected slowly into a vein. The dose is given over a period of four to six hours once a day for three to four days. Your doctor may repeat the treatment if needed.
      • Children—Dose must be determined by your doctor.

Precautions While Using This Medicine:

It is very important that your doctor check your progress daily while you are receiving plicamycin to make sure that this medicine does not cause unwanted effects.

Your doctor may want you to follow a low-calcium, low–vitamin D diet. If you have any questions about this, check with your doctor.

Do not take aspirin or large amounts of any other preparations containing aspirin, other salicylates, or acetaminophen without first checking with your doctor. These medicines may increase the effects of plicamycin.

While you are being treated with plicamycin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Plicamycin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Plicamycin can lower the number of white blood cells in your blood temporarily, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions your doctor may ask you to take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

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

Some side effects 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:

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

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:

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

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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