Plicamycin (Intravenous)

Plicamycin belongs to a group of medicines called 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 can happen with some types of cancer.

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

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

The manufacturer stopped making plicamycin in 2000.

It is very important that your doctor check your progress daily while you are receiving plicamycin to ensure 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.

In deciding to use a medicine, you need to think about the risks of taking it compared to the benefits it may provide. This decision should be made together with your doctor. For this medicine, consider the following:

Plicamycin is a very strong medicine. While it can help treat your medical issue, it can also have serious side effects. Make sure to discuss its use with your doctor before receiving this medicine.

Allergies

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

Pediatric

Studies on this medicine have not been conducted in children; however, plicamycin can cause serious side effects in any patient. Therefore, it is especially important to discuss with the child's doctor the benefits and risks of using this medicine.

Geriatric

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

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might happen. In these situations, your doctor may adjust the dose, or other precautions may be needed. Inform your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicines.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used around the time of eating food or certain types of food due to potential interactions. Using alcohol or tobacco with some medicines may also lead to interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may impact the use of this medicine. Be sure to tell your doctor if you have any other medical issues, especially:

• Bleeding problems—Using plicamycin may increase the risk of bleeding.

• Blood disease or
• Kidney disease or
• Liver disease—Using plicamycin may worsen these conditions.

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Using plicamycin may worsen your reaction to either of these conditions.

Along with its needed effects, this medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need medical attention.

Check with your doctor right away if you experience any of the following side effects:

Less common

• Muscle and abdominal cramps

Symptoms of overdose

• Bloody or black, tarry stools
• Flushing or redness or swelling of the face
• Nosebleed
• Skin rash or small red spots on the skin
• Sore throat and fever
• Unusual bleeding or bruising
• Vomiting of blood
• Yellowing of eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away as your body adjusts to the medicine. Your health care professional may also provide ways to prevent or lessen some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

More common

• Diarrhea
• Irritation or soreness of the mouth
• Loss of appetite
• Nausea or vomiting—may occur 1 to 2 hours after the injection begins and last for 12 to 24 hours

Less common

• Drowsiness
• Fever
• Headache
• Mental depression
• Pain, redness, soreness, or swelling at the injection site
• Unusual tiredness or weakness

After you stop using this medicine, it may still cause some side effects that need attention. During this time, check with your doctor right away if you notice any of 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 can report side effects to the FDA at 1-800-FDA-1088.

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.