Plicamycin (Intravenous)

Plicamycin is a powerful drug used in courses of chemotherapy for patients with testicular cancer.

Overview

Plicamycin is a form of medication used in treatments for cancer. It is most commonly used to treat patients who have been diagnosed with testicular cancer. It works by inhibiting the growth of cancer cells so that they cannot spread as quickly throughout the body. It interferes with the enzymes required for the cancerous cells to reproduce and therefore prevents them from multiplying within the body. Throughout the course of treatment with Plicamycin, cancerous tumors may shrink and regress to the point of almost nothing, allowing the patient to eventually enter a state of remission.

Plicamycin is a drug which in rare cases is used to treat some of the consequences of other types of cancer. Some cancers can cause patients to have dangerously high levels of calcium in the bloodstream (hypercalcemia) or similarly high levels of calcium in the urine (hypercalciuria). These conditions are particularly associated with advanced stages of cancer. The drug lowers calcium levels by affecting the way in which the parathyroid hormone can interact with osteoclasts in the body.

Conditions treated

Type of medicine

  • Antineoplastic antibiotic

Side Effects

At the same time as treating the condition in question, certain drugs may cause unwanted side effects alongside their treatment of an illness. Plicamycin is a powerful drug, and side effects are therefore likely. When prescribing a certain form of medicine, doctors will weigh up the benefits of taking that drug with the potential discomfort or damage caused by any possible side effects. If they proceed with a prescription, it is because they believe that the potential benefit to the patient is greater than the risk of any potential side effects.

The following symptoms are serious indicators of overdose, and patients should advise their doctor immediately if they experience any of the following during or soon after a course of Plicamycin:

  • Abdominal cramps
  • Muscle cramps or spasms
  • Black feces
  • Redness or swelling of the face
  • Yellowing of the eyes of skin
  • Vomiting blood
  • Skin rash, red patches or small red dots
  • Sore throat
  • Fever
  • Nosebleeds
  • Unexplained bruises or bleeding

There are some side effects of Plicamycin which are relatively minor and although they may cause the patient some discomfort, they are unlikely to be indicators of anything more serious. These side effects can often be managed without medication and may even start to go away as treatment progresses and the body becomes used to the medicine in its system. Doctors or nurses may have some advice about how these side effects may be managed or reduced. Patients only need to seek medical attention if any of the following side effects are particularly severe or long-lasting:

  • Diarrhea
  • Soreness in the mouth
  • Mouth ulcers
  • Lack of appetite
  • Vomiting
  • Nausea (likely to begin about an hour after an injection of Plicamycin and could continue for up to 24 hours)
  • Headaches
  • Unusual weariness or tiredness
  • Drowsiness
  • Depression
  • Swelling, soreness or redness at the site of the injection

There may also be other side effects which do not exhibit external symptoms. It is possible that your doctor will want to run regular tests, such as blood tests or scans, throughout the course of the treatment in order to check for any hidden complications.

Dosage

Plicamycin is a strong form of medication with a high risk of harm if not administered safely by qualified chemotherapeutic professionals. It is therefore only given in a hospital or specialized clinic, with constant supervision from qualified doctors and nurses.

The doctor will vary the dose of Plicamycin according to the individual needs of the patient, and the exact dose will differ according to the age of the patient, any other conditions they may have as well as the form of cancer being treated.

The effects of Plicamycin are cumulative, and this drug is often a crucial part of treatment for patients with very severe diagnoses. It is therefore imperative that patients do not miss doses and make sure to attend all of their appointments scheduled with the hospital. If for some reason the patient does miss an appointment or a dose, they should contact their doctor as soon as possible to discuss the best course of action.

Adults Usual dose for treatment of testicular cancer:

The usual prescribed dose to treat testicular cancer is between 25 to 30 mcg per kilo of the patient's body weight. This treatment usually involved a daily dose to be given once a day for 8 to 10 days, provided that the patient does not experience severe side effects or begin to show signs of toxicity. It is not recommended for courses of treatment to last more than 10 days at a time.

The tumor is then monitored after this initial treatment, and if the tumor is showing some signs of regression, these will usually be apparent 3 to 4 weeks after the initial course of Plicamycin. The doctor will monitor the tumor for signs that it is starting to regress, and plan future courses of Plicamycin accordingly. These are most likely to be at monthly intervals.

Adults Usual dose for treatment of Hypercalcemia:

For adults diagnosed with hypercalcemia following a diagnosis of cancer, doctors will usually prescribe a dose of 25mcg of Plicamycin per kilo of the patient's body weight, to be taken once a day for 3 to 4 days.

If this initial course of treatment does not have the desired effect in restoring the patient's calcium levels to a healthy medium, then additional courses of Plicamycin may be advised. These additional courses are most often taken at weekly intervals until calcium levels in the blood are restored to a healthy balance.

In rare cases, Plicamycin may be prescribed up to 2 or 3 times a week in cases where patients are unable to maintain a healthy balance of calcium.

Adults Usual dose for treatment of hypercalciuria:

For adults diagnosed with hypercalciuria following a diagnosis of cancer, doctors will usually prescribe a dose of 25mcg of Plicamycin per kilo of the patient's body weight, to be taken once a day for 3 to 4 days.

If this initial course of treatment does not have the desired effect in restoring the patient's calcium levels to a healthy medium, then additional courses of Plicamycin may be advised. These additional courses are most often taken at weekly intervals until calcium levels in the blood are restored to a healthy balance.

Interactions

Whenever a patient takes one of more pharmaceuticals at the same time, there is always a possibility of interactions between these drugs. It is therefore important for patients to keep any up-to-date and accurate list of all of the mediation that they are currently taking, just in case any of these medications are known to have a contraindication when combined with Plicamycin. This list should include any over-the-counter drugs as well as herbal remedies and dietary supplements.

Live vaccines

Live vaccines are known to be dangerous whilst taking a course of Plicamycin patients will have a compromised immune system and are therefore likely to contract the disease from the vaccination.

If you are worried about any other interactions between Plicamycin and other drugs, you should contact your doctor or pharmacist.

Warnings

It is sometimes possible for drugs to have unintended reactions to underlying medical conditions which the patient may be suffering at the same time as receiving their treatment for a different illness or condition. It is therefore extremely important for patients to keep an up-to-date and accurate medical history and list of all the medications which they are currently taking, to avoid any possible interactions between pharmaceuticals and different conditions. If patients are prescribed a course of Plicamycin, it is particularly important for them to notify their doctor if any of the statements listed below are true:

  • You have ever experienced an allergic reaction to Plicamycin
  • You are allergic to any medications that you are aware of
  • You have a latex allergy
  • You have ever suffered from abnormalities in the levels of calcium in your bloodstream or urine
  • You suffer from kidney failure or any kidney problems
  • You have ever been diagnosed with liver disease or other liver conditions
  • You have any issues with your bone marrow or a condition with affects the bone marrow
  • You have any blood or bleeding disorders
  • You are pregnant, or plan to become pregnant whilst having this treatment
  • You are breastfeeding, or plan to breastfeed whilst having this treatment

Doctors need to be aware of any of the above statements are true as any of these factors could have serious implications if Plicamycin is prescribed at the usual doses. The doctor or healthcare professional in charge of your treatment may choose to adjust the dosage of Plicamycin or monitor certain aspects of your condition especially closely in the light of this information.

Pregnancy

Plicamycin is a drug which has been placed in the X category by the FDA. This is because Plicamycin has been proven to cause difficulties in pregnancy and to cause harm to unborn babies. It may also affect the fertility of both men and women. It is therefore not advised to take Plicamycin whilst pregnant, or to become pregnant whilst undergoing a course of Plicamycin medication.

Breastfeeding

It is unknown as to whether it is possible for Plicamycin to pass through into breast milk. It is therefore advisable for patients to consult their doctor if they are currently breastfeeding and have been prescribed a course of Plicamycin.

Immune system

This drug has been known to alter the effectiveness of the immune system. It can lower the body's natural defenses to infection and disease, making patients much more likely to develop illnesses. It is therefore advised that patients currently undergoing a course of treatment including Plicamycin should avoid people with colds, influenza, stomach flu and other conditions which are known to be contagious. They should also avoid receiving live vaccines as well as people who have recently received vaccinations with live vaccines. There is a chance that whilst they are not suffering from the illness, they could still pass the virus onto patients with weakened immune systems.

Storage

Plicamycin is a controlled drug which is only administered within a controlled medical environment such as a hospital or a clinic.

Plicamycin should be refrigerated but care should be taken to ensure that it does not freeze. It should remain at a steady temperature between 2°C to 8°C. The vials of Plicamycin should be kept in their original outer packaging, which should be opaque in order to keep the drugs from being exposed to direct sunlight.

Both the outer and inner packaging for the drug should be clearly labeled so that they can be quickly and correctly identified at any point. As with all forms of medication, care should be taken to ensure that Plicamycin is kept somewhere safe where it cannot be tampered with or accidentally ingested by pets or children.

Once administered, any unused quantities of Plicamycin in packaging which has been opened should be disposed of safely and immediately. All needles used to administer the medication should be disposed of according to health and safety best practices. When not in use, needles should be stored separately to the vials of Plicamycin.

Summary

Plicamycin is a strong and powerful form of medication which is most commonly used in treatments for patients with testicular cancer. It is administered through an IV drip and multiple doses are usually given over the course of several consecutive days. It is a powerful drug, and can, therefore, cause unpleasant side effects for patients taking it. Due to the nature of Plicamycin, it is only administered to patients whilst they are under medical supervision in a hospital or clinic. Patients can then be monitored for any signs of change in their condition and medical professionals are on-hand at all times.