Brentuximab Vedotin
Contraindicated
Database
Synergistic pulmonary toxicity (pneumonitis)
Contraindicated combination (BV-AVD replaced ABVD-BV)
Source: Kimi deep-research + Cla
Drug reference
Bleomycin
Glycopeptide antineoplastic antibiotic · Antineoplastic
START
ABVD 10 units/m² IV d1,15 of 28-day cycle; test dose 1–2 units IV in lymphoma
TYPICAL MAX
Cumulative lifetime ~400 units (lower in elderly / renal)
STOP IF
Pulmonary symptoms / DLCO drop, anaphylactoid reaction, or severe skin toxicity
WATCH
Baseline + serial DLCO, pulmonary symptoms, fever post-dose, skin
CDSCO approvedATC L01DC01
KDIGO 2024 + manufacturer label
- ONSET
- 6min · infusion start
- PEAK
- 30min · end infusion
- t½
- 2h · t½ parent
- DURATION
- 2w · ABVD weekly
EXCRETION
Renal — ~70% unchanged
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Can cause fetal harm — avoid; effective contraception during and 6 months after.
FDA category + note
Top interactionssee all 12 →
- Brentuximab VedotinContraindicatedDatabaseKimi deep-research + Cla
- AdalimumabSevereDatabaseDDInter
- BaricitinibSevereDatabaseDDInter
- CertolizumabSevereDatabaseDDInter
Mechanism
Glycopeptide that binds DNA and iron, generating reactive oxygen species that cause single- and double-strand DNA breaks; preferentially active in G2/M phase, with relative sparing of bone marrow due to bleomycin hydrolase distribution.
Indications
Hodgkin lymphoma (ABVD)Testicular germ-cell tumours (BEP)Squamous cell head/neck and cervical cancers (selected)Pleurodesis for malignant pleural effusion (intrapleural)
Dosing
- Adult
- ABVD: 10 units/m² IV days 1, 15 of 28-day cycle. BEP: 30 units IV weekly. Cumulative lifetime limit ~400 units (pulmonary toxicity).
- Pediatric
- Per protocol (specialist).
- Renal adjustment
- CrCl <50: reduce dose substantially (renally excreted).
- Hepatic adjustment
- No specific adjustment.
- Geriatric
- Higher pulmonary toxicity risk; lower cumulative ceiling.
- Max dose
- Cumulative lifetime ~400 units (toxicity-limited; lower in elderly)
Pharmacokinetics
Onset
Cytoreduction over cycles
Peak effect
End of infusion
Duration
Cycle-based
Half-life
~2 h (parent); much longer in renal failure
Bioavailability
IV/IM/intrapleural
Protein binding
Low
Metabolism
Inactivated by bleomycin hydrolase (low in skin/lung)
Excretion
Renal (~70% unchanged)
Contraindications
- Severe hypersensitivity (anaphylactoid reaction history)
- Severe pulmonary disease
- Caution: prior pulmonary radiation, age >70, smokers, renal impairment
Side effects
Common
Fever / chills (acute reaction)Skin pigmentation / hyperkeratosisAlopeciaMucositisMild myelosuppression
Serious
- Pulmonary fibrosis / bleomycin lung (dose-related; boxed-style)
- Anaphylactoid reaction (lymphoma — boxed type)
- Severe skin reactions (Raynaud, scleroderma-like)
- Cumulative dose toxicity
Pregnancy & lactation
Pregnancy
Can cause fetal harm — avoid; effective contraception during and 6 months after.
Lactation
Avoid breastfeeding during therapy.
Drug interactions
Adalimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Baricitinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Certolizumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cladribine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Deferiprone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Etanercept
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Fingolimod
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Golimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
High Inspired Oxygen
Severe
Database
Oxidative pulmonary injury
Use lowest FiO2 for surgery / anaesthesia; warn anaesthesia teams
Source: Kimi deep-research + Cla
Infliximab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Cervical cancer screening and management
ICMR · Oncology · 2022
Gastric premalignant conditions
ACG · Gastroenterology · 2025
Extrapulmonary tuberculosis
ICMR · Infectious Diseases · 2022
Acute dental pain and intraoral swelling
ADA_DENTAL · Dentistry · 2019
Infective endocarditis prevention
ADA_DENTAL · Dentistry · 2015
Ask House about Bleomycin
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20