Class: Chemotherapy

Generic Name: Plicamycin (plye-kuh-MYE-sin)
Trade Name: Mithracin

How is this drug used? Plicamycin is FDA approved for the treatment of testicular cancer that has already been treated with appropriate surgery and/or radiation therapy, and for the treatment of high levels of calcium in the blood (hypercalcemia). It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Plicamycin belongs to a group of agents classified as antitumor antibiotics.  Plicamycin produces its anti-cancer effects by binding to DNA and inhibiting the production of proteins necessary for sustaining the life of a cell.

How is plicamycin given (administered)? Plicamycin is administered into a vein (intravenous), and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used, and the overall health of the patient.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with plicamycin.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

In addition, patients will be monitored for the length of time it takes for their blood to clot, as treatment with plicamycin may be associated with bleeding. Patients will also be closely monitored for abnormal bleeding or bruising, as these may be indications of more serious bleeding events with continued doses.

What are the common (occur in 30% or more of patients) side effects of treatment with plicamycin?

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Mouth sores

What are the less common (occur in 10% to 29% of patients) side effects of treatment with plicamycin?

• Muscle or abdominal cramps
• Drowsiness
• Headaches
• Facial flushing, rashes
• Low platelets – increases risk of bleeding
• Low white blood cells – increases risk of infection
• Low red blood cells – increases risk of anemia
• Irritation at site of administration
• Nervousness
• Changes to kidney
• Changes to liver
• Fever

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.

When should patients notify their physician?

• Nosebleed
• Blood in vomit, urine, or stool
• Pinpoint spots on skin
• Any unexpected or abnormal bleeding
• Nervousness, weakness, irritability
• Swelling of the ankles or feet
• Sudden weight gain
• Yellowing of skin or eyes
• Change in color of urine or stool
• Severe abdominal or muscle cramps
• Severe fatigue or weakness
• Pain, swelling or irritation at the infusion site
• Persistent fever or chills
• Mouth sores
• Signs of infection: fever, redness, swelling, pus, tenderness

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2010 CancerConnect Last updated 07/10.

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