Plicamycin Dosage

Usual Adult Dose for Testicular Cancer

For the treatment of carefully selected hospitalized patients with malignant tumors of the testis in whom successful treatment by surgery and/or radiation is impossible:
25 to 30 mcg (0.025-0.030 mg) per kilogram of body weight. Therapy should be continued for a period of 8 to 10 days unless significant side effects or toxicity occur during therapy. A course of therapy consisting of more than 10 daily doses is not recommended. Individual daily doses should not exceed 30 mcg (0.030 mg) per kilogram of body weight.

In those patients with responsive tumors, some degree of tumor regression is usually evident within 3 or 4 weeks following the initial course of therapy. If tumor masses remain unchanged following an initial course of therapy, additional courses of therapy at monthly intervals are warranted.

When a significant tumor regression is obtained, it is suggested that additional courses of therapy be given at monthly intervals until a complete regression of tumor masses is achieved or until definite tumor progression or new tumor masses occur in spite of continued courses of therapy.

Usual Adult Dose for Hypercalcemia

In hypercalcemia associated with advanced malignancy the recommended course of treatment with plicamycin is 25 mcg (0.025 mg) per kilogram of body weight per day for 3 or 4 days.

If the desired degree of reversal of hypercalcemia is not achieved with the initial course of therapy, additional courses of therapy may then be administered at intervals of one week or more to achieve the desired result or to maintain serum calcium and urinary calcium excretion at normal levels. It may be possible to maintain normal calcium balance with single, weekly doses or with a schedule of 2 or 3 doses per week.

Usual Adult Dose for Hypercalciuria

In hypercalciuria associated with advanced malignancy the recommended course of treatment with plicamycin is 25 mcg (0.025 mg) per kilogram of body weight per day for 3 or 4 days.

If the desired degree of reversal of hypercalciuria is not achieved with the initial course of therapy, additional courses of therapy may then be administered at intervals of one week or more to achieve the desired result or to maintain serum calcium and urinary calcium excretion at normal levels. It may be possible to maintain normal calcium balance with single, weekly doses or with a schedule of 2 or 3 doses per week.

Precautions

Plicamycin is contraindicated in patients with thrombocytopenia, thrombocytopathy, coagulation disorder or an increased susceptibility to bleeding due to other causes. Plicamycin should not be administered to any patient with impairment of bone marrow function.

Mithracin should be administered only to patients who are hospitalized and who can be observed carefully and frequently during and after therapy.

Severe thrombocytopenia, a hemorrhagic tendency and even death may result from the use of plicamycin. Although severe toxicity is more apt to occur in patients who have far-advanced disease or are otherwise considered poor risks for therapy, serious toxicity may also occasionally occur even in patients who are in relatively good condition.

Electrolyte imbalance, especially hypocalcemia, hypokalemia, and hypophosphatemia, should be corrected with appropriate electrolyte therapy prior to treatment with plicamycin.

Plicamycin should be used with extreme caution in patients with significant impairment of renal or hepatic function.

Other Comments

The daily dose of plicamycin is based on the patient's body weight. If a patient has abnormal fluid retention such as edema, hydrothorax or ascites, the patient's ideal weight rather than actual body weight should be used to calculate the dose.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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