Medical Editor: John P. Cunha, DO, FACOEP
Mithracin (plicamycin) is a cancer (antineoplastic) medication used to treat cancer of the testicles. Mithracin is also used in the treatment of treat too much calcium in the blood (hypercalcemia) and too much calcium in the urine (hypercalciuria) associated with a variety of advanced forms of cancer. The brand name Mithracin is discontinued, but generic versions may be available. Common side effects of Mithracin (plicamycin) include:
- decreased appetite
- mouth sores
- loss of appetite
- drowsiness and extremely deep sleep
- a general discomfort or uneasiness (malaise)
- skin rash
- facial flushing, and
The daily dose of Mithracin is based on the patient's body weight. Mithracin may interact with "live" vaccines. Tell your doctor all medications and supplements you use. Mithracin is known to cause birth defects in fetuses. It may also affect egg production in women and sperm production in men. Do not take Mithracin if you are pregnant or could become pregnant during treatment. Contraception is recommended during treatment with Mithracin. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Our Mithracin (plicamycin) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
THE MOST IMPORTANT FORM OF TOXICITY ASSOCIATED WITH THE USE OF MITHRACIN (plicamycin) CONSISTS OF A BLEEDING SYNDROME WHICH USUALLY BEGINS WITH AN EPISODE OF EPISTAXIS. This bleeding tendency may only consist of a single or several episodes of epistaxis and progress no further. However, in some cases, this hemorrhagic syndrome can start with an episode of hematemesis which may progress to more widespread hemorrhage in the gastrointestinal tract or to a more generalized bleeding tendency. This hemorrhagic diathesis is most likely due to abnormalities in multiple clotting factors.
A detailed analysis of the clinical data in 1,160 patients treated with Mithracin (plicamycin) indicates that the hemorrhagic syndrome is dose related. With doses of 30 mcg/kg/day or less for 10 or fewer doses, the incidence of bleeding episodes has been 5.4% with an associated drug-related mortality rate of 1.6%. With doses greater than 30 mcg/kg/day and/or for more than 10 doses, a significantly larger number of bleeding episodes occurred (11.9%) and the associated drug-related mortality rate was also significantly higher (5.7%).
The most common side effects reported with the use of Mithracin (plicamycin) consist of gastrointestinal symptoms: anorexia, nausea, vomiting, diarrhea, and stomatitis. Other less frequently reported side effects include fever, drowsiness, weakness, lethargy, malaise, headache, depression, phlebitis, facial flushing, and skin rash.
Thrombocytopenia may be rapid in onset and may occur at any time during therapy or within several days following the last dose. With the occurrence of severe thrombocytopenia, the infusion of platelet concentrates of platelet-rich plasma may be helpful in elevating the platelet count.
The occurrence of leukopenia with the use of Mithracin (plicamycin) is relatively uncommon, occurring only in approximately 6% of patients.
It has been uncommon for abnormalities in clotting time or clot retraction to be demonstrated prior to the onset of an overt bleeding episode noted in some patients treated with Mithracin (plicamycin) . Nevertheless, the performance of these tests periodically is recommended because in a few instances, an abnormality in one of these studies may have served as a warning to terminate therapy because of impending serious toxicity.
Abnormal Liver Function Tests: Increased levels of serum glutamic oxalacetic transaminase, serum glutamic pyruvic transaminase, lactic dehydrogenase, alkaline phosphatase, serum bilirubin, ornithine carbamyl transferase, isocitric dehydrogenase, and increased retention of bromsulphalein.
Read the entire FDA prescribing information for Mithracin (Plicamycin)