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bendamustine

Pronunciation

Generic Name: bendamustine (BEN da MUS teen)
Brand Name: Treanda

What is bendamustine?

Bendamustine is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.

Bendamustine is used to treat chronic lymphocytic leukemia. Bendamustine is also used to treat indolent B-cell non-Hodgkin lymphoma after other medications have been tried without successful treatment of this condition.

Bendamustine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about bendamustine?

Bendamustine is used to treat chronic lymphocytic leukemia, or indolent B-cell non-Hodgkin lymphoma.

Before you receive bendamustine, tell your doctor if you have a weak immune system, fever or other signs of infection, a metabolic disorder or electrolyte imbalance, liver or kidney disease, or if you smoke.

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Tell your caregiver right away if you have a fever, chills, itching, or skin rash during or shortly after the injection.

Bendamustine can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

What should I discuss with my healthcare provider before I receive bendamustine?

You should not receive this medication if you are allergic to bendamustine or mannitol (Osmitrol).

To make sure bendamustine is safe for you, tell your doctor if you have:

  • a weak immune system;

  • fever or other signs of infection;

  • a metabolic disorder or electrolyte imbalance;

  • liver disease;

  • kidney disease; or

  • if you smoke.

FDA pregnancy category D. Do not receive bendamustine if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether bendamustine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Some people receiving bendamustine have developed certain types of cancers. It is not known whether this medication causes cancer. Talk with your doctor about the risks and benefits of using bendamustine.

How is bendamustine given?

Bendamustine is injected into a vein through an IV. A healthcare provider will give you this injection.

Bendamustine is usually given for 2 days in a row every 21 to 28 days. You may receive up to 8 treatments total, depending on the condition being treated. Follow your doctor's instructions.

You may be given other medications to help prevent certain side effects of bendamustine.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when the medicine is injected.

Bendamustine can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your bendamustine injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving bendamustine?

Bendamustine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Bendamustine side effects

Some people receiving a bendamustine injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you have fever, chills, itching, or skin rash during or shortly after the injection.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have:

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • easy bruising or bleeding, purple or red pinpoint spots under your skin, unusual weakness;

  • cold symptoms such as stuffy nose, sneezing, cough, sore throat;

  • lower back pain, blood in your urine, urinating less than usual or not at all;

  • numbness or tingly feeling around your mouth;

  • muscle weakness, tightness, or contraction, overactive reflexes;

  • fast or slow heart rate, weak pulse, confusion;

  • dry mouth, feeling very thirsty or hot, heavy sweating or hot and dry skin;

  • severe blistering, peeling, and red skin rash; or

  • pain, swelling, redness, skin changes, or signs of infection where the medicine was injected.

Common side effects may include:

  • mild nausea, vomiting, diarrhea, constipation, or upset stomach;

  • swelling in your hands or feet;

  • headache, dizziness, drowsiness;

  • loss of appetite, weight loss; or

  • mild skin rash.

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.

See also: Side effects (in more detail)

Bendamustine Dosing Information

Usual Adult Dose for Chronic Lymphocytic Leukemia:

Recommended dose: 100 mg/m2 administered intravenously on days 1 and 2 of a 28 day cycle, up to 6 cycles. Bendamustine is intended for administration as an intravenous infusion over 30 minutes.

Consider using allopurinol as prevention for patients at high risk of tumor lysis syndrome for the first few weeks of treatment.

Bendamustine administration should be delayed in the event of grade 4 hematologic toxicity or clinically significant greater than or equal to grade 2 nonhematologic toxicity. Once nonhematologic toxicity has recovered to less than or equal to grade 1 and/or the blood counts have improved [Absolute Neutrophil Count (ANC) greater than or equal to 1 x 10^9/L, platelets greater than or equal 75 x 10^9/L], bendamustine can be reinitiated at the discretion of the treating physician. Dose delays may be warranted.

Dose modifications for hematologic toxicity: for grade 3 or greater toxicity, reduce the dose to 50 mg/m2 on days 1 and 2 of each cycle; if grade 3 or greater toxicity recurs, reduce the dose to 25 mg/m2 on days 1 and 2 of each cycle.

Dose modifications for nonhematologic toxicity: for clinically significant grade 3 or greater toxicity, reduce the dose to 50 mg/m2 on days 1 and 2 of each cycle.

Dose reescalation in subsequent cycles may be considered at the discretion of the treating physician.

Usual Adult Dose for non-Hodgkin's Lymphoma:

Recommended dose: 120 mg/m2 intravenously on days 1 and 2 of a 21 day cycle for up to 8 cycles. Bendamustine is intended for administration as an intravenous infusion over 60 minutes.

Bendamustine administration should be delayed in the event of a grade 4 hematologic toxicity or clinically significant greater than or equal to grade 2 nonhematologic toxicity. Once nonhematologic toxicity has recovered to less than or equal to grade 1 and/or the blood counts have improved [Absolute Neutrophil Count (ANC) greater than or equal to 1 x 10^9/L, platelets greater than or equal 75 x 10^9/L], bendamustine can be reinitiated at the discretion of the treating physician. In addition, dose reduction may be warranted.

Dose modifications for hematologic toxicity: for grade 4 or greater toxicity, reduce the dose to 90 mg/m2 on days 1 and 2 of each cycle; if grade 4 or greater toxicity recurs, reduce the dose to 60 mg/m2 on days 1 and 2 of each cycle.

Dose modifications for nonhematologic toxicity: for grade 3 or greater toxicity, reduce the dose to 90 mg/m2 on days 1 and 2 of each cycle; if grade 3 or greater toxicity recurs, reduce the dose to 60 mg/m2 on Days 1 and 2 of each cycle.

What other drugs will affect bendamustine?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with bendamustine, especially:

  • allopurinol;

  • carbamazepine;

  • cimetidine;

  • ciprofloxacin;

  • fluvoxamine;

  • omeprazole;

  • thiabendazole; or

  • a barbiturate--butabarbital, secobarbital, phenobarbital, and others.

This list is not complete. Other drugs may interact with bendamustine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about bendamustine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.02. Revision Date: 2013-07-01, 12:02:55 PM.

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