Medication Guide App

Bendamustine Side Effects

Not all side effects for bendamustine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to bendamustine: intravenous powder for solution, intravenous solution

In addition to its needed effects, some unwanted effects may be caused by bendamustine. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking bendamustine, check with your doctor or nurse immediately:

More common
  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • chest pain
  • chills
  • cough or hoarseness
  • diarrhea
  • fever
  • headache
  • joint pain, stiffness, or swelling
  • lack or loss of strength
  • lower back, side, or stomach pain
  • muscle aches
  • nausea
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • sore throat
  • stuffy or runny nose
  • swelling of the feet or lower legs
  • swollen glands
  • troubled breathing with exertion
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
Less common
  • Burning or stinging of the skin
  • fast heartbeat
  • hives
  • itching
  • irritation
  • painful cold sores or blisters on the lips, nose, eyes, or genitals
  • rash
  • redness of the skin
  • stiffness or swelling
  • swelling of the eyelids, face, lips, hands, or feet
  • tightness in the chest
  • troubled breathing or swallowing
Incidence not known
  • Blistering, flaking, or peeling of the skin
  • bluish color
  • changes in skin color
  • dizziness
  • pain, tenderness, or swelling of the foot or leg
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • weakness

Some of the side effects that can occur with bendamustine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Decreased weight

For Healthcare Professionals

Applies to bendamustine: intravenous powder for injection, intravenous solution


Tumor lysis syndrome associated with bendamustine treatment has been reported in patients in clinical trials and in postmarketing reports. The onset tends to be within the first treatment cycle of bendamustine and, without intervention, may lead to acute renal failure and death. Preventive measures include maintaining adequate volume status, and close monitoring of blood chemistry, particularly potassium and uric acid levels. Allopurinol has also been used during the beginning of bendamustine therapy. However, there may be an increased risk of severe skin toxicity when bendamustine and allopurinol are administered concomitantly.

Red blood cell transfusions were administered to 20% of patients receiving bendamustine.[Ref]

Hematologic side effects including neutropenia (28%), thrombocytopenia (23%), anemia (19%), leukopenia (18%), lymphopenia (7%), and tumor lysis syndrome have been reported.

Laboratory abnormalities have included decreased lymphocytes (up to 99%), decreased leukocytes (up to 94%). decreased hemoglobin (up to 89%), decreased platelets (up to 86%), and decreased neutrophils (up to 86%).[Ref]


Gastrointestinal side effects including nausea (up to 75%), vomiting (up to 40%), diarrhea (up to 37%) constipation (29%), stomatitis (15%), abdominal pain (13%), dyspepsia (11%), gastroesophageal reflux disease (10%), dry mouth (9%), upper abdominal pain (5%), and abdominal distension (5%) have been reported.[Ref]


General side effects including fatigue (up to 57%), pyrexia (up to 34%), chills (up to 14%), peripheral edema (13%), asthenia (up to 11%), and chest pain (6%) have been reported.


Metabolic side effects including anorexia (23%), dehydration (14%), decreased appetite (13%), hypokalemia (9%), and hyperuricemia (7%) have been reported.


Respiratory side effects including cough (up to 22%), dyspnea (16%), upper respiratory tract infection (10%), sinusitis (9%), pneumonia (8%), pharyngolaryngeal pain (8%), nasopharyngitis (7%), wheezing (5%), nasal congestion (5%), and cough (4%) have been reported.

Nervous system

Nervous system side effects including headache (21%), dizziness (14%), and dysgeusia (7%) have been reported.[Ref]


Some skin reactions have occurred when bendamustine was given in combination with other anticancer agents, so the precise relationship to bendamustine is uncertain.

Where skin reactions occur, they may be progressive and increase in severity with further treatment. If skin reactions are severe or progressive, bendamustine should be withheld or discontinued.

Dermatologic side effects including rash (up to 16%) pruritus (up to 6%), dry skin (5%), night sweats (5%), hyperhidrosis (5%), toxic skin reactions, and bullous exanthema have been reported. Cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) some fatal, have also been reported.


Musculoskeletal side effects including back pain (14%), arthralgia (6%), pain in extremity (5%), and bone pain (5%) have been reported.[Ref]


Psychiatric side effects including insomnia (13%), anxiety (8%), and depression (6%) have been reported.


Other side effects including herpes zoster (10%), decreased weight (7%), febrile neutropenia (6%), oral candidiasis (6%), infection (6%), and herpes simplex (3%) have been reported.


Renal side effects including urinary tract infection (10%) have been reported.[Ref]


Cardiovascular side effects including tachycardia (7%) and hypotension (6%) have been reported.[Ref]


There have been postmarketing reports of bendamustine extravasations resulting in hospitalizations from erythema, marked swelling, and pain. Precautions should be taken to avoid extravasation, including monitoring of the intravenous infusion site for redness, swelling, pain, infection, and necrosis both during and after administration.[Ref]

Local side effects including infusion site pain (6%), catheter site pain (5%), extravasations, phlebitis, pruritus, irritation, pain, and swelling have been reported.[Ref]


Immunologic side effects including hypersensitivity (5%) have been reported.


Hypersensitivity side effects including anaphylaxis have been reported.[Ref]


Oncologic side effects have included pre-malignant and malignant diseases that have been reported in patients who have been treated with bendamustine, including myelodysplastic syndrome, myeloproliferative disorders, acute myeloid leukemia, and bronchial carcinoma.[Ref]

The association between the oncologic side effects and bendamustine therapy has not been determined.[Ref]


1. "Product Information. Treanda (bendamustine)." Cephalon Inc, West Chester, PA.

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