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Bendamustine Side Effects

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

Minor Side Effects

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


Very common (10% or more): Decreased lymphocytes (up to 99%), decreased leukocytes (up to 94%), decreased hemoglobin (up to 89%), decreased neutrophils (up to 86%), decreased platelets (up to 86%), lymphocytopenia (up to 74%), neutropenia (up to 45%), thrombocytopenia (up to 39%), anemia (up to 38%), leukopenia (up to 37%)
Common (1% to 10%): Febrile neutropenia, hemorrhage, lymphopenia
Very rare (less than 0.01%): Hemolysis
Postmarketing reports: Pancytopenia[Ref]


Very common (10% or more): Nausea (up to 77%), diarrhea (up to 42%), vomiting (up to 40%), constipation (up to 31%), stomatitis (up to 21%), abdominal pain (up to 14%), dyspepsia (up to 14%), gastroesophageal reflux disease (up to 11%)
Common (1% to 10%): Dry mouth, upper abdominal pain, abdominal distension, oral candidiasis
Very rare (less than 0.01%): Gastrointestinal hemorrhage, hemorrhagic esophagitis[Ref]


Very common (10% or more): Fatigue (up to 64%), infectious episodes (up to 37%), pyrexia (up to 36%), chills (up to 14%), asthenia (up to 13%), herpes zoster (up to 12%), mucosal inflammation
Common (1% to 10%): Pain, infection, herpes simplex, amenorrhea, epididymitis, thirst, cytomegalovirus infection
Uncommon (0.1% to 1%): Sepsis
Very rare (less than 0.01%): Infertility, multi-organ failure
Frequency not reported: Septic shock, general physical health deterioration[Ref]


Very common (10% or more): Elevated bilirubin (up to 34%), increased creatinine, increased urea
Common (1% to 10%): Increased AST, increased ALT, increased alkaline phosphatase
Frequency not reported: Hepatitis, hepatic failure, gallbladder pain[Ref]


Very common (10% or more): Anorexia (up to 24%), decreased weight (up to 20%), dehydration (up to 15%), decreased appetite (up to 13%), hypokalemia (up to 11%)
Common (1% to 10%): Hyperuricemia, tumor lysis syndrome, hypomagnesemia[Ref]


Very common (10% or more): Cough (up to 22%), dyspnea (up to 17%), upper respiratory tract infection (up to 10%), pharyngolaryngeal pain (up to 10%)
Common (1% to 10%): Nasopharyngitis, sinusitis, pneumonia, wheezing, nasal congestion, pulmonary dysfunction
Very rare (less than 0.01%): Pulmonary fibrosis
Frequency not reported: Lung neoplasm, lung infiltration, pleural effusion
Postmarketing reports: Pneumocystis jiroveci pneumonia, pneumonitis[Ref]

Nervous system

Very common (10% or more): Headache (up to 21%), dizziness (up to 15%), dysgeusia (up to 11%)
Rare (less than 0.1%): Somnolence, aphonia
Very rare (less than 0.01%): Paresthesia, peripheral sensory neuropathy, anticholinergic syndrome, neurological disorders, ataxia, encephalitis
Frequency not reported: Paraplegia, neuralgia[Ref]


Very common (10% or more): Rash (up to 16%), erythema (up to 16%), skin allergic reactions (up to 15%)
Common (1% to 10%): Pruritus, dry skin, night sweats, hyperhidrosis, alopecia, skin disorders
Rare (less than 0.1%): Dermatitis, macular-papular rash
Frequency not reported: Toxic skin reactions, bullous exanthema, urticaria
Postmarketing reports: Stevens-Johnson syndrome, toxic epidermal necrolysis[Ref]


Very common (10% or more): Insomnia (up to 15%)
Common (1% to 10%): Anxiety, depression[Ref]


Very common (10% or more): Peripheral edema (up to 14%)
Common (1% to 10%): Tachycardia, chest pain, hypotension, cardiac dysfunction (palpitations, angina pectoris, arrhythmia), hypertension
Uncommon (0.1% to 1%): Pericardial effusion
Rare (less than 0.1%): Myocardial infarction, acute circulatory failure, cardiac failure
Very rare (less than 0.01%): Phlebitis
Frequency not reported: Vasculitis
Postmarketing reports: Atrial fibrillation, congestive heart failure[Ref]


Very common (10% or more): Back pain (up to 14%)
Common (1% to 10%): Arthralgia, extremity pain, bone pain, myalgia
Frequency not reported: Sacral pain[Ref]


Very common (10% or more): Urinary tract infection (up to 11%)[Ref]


Common (1% to 10%): Hypersensitivity reactions
Rare (less than 0.1%): Anaphylaxis, anaphylactoid reaction
Very rare (less than 0.01%): Anaphylactic shock[Ref]


Common (1% to 10%): Infusion site pain, catheter site pain
Frequency not reported: Extravasation injury, infusion reactions, injection site reactions[Ref]


Frequency not reported: Retinal detachment[Ref]


Frequency not reported: Pre-malignant and malignant diseases/secondary tumors[Ref]


Frequency not reported: Acute renal failure[Ref]


1. "Product Information. Bendeka (bendamustine)." Teva Pharmaceuticals USA, North Wales, PA.

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

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

4. Cerner Multum, Inc. "Australian Product Information." O 0

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.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.